Mr BELL (Mount Gambier) (11:06): I move:

That this house—

(a) recognises the importance of the Patient Assistance Transport Scheme (PATS) to regional patients that are required to travel over 100km for essential medical services;

(b) notes that the accommodation allowance for the PATS scheme has not increased since 2014; and

(c) calls on the state government to increase the accommodation allowance and all subsidies to be tied to CPI.

In 2013, I began my campaign to be the member for Mount Gambier. During this time, I was approached by a local resident called Fred de Bruin. Fred had undergone life-threatening heart surgery and had just had part of his Patient Assistance Transport Scheme (PATS) claim refused and was seeking my assistance, as the candidate, to have his story heard.

Fred was seeking an accommodation payment for his wife, Heather, who I got to know very well over that period of time and since. Heather travelled with Fred to Adelaide as his escort while he underwent his procedure. He had discovered conflicting information in the PATS booklet and on the website regarding entitlements of patient escorts and was determined to fight for what he believed was right. If you ever met Fred—who has, sadly, passed away now—he certainly made sure of that.

Prompted by Fred's story, I set up a community meeting to hear firsthand residents' experiences with the PATS scheme. What became clear was that while PATS was an essential service for country residents, it was in drastic need of an overhaul and increased funding. I started a petition calling for serious reform to PATS which garnered over 2,000 signatures and was presented to parliament in early 2014. I was fortunate enough to become the member for Mount Gambier in March of the same year, and so began my now 10-year campaign to improve PATS for our regional residents.

I do not think anyone here would deny the crucial role that PATS currently plays. Last year, over 13,000 South Australians received financial assistance from the scheme. While improvements have been made in recent years, including a much-needed doubling of the fuel subsidy, what is clear from the stories that we regularly receive in our office is it is not enough.

The last significant independent review into PATS was conducted in 2013 by Dr David Filby. Some of the main themes to come from the numerous letters and submissions at the time were the need for increased fuel and accommodation subsidy, the administration of PATS claims, the lack of provision for escorts and carers, and the need for expanded coverage of services. I would argue that those themes are still very relevant today.

As I mentioned earlier, the fuel subsidy was increased last year and I do thank the health minister for that. But let us not forget it had been over 20 years since the previous change. In 2001 when the subsidy stood at 16¢ per kilometre, petrol averaged 87¢ per litre; 2023's average petrol price was $1.91 per litre. While the subsidy may have increased 100 per cent, the cost of petrol has increased 120 per cent, so we could argue South Australians are getting less today than they did in 2001. That is why I state there must be an inclusion in the PAT Scheme that allows for annual CPI indexation.

This becomes even more apparent when we look at accommodation costs. It has been 10 years since the accommodation subsidy was last increased, from $33 per night to $44 per night, the lowest rate anywhere in Australia. A quick search of Adelaide's accommodation will show you that $44 does not get you very far, maybe a tent somewhere. In comparison, New South Wales residents receive $75 per night for the first seven nights, which then increases to $120 per night from night 8 onwards. New South Wales also provides a $40 per night subsidy for those staying in private accommodation, allowing them to contribute something towards their cost to stay with friends or relatives. There is no such provision in South Australia.

We also need to highlight that South Australia is the only state that requires residents—unless they hold a healthcare card or are pensioners—to pay for the first night's accommodation themselves. My electorate is approximately a five-hour drive from Adelaide. I am constantly hearing that residents are undertaking daytrips to Adelaide, which can often turn into 14-hour journeys, simply because they cannot afford the accommodation. At a time when our road toll is higher than it ever has been and we are constantly pushing the road safety message, we should be doing everything we can to encourage safe driving. It needs to be remembered that a lot of the people accessing the Patient Assistance Transport Scheme are in their 80s and beyond, and I do not think 14 hours on the road is a safe practice.

Wendy from Port MacDonnell contacted our office with her recent experience. She had submitted her claim form for two trips to Adelaide with a night's accommodation for her husband, who was escorting her while Wendy was treated in hospital. Her specialist had said that an escort was required to support Wendy while she travelled, yet her claim was rejected and the accommodation not paid. Without her husband's assistance, an extra night's accommodation for each stay would have been required, and as her second visit involved Wendy being under anaesthesia, she was unable to drive for a further 24 hours and would not have been able to leave hospital without a responsible person to take care of her.

