Australians living in aged care are often denied proper health care, with disturbing accounts of misdiagnosed, mistreated or ignored health issues described to the aged care royal commission on Monday.
The royal commission into issues with quality and safety in the aged care system is holding a week of hearings in Canberra, focusing on the way the aged care system interacts with the health system.
Rhonda McIntosh told the royal commission her father Allan Sheldon had told anyone who would listen for four days that he was having chest pains and thought he was having a heart attack.
"He said 'I'm having a heart attack, I'm having chest pains'," Ms McIntosh said.
"He said: 'I'm telling everybody, everybody who will come in, everybody I can tell, I'm telling them."
But his complaints were dismissed by nurses and staff at his aged care facility, who told him it was "all in his head" and even told his family there was no point in calling an ambulance for him as it wouldn't come.
He shouldn't have to beg staff for it or he shouldn't have to wait until we're able to advocate for him.Rhonda McIntosh
Instead staff gave him Panadol, and it was up to Ms McIntosh to take Mr Sheldon to a GP outside the facility, where it was detected he was having a heart attack and an ambulance was called.
Ms McIntosh said she hoped her evidence would lead to better care for people like her father.
"He still should be able to see a doctor when he wants to or when he needs to.
"He shouldn't have to beg staff for it or he shouldn't have to wait until we're able to advocate for him."
Ms McIntosh said her father had moved to a new facility and the difference was "like chalk and cheese" in the care he received.
Kristine Stevens from Dubbo also told the Commission her mother Nena Stevens developed a pressure sore while living in an aged care facility, and what should have been a manageable wound turned into a life-threatening infection requiring hospitalisation.
"My experience has been that unless people who can't speak on their own behalf have someone to advocate for them, then they'll be overlooked and basically neglected because of insufficient staffing levels," Ms Stevens said.
Canberra GP Dr Paresh Dawda, who is also an Adjunct Professor at the University of Canberra and an Associate Professor at the Australian National University, told the Commission the funding model for access to health care in the aged system needed to be adjusted.
"There's no payment model that is truly fit for service," he said.
"So therefore a blended model that makes most of the advantages of the different models and tries to minimise the disadvantages is perhaps the way to go in my opinion."
Dr Dawda also suggsted an "integrated practice model" that would lead to better outcomes for patients and more sustainable costs.
He said he supported the proposal for funding of multi disciplinary outreach teams to improve access to specialists, but warned that any funding model had to bridge the silos between state and Commonwealth funded services.
"It's important that it lends itself to integration between the two elements of the health system," he said.
Senior Counsel assisting the Royal Commission Peter Gray said evidence to the commission clearly showed people in aged care didn't have the same access to health care as other Australians, with almost 70 per cent of aged care residents not seeing a medical specialist in 2016-17, compared to 40 per cent of similarly aged people living in the community.
"Also, those residents who did receive at least one specialist service received fewer such services than people in the community," Mr Gray said.
The Commission heard there were issues around access to GPs, continuity and communication around care and understaffing.