Health Forum notes
The points below indicate issues raised by participants at the forum on access to health services for people with disabilities convened by HREOC on 28 May 2004. These notes do not represent conclusions by HREOC or necessarily represent the views of all forum participants. They are published to promote further discussion.
Papers presented to the Forum identified a range of issues, some of which were common for people with a range of disabilities. Discussions during the Forum focussed on a number of issues:
- The need for nationally consistent education on disability awareness and communication issues. While it is important that this is included in curriculum for undergraduate courses, professional bodies also need to ensure those already working in the field have access to information and education in this area. There is a need to negotiate with health professional training bodies, curriculum developers, Deans of education institutions and Australian Medical Council.
- Significant public contact with medical/dentist and related services is with non-medical staff. These staff specifically need to have access to information and education to ensure appropriate communication and service delivery.
- While welcoming the Government announcement on Auslan interpreter services it was noted that interpreter services are also required to access health related services that are not covered by Medicare.
- It was noted that the operation of the Auslan service was under discussion. Access for deaf/blind people and gender sensitivity issues were raised.
- Many services and technologies of assistance to people with disabilities effectively become inaccessible because they are not affordable the individual. Access to hearing aid technology is one example.
- Screening of children for hearing difficulties needs to have greater priority.
- Information available to people with disabilities, parents and carers needs to be improved. Information may be available but better ways of getting it to people need to be identified. For example while the national breast screening program has sought to ensure it is available to a diverse community it was acknowledged that extra efforts might be needed to ensure women with disabilities are accessed.
- People with disabilities should be involved in developing strategies to ensure information gets out.
- Access to information on health matters must be available in a range of formats.
- Medication labelling advice and instructions must be available in formats that are accessible to blind people and people with a vision impairment.
- Web sites providing information on health issues must be accessible and provide information in accessible formats.
- Health related buildings must provide better wayfinding information, clearer signage and use better use of contrast to assist in accessing the services available.
- Checklists covering building and fitout for accessible surgeries and health care facilities need to be developed and adopted as standards by professional bodies.
- Structural inequalities and the status of women in society impact on health access. Women are more likely to delay seeking medical attention, more likely to be institutionalised and are less likely to have high self esteem which will impact on their capacity to access health systems.
- People with disabilities are often subject to 'diagnostic overshadowing' which occurs when a person's symptoms or condition is wrongly attributed to their disability rather than to a separate medical condition. This occurs partly because of attitude and partly because of a lack of understanding about disability.
- There should be more attention by the pharmaceutical industry to drug testing, to include people with disability as participants to test for different affects and the impact of other medications/ technologies.
- Health information privacy issues can be particularly important for people with a disability and training and records systems need to address these issues.
- People with disability who are or want to be parents are often affected by the values judgments and consequent actions of people involved either as nurses, doctors, baby health workers or fertility clinics.
- The sexual needs and rights of people with disability are often poorly understood or protected by the medical profession. This can put them at risk where they are sexually active but are not given the appropriate information and support to protect themselves.
- There should be consideration of a Disability Standard in non discriminatory health care as part of the DDA.
- Can HREOC seek to have input regarding health care rights as part of the UN Convention development.People with disabilities also experience significant misdiagnosis and there is a tendency to not taking the person seriously when reporting on their condition.
- Issues affecting people with a disability do not get enough priority or recognition in areas such as data collection and research. For example, the Women and Safety Survey did not recognise women with disabilities as a grouping to collect data on.
- People with disabilities may require more time in consultations to discuss their condition and understand treatment plans and options, but time slot Doctors work by (the '10 minute' rule) often make this difficult. Medicare needs to recognise this issue in payment schedules.
- Best practice models for assisting people with disabilities to maintain regular health checks and record treatments need to be identified. For example, the 'My Health Record' booklet that could be promoted to GP's.
- Health records for people with disabilities are often lost or not up to date. A public education program encouraging people with disabilities to ensure their health records are up to date is required.
- Annual multi-disciplinary health assessments would assist in maintaining good overall health.
- Some people with disabilities may require support and assistance with communication in their contact with health services, but at all times the communication must be directed to the patient and not their assistant or interpreter.
- There is no national body representing Aboriginal and Torres Strait Islander people with disabilities. Such a body could advocate and focus on health matters relating to people with disabilities.
- People with psychiatric disabilities are still experiencing real difficulties accessing services particularly in prisons and rural and remote areas and there is very little expertise or information available about dual-diagnosis difficulties.
- People with psychiatric disabilities often have other health issues overlooked because of a focus on mental health.
- People with psychiatric disabilities from a non-English speaking background experience a double disadvantage.