Yet when Wendy appealed the decision, she was told, 'As the specialist has written support this is not a valid medical reason.' This strict interpretation of the rules surrounding escorts and support carers is not in touch with the needs of patients. How can we expect patients who are travelling long journeys for a hospital stay, often when they are extremely unwell or frail and elderly, to undertake these journeys on their own?

Paul and Gwenda from Mount Gambier recently submitted their accommodation claim for a stay. They have been using PATS for 10 years, as Gwenda suffers from MS. They used the booking platform Wotif, which they have done previously without issue, and provided the confirmation to PATS. Their claim was denied. When they appealed the decision, they were told it was not a tax invoice so PATS was unable to accept the receipt from Wotif.

After further investigation by my office, we discovered that Wotif is not registered for GST in Australia and is therefore unable to provide an appropriate tax invoice for PATS. How is the public supposed to know this information? The users of PATS, again—I have said before—are often elderly and can struggle to navigate online booking systems. The stress of having claims rejected due to perceived technicalities places further unnecessary anxiety on patients.

The bureaucracy and red tape around navigating the PATS system is at best frustrating and at its worst, I would say, dangerous. We are finding ourselves in a situation where people are not undergoing medical treatment as they cannot afford to do so or they are unable to navigate often complicated processes of submitting a PATS claim.

Just last week, Limestone Coast residents Pauline and John dropped into our electorate office. They wanted to detail their experience with PATS and how it had impacted them during Pauline's cancer journey.

Pauline was diagnosed with cancer in December of 2022 and subsequently spent 13 weeks, between January and April of 2023, in Adelaide undergoing chemotherapy and radiation therapy. Pauline filed her block treatment PATS claim after her treatment but had her claim rejected. We are currently trying to assist her with following up why this was the case.

Pauline and John were offered accommodation through the Cancer Council at Greenhill Lodge; however, Pauline was conscious of taking accommodation that others might need so elected to decline the offer as they were in the fortunate position of having family they could stay with. However, this decision also came at an extra cost. John was not always able to be in Adelaide, which resulted in Pauline having to take a taxi to her appointment, adding additional financial burden as there is no provision in PATS for taxi services.

Due to the nature of Pauline's treatment she has since suffered ongoing issues with severe hearing loss, loss of eyesight, a perforated bowel, burns, dental issues and more. This has meant regular trips to Adelaide to visit specialists that are not available to her in Mount Gambier. However, many of these appointments, such as her audiology and dental appointments, come under allied health and are not covered by PATS. These issues are a direct result of her cancer treatment, yet it is up to Pauline and John to carry the full financial burden of addressing these issues.

The next step in Pauline's journey is 40 days of hyperbaric oxygen therapy at the Royal Adelaide Hospital: 40 days away from her home and family and relying on the kindness of relatives while she is undergoing treatment. There needs to be further investigation into the expansion of PATS to allied health services, particularly if it is linked to a primary diagnosis such as cancer and treatment is not available locally.

Until her diagnosis Pauline worked as a nurse at our local hospital. It is now unlikely she will ever work again, and she has been unable to drive for the past 12 months. Her independence has been taken away and the physical, emotional, and financial effects of Pauline's cancer and subsequent treatment have taken a heavy toll on Pauline, John and their extended family. While they are grateful for the support they have received, they want their story told to raise awareness of how this affects everyday country people so that others do not face the same barriers. This is an example of how one diagnosis can take a hardworking family from financial independence to living week to week.

Patients using this scheme are doing so because they cannot access the services locally. They do not have the ability to return to the comfort of their own home at the end of a day of treatment in Adelaide. They are often in a motel room worrying about the financial implications of accommodation, travel and time off work when they really need to be focusing and should be focusing on recovery.

Our rural patients require increased support. I believe the government must introduce a practical subsidy to aid country residents in accessing the necessary medical treatment that is not available locally, without facing excessive financial strain. This subsidy should be regularly adjusted in line with CPI to keep pace with rising costs. Immediate action is needed, beginning with an increase of the accommodation allowance. It is unacceptable that the subsidy has remained unchanged for a decade and we must do better for the future health and wellbeing of our regional residents.