Catherine reflects on some of the difficulties that she has encountered when travelling to access healthcare.
Challenge Poverty Week was an opportunity to focus on some of the issues that can negatively affect people on low incomes and consider the solutions that may help to loosen the grip of poverty. This year’s event also fell during the week the Scottish Parliament discussed transport, which made me reflect on some of the difficulties that I have experienced when travelling to access healthcare.
When we become unwell and are in need of urgent care, we all expect that in a compassionate and just society our NHS will be there for us. Those who are constrained by poverty however, face a daily struggle to keep their head above water and are anxious that they will drown as they endeavour to stay afloat. This has an impact on people’s physical and emotional health both in the short and long term.
Accessing healthcare can be particularly difficult for those caught in the grip of poverty as many cannot afford the cost of travelling to their GP or hospital.
Those who are claiming a qualifying benefit, in receipt of certain tax credits or by applying via an HC1 (SC) form and are named on a valid HC2 Certificate may be eligible for help with their travel costs to hospital. But if you need to see your GP, dentist or other primary care practitioner or if you need to access urgent primary care services during out of hours periods these costs are not generally reimbursed. Even if you are eligible, travel costs to hospital will not always be refunded in every circumstance and a lack of funds could stop people seeking the help they need.
If people cannot travel by public transport due to their condition or disability, or if they are so unwell that they need a taxi to travel to hospital or may live in a rural area where public transport services are poor then these costs are generally not refunded, even if they are in receipt of a qualifying benefit. If the individual were well off enough to afford to own a car then their mileage and costs of fuel would be reimbursed but people who can’t afford a car have to suffer the cost.
I have experienced numerous occasions where public transport was inappropriate and the cost of taxis were not refunded, adding to the burden of living in poverty. This may make many question whether they can afford to travel to hospital to seek the healthcare that they need. In the past year alone due to serious health issues and complications myself and my Mum have had to spend in excess of £500 to travel to our GP and to attend hospital by taxis.
I have sought to clarify the issue and was told that in some circumstances taxis may be provided, however my attempts to try to arrange this or get my fares reimbursed when I have needed to travel by taxi have been futile. The costs of travel to the GP are not eligible to be refunded at all by anyone and a GP told me she has personally paid from her own purse for a few people who had no money available. However, the cost of reimbursing taxis is significantly less for our NHS and the public purse than having to provide hospital patient transport or an ambulance. There therefore needs to be a review.
Alarmingly, in the past year NHS Greater Glasgow & Clyde’s out of hours services have been closed in excess of 200 times which has disproportionately affected those who are disadvantaged and experience health inequalities and poverty. At a meeting I attended earlier this year, a person from Inverclyde expressed their concern that they were having to pay £30 each way resulting in a £60 round trip cost to travel by taxi to access out of hours care when their local facility was closed. There are many people whether working or not who would struggle to be able to afford this. In the past year, myself and my Mum have had to attend out of hours services, A&E and for investigations. Although we enquired about how we could go about reclaiming our taxi fares to travel to hospital even though we are in receipt of an eligible benefit we were informed that we couldn’t.
Last year, in the dead of winter, travelling through the Queen Elizabeth University Hospital I saw parents with three tiny children under five who had been attending the hospital who were walking home at midnight as the last bus had been. This is not humane and the issue of travelling to access healthcare needs to be reassessed.
In a country like ours everyone should be able to get to the healthcare that they need when they need it. People may be in a position where if they cannot afford to travel to their GP, they may then misuse the ambulance service or decide to travel to hospital when their issue could have been resolved by their GP.
The solution is to ensure that out of hours services are appropriately staffed and not closed, particularly in those in areas disproportionately affected by the grip of poverty where many people have higher healthcare needs and experience health inequality. People and carers should receive assistance with the costs of travelling to access healthcare whether that be travelling to the GP or hospital and needs to be reviewed urgently along with the policy regarding taxi fares.
The Poverty Alliance and the Health and Social Care Alliance Scotland are jointly hosting an event on the 6th November to examine the links between poverty and health and to hear your views about the issues and some of the solutions. What do think are the main issues affecting the health of people who are experiencing poverty?