Former adviser to Tony Abbott, Terry Barnes, says people who end up in hospital with self-inflicted injuries should pay.

Former adviser to Tony Abbott, Terry Barnes, says people who end up in hospital with self-inflicted injuries should pay. Photo: Alex Ellinghausen

People who go to hospital for injuries sustained while drunk should be asked to pay something towards the cost of their treatment, according to a former adviser to Tony Abbott.

Terry Barnes, who worked for Mr Abbott when he was health minister, was appearing before a Senate committee, which is scrutinising the Abbott government's national Commission of Audit.

In a submission to the commission, Mr Barnes proposed a $6 fee for GP visits to deter people from making unnecessary trips to the doctor. He has also said public hospitals should have the discretion to charge such a fee to prevent people going to emergency departments for treatment better provided by a GP.

''If somebody presents to an emergency department who has injured themselves in a drunken incident, self-inflicted, should the taxpayer be expected to take the full cost for cleaning up that person's mess?'' Mr Barnes asked at the hearing in Canberra on Tuesday.

''If you presented with a milk bottle in a place where it shouldn't be as a grown adult that's something that I don't really feel that our emergency departments should have to deal with.

''Basically it comes down to actions or behaviour that causes consequences that are avoidable.''

Mr Barnes said smokers or overweight people should not automatically be charged, but said such a fee should be applied on a ''consistent'' basis nationally.

Health groups have strongly criticised Mr Barnes' proposals, predicting they would have the greatest impact on the poorest and sickest, and questioning how much money they would save.

Under questioning from committee chairman, Greens Senator Richard Di Natale, Mr Barnes said well-off Australians needed to contribute more to make the health system sustainable.

''I don't think you or I should expect to go to a GP or any other medical practitioner and expect to be bulk-billed,'' Mr Barnes said.

''If Medicare is about everyone paying according to their means, those with means should pay.''

Senator Di Natale said people on higher incomes made a greater contribution to the health system through the tax system.

Welfare and community advocates also faced the Senate hearing, with the Australian Services Union questioning the political agenda behind the Audit Commission.

''We should not allow . . . one group of our society to make decisions that have unilateral application,'' assistant national secretary Greg McLean said.

Mr McLean added that the process behind appointing the commission, which includes the Business Council's Tony Shepherd as chair and former Howard government minister Amanda Vanstone as a commission, was ''not ideal''.

''There was no advertisement for positions,'' he said.

The Australian Council of Social Service, whose submission to the inquiry advocates for the closing of tax ''loopholes'' that benefit high income earners, also argued that there should be someone from the not-for-profit or community sector on the Commission's five-person panel.

''We believe that the voices in the room make a difference,'' chief executive Cassandra Goldie said.

The Commission handed an interim report to the government on Friday, and will deliver a second report by the end of March.