Following my earlier post, Paying for ambulance services in the ACT (July 16, 2018), I noted the following story being reported by the ABC:
Kathy Lord and Tim Lamacraft, ‘‘Good Samaritan’ chased by debt collectors after calling ambulance for man hit by car’, ABC News (Online) 19 July 2018.
I was asked to comment on the news story and had the privilege of being interviewed for ABC News24 and broadcast on ABC News Afternoons with Fauziah Ibrahim. The audio from the TV interview was also edited into a story broadcast on many ABC radio stations. See:
- Ellen Coulter, Ambulance costs can be a burden long after emergency care, PM with Linda Mottram (19 July 2018); see also
- Ambulance costs around Australia: why is it free in some states and not others? ABC News (Online) 19 July 2018.
With respect to the story on PM, I did not say that the power to charge fees was set out in statute in all Australian States and Territories as I do note that is not the case in either Western Australia or the Northern Territory where the state governments do not operate ambulance services.
I also note that in Queensland there is a statutory authority to render an account for emergency ambulance services but not to Queensland residents. Out of state visitors can expect a bill as can relevant motor vehicle and workers compensation insurers (Ambulance Service Act 1991 (Qld) s 53B). (Many people say that the fee for ambulance services in Queensland is included in power or utility bills but that appears not to have been the case since 2011 – see Community Ambulance Cover Levy Repeal Act 2011 (Qld))). Tasmania has similar arrangements to those in Queensland (Ambulance Service Act 1982 (Tas) s 36). In New South Wales there are prescribed fees but a NSW resident is charged only 51% of the Scheduled Fee for emergency ambulance services (Health Services Act 1997, Order Fixing A Scale Of Fees In Respect Of Ambulance Services, NSW Government Gazette No 67 of 23 June 2017, p 3013, ).
With respect to the story as originally published it is important to identify what is, and is not, being alleged. ‘Jenna (surname withheld)’ is not alleging that she was asked to pay the ambulance bill. She says ‘it was “unethical and outrageous” to chase a homeless person for medical debts and it was a breach of privacy for Ambulance Victoria to pass her details to ARL’. Further, as the Ambulance Victoria spokesperson is quoted as saying ‘They called to identify if Jenna is responsible for the bill. She’s not responsible for the bill so that should’ve been the end of the matter.’ Further, Ambulance Victoria’s executive director of corporate services Robb Barr is quoted as saying “We provided the agency with the phone number, in this case used to call triple zero, as this can assist in making contact with a patient,” he said.
I infer then that she was contacted to make inquiries and to help locate the patient, not that it was alleged that the ambulance account was her responsibility. Her concern was that they were pursuing a homeless man for the bill and that her details were given to the debt collectors.
As noted in an earlier post (Paying for ambulance services (October 4, 2014)), in Victoria:
… the Secretary of the Department of Health may set fees that an ambulance service may charge (Ambulance Services Act 1986 (Vic) s 10(5)) and the ambulance service must comply with the Secretary’s direction (s 10(6)). An ambulance service (remembering Ambulance Service Victoria is an umbrella title covering a number of separate ambulance services; ss 3 and 23, Schedule 1) may charge reasonable fees for the provision of its services (s 16) and by implication what is a reasonable fee is a fee that complies with the Secretary’s direction under s 10.
To hope that an agency like Ambulance Victoria will not pursue a debt against a homeless man means that they know he is homeless. Most agencies will make some effort to contact a debtor even if they later write the debt off.
With respect to passing on Jenna’s details I don’t know the exact process and whether AV sells the debt to the debt collectors or whether the debt collectors are acting on AV’s behalf. If a creditor sells a debt they may sell it for say $0.10 in the dollar which they see as better than nothing. The debt collector can then try and collect the full debt. If they succeed they get $0.90 in the dollar but often they won’t succeed so they take the loss, on balance hoping that they money they do recover creates a profitable business. If they are not sold the debt but act as agents for the creditor I would assume they get paid a fee whether they recover the money or not and the risk stays with the creditor. I can’t comment on the ethics of debt collection agencies or what the arrangements were between this debt collector and AV.
What we do know is that the Australian Privacy Principles say that an agency, such as AV, that collects personal information such as the phone number used to call triple zero should use that information only for the purpose for which it was collected; see Privacy and Data Protection Act 2014 (Vic) Schedule 1, Principle 2 Use and Disclosure. It begs the question of why information is collected. It is not only for patient care but also for accounting purposes including rending the account that is authorised by statute (see also First aid patient records – who and what are they for? (January 31, 2015)). The Privacy and Data Protection Act 2014 (Vic) s 17 provides for Victorian agencies to outsource various functions.
Although one can’t say, without knowing the relationship between AV and the debt collection agency, and the terms of any contract between them, it follows that the provision of Jenna’s information to the debt collection agency is not axiomatically a breach of the privacy laws in that State. To again use a quote attributed to Ambulance Victoria’s executive director of corporate services Robb Barr, AV says:
“We provided the agency with the phone number, in this case used to call triple zero, as this can assist in making contact with a patient,” he said.
“A call was made by the agency [to Jenna] who had no link to the patient.
“No further contact should have been made.
They are admitting they provided the number and not conceding that was an error or mistake. The concern they are acknowledging is that the recovery agency made follow up calls.
Whilst this story raises concerns about the conduct of Debt Collection Agencies (and I work at a legal advice clinic and know that there is much to be concerned about) it doesn’t alter the conclusion that a person who rings triple zero is not responsible for the account. There has been no suggestion in this story (as reported by the ABC) that Jenna was being perused for the bill. And as AV says:
“A passer-by who calls triple zero for an ambulance will never be required to pay an invoice.”
Very interesting. If it runs further, would appreciate splitting charges between emergency and non emergency. Tas hides behind “free ambulance in Tas” without explaining they refuse to transport private hospital pts home or to other facilities, refuse to take patients to or from non public hospital appointments, and delay non urgent bookings as long as possible on the basis they will eventually go away.
The funds also refuse to pay, stating Tas offers a free service so fund involvement is not required.
Most people are confused by emergency and non emergency.
My credentials? Director of ambulance Private in Tas, running 30 ambs around the state.
Certainly the post was written about emergency ambulance transport and I’ll edit it to reflect that.
Slightly off topic from the main discussion.
Victoria has compulsory third party insurance as part of their motor vehicle registration administered under the Transport Accident Commission (TAC)
Shouldn’t the service charge be paid by this insurance (TAC) of the driver who hit him? Like it does in WA (Motor Vehicle (third party insurance) act 1943, administered by Insurance Commission of Western Australia).
With recovery times from major trauma (pedestrian Vs car >30km/h) improved with time to definitive care. Surely the public knowing they won’t be disadvantaged by being assessed, treated and transported by road or air Ambulance to Emergency Department/Trauma Centre can only improve Patient outcomes and reduce CIS after an accident.
Then maybe the bigger issue here highlights why it should be better communicated to the public what they’re entitled to.
He may not have run and this would have never been discussed.
There are many rules that are too hard to explain in a short blog post. You’re right though if a person is injured in a motor vehicle accident or at work they don’t pay for emergency ambulance as the relevant insurer either pays or for example in NSW, the CTP insurers all pay to the government a contribution for ambulance services rather than a per patient fee. Also pensioners (except in WA where it’s restricted to age pensioners) health care card holders and others don’t pay ambulance bills. But that was too much detail for a blog and as you say not quite the context of the person calling triple zero. Why AV didn’t pursue the CTP insurer in this case if the fellow was hit by a car we can’t know.