THE number of patients putting off a visit to the doctor because of cost has risen sharply, souring the government's boasts of fee-free access to Medicare.
The latest figures, revealed in the Productivity Commission's annual report card on the performance of governments - both federal and state - in delivering services, show that nearly 9 per cent of patients deferred seeing their general practitioner because of the out-of-pocket expense in 2010.
The report also reveals shortcomings in early childhood development. Disadvantage limits children's opportunities from infancy, the commission found. Children from low-income families, with disabilities and from non-English-speaking backgrounds are less likely to be enrolled in early childcare and preschool.
And the report showed deteriorating perceptions of safety across the nation, with fewer Australians feeling safe on streets or on public transport in 2010-11, although more people felt safe at home.
The report pulls together various sets of data from 2010 and 2011.
The rise in the number of patients avoiding the doctor was a significant jump from the previous year when the Australian Bureau of Statistics found that about 6 per cent of Australians held off a visit due to cost.
The latest figures contrast with historically high bulk-billing rates, which mean that about 80 per cent of GP visits are at no cost to the patient.
Where GPs are scarce, however, bulk billing is less common and patients can face out-of-pocket costs of $35 or more for a standard visit.
As a result, many people end up seeking free treatment at clogged public hospitals. In 2010, more than 2.1 million patients turned up at public hospital emergency departments with conditions that a GP could handle, the commission report says.
The latest figures show a rise in numbers baulking at the cost in NSW and Victoria, although the biggest impact was in the ACT and NT where 15 per cent of the population cited expense as a deterrent to seeing their GP. Both territories are chronically short of GPs.
In contrast, another key marker of access to medical care, the deferral of prescribed medicines because of cost has levelled out with just under 10 per cent delaying getting drugs because of cost - largely unchanged since 2009.
The Australian Education Union said the commission's report showed the need for increased government sector funding, with patterns of disadvantage consolidating into children's school years.
AEU federal president Angelo Gavrielatos said Australia was lagging behind the rest of the OECD in public education expenditure.
''The response is simple,'' he said. ''If we are serious about lifting overall performance and closing the achievement gap we need to invest in public schools.''
NAPLAN data also shows that indigenous students continue to under-perform compared with non-indigenous counterparts.
-The Age
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