“Every minute of your delay costs me money,” a patient grumbles, brandishing a parking ticket.
“I am sorry,” I sympathise. “Let’s finish up as quickly as we can.”
What I don’t say is that I am running late because of my last patient, who is as disadvantaged as they come. Catching public transport would involve a train, a bus and a walk she can’t manage.
So, having driven 90 minutes on a jam-packed freeway and conscious of the fuel cost, she had been circling the area for free parking.
As usual, such parking was elusive and, by the time she found it, she was a 15-minute walk from the hospital entrance, from which it took a further 10 minutes to reach my clinic.
Thus, her free parking had come at the cost of my time but, given the frequency of her visits, how could I blame her?
Feeling chastised, I stopped by the parking payment machine later to check out the rates.
The first 15 minutes are free, and the first hour thereafter is $11. But no one would bank on concluding any hospital visit within an hour from the time of parking, nudging the effective minimum fee to $21 for 2 hours. The daily and weekly “repeat” fees (allowing unlimited entry) are $32 and $72, respectively.
It’s hardly consoling knowing that other hospitals charge as much as $60 a day and $110 for a weekly pass.
Then, I came upon a doctor reasoning with security that if there was an automatic parking deduction from his salary, he should have access to staff parking. Instead, on some days, he was forced to use the visitors’ parking at visitors’ rates.
It was expensive, the doctor said. The security guard was unmoved. “I don’t make the rules, mate.”
Which got me thinking, who makes the rules, and why is hospital parking so expensive?
Leave it to a couple of health economists to ask the question that is on the mind of every hospital visitor.
It turns out that, in the absence of a centralised policy, each hospital outsources parking or sets its own fees, claiming that the funds are funnelled back into patient services. Exhortations from the government to be fair to vulnerable patients have resulted in concessions that are variably applied and advertised.
At many hospitals, concessions are available for concession card holders, which is means-tested. This excludes many patients and is costly for those who require frequent visits.
For instance, a cancer patient might need to see a surgeon, oncologist, physiotherapist and nurse practitioner in one week. (These appointments could be consolidated but for the lack of administrative staff.)
If the patient attends the chemotherapy unit most weeks, there are inevitable visits to emergency. Inpatient admissions are rarely brief, necessitating visits from relatives. Add to this various family meetings and it’s easy to see how quickly the parking bill rises.
Discounts exist for patients receiving palliative care, dialysis or chemotherapy but it is often up to harried families to find out more. Admittedly, I can’t remember initiating a discussion about parking fees with any of my patients, who must be stung the hardest.
But amid pressures on the cost of living it’s no wonder I am often writing (largely unsuccessful) letters to forgive the council fines of those who have overstayed street parking.
Meanwhile, hospital parking is a multimillion-dollar business. New South Wales collected more than $51m from parking fees in 2024, and Victoria is not far behind. Hospitals don’t say how the funds are reinvested to benefit patients.
By now, Australians know that “free” healthcare is not really free. In 2017 half of all patients (10.9 million people) incurred an out-of-pocket cost for non-hospital Medicare services. Individuals pay for 15% of all healthcare expenditures, a greater proportion than in comparable systems including France, New Zealand and the UK.
Easing the cost of parking would be a practical way of helping patients.
I agree with the health economists’ suggestion of applying concessions based on need rather than income. That need could be informed by patient-centred thinking.
For an agitated dementia patient, the cost to the hospital of providing free parking to a relative (and while we are at it, a comfortable armchair) would be significantly less, not to mention kinder than stationing an anonymous guard at the door and still relying on registered nurses to soothe patients and shepherd them back to their room when they resist.
Relatives of dying patients shouldn’t have to base their decision on whether to stay or leave based on the parking fee. The same goes for the parents of sick children.
Close relatives of the chronically ill have enough to worry about without also needing to stress about parking fees, not to mention the eye-watering cost of the hospital’s ordinary food – a topic for another day.
Recently, as I was leaving the hospital, a weary young man asked if he needed to validate a parking ticket. I enquired if the elderly relative by his side had a concession card.
“Why does that matter?” he asked sceptically.
“Because if you got your ticket stamped, it would reduce your parking cost to a flat $11,” I replied.
He nodded gratefully.
But the clock had struck 8pm and, while visitors were still leaving, the reception was shut.
So I watched him count $29 and felt bad for giving him useful information the system made it impossible for him to use.
Ranjana Srivastava is an Australian oncologist, award-winning author and Fulbright scholar. Her latest book is called A Better Death
