One man spent four days complaining he was having a heart attack, only for aged care staff to dismiss his chest pains as "all in his head".
A woman in another facility ended up with a life-threatening pressure wound that ate through her skin, flesh and muscle, all the way down to the bone, the aged care royal commission was told.
Senior counsel assisting the commission Peter Gray QC said all people receiving aged care should have access to the health services they need, but it is clear that is not happening.
"The evidence is clear that while Australia prides itself on having a universal health care scheme, aged care recipients are often denied practical access to this health care," Mr Gray said on Monday.
The inquiry was told 83-year-old Allan Sheldon spent four days in January complaining of chest pains and telling a Melbourne facility's nursing and care staff he was having a heart attack.
His daughter Rhonda McIntosh took him to a doctor, who called an ambulance to take him to hospital to take him to hospital where he was diagnosed as having a heart attack that was still continuing.
Ms McIntosh said her father should be able to see a doctor when he wants or needs to, like anyone else.
"He shouldn't have to beg staff for it or he shouldn't have to wait until we're able to advocate for him," she told the Canberra hearing.
In addition to difficulties seeing a GP, aged care residents have very poor access to specialists despite often having chronic and complex health care needs.
It needs urgent attention, the inquiry was told.
"This is a shocking state of affairs," commissioner Lynelle Briggs said.
"And it seems the only way they can access specialist services is to be hospitalised."
The royal commission is examining the problems and possible solutions, including extending "flying squads" or outreach health services from local hospital networks across Australia.
"These services, we suggest, should reach into residential aged care facilities or people's homes and provide services in situ, wherever possible," Mr Gray said.
It would include 24/7 advice and triage services, and teams of nurses and others specialising in acute level care with access to a core team of specialists.
Mr Gray said a national expansion would require regular and reliable funding, which could be achieved through the national health reform agreement between the federal, state and territory governments.
Australian Medical Association president Anthony Bartone agreed there should be more systematic funding of the service, rather than just hospital by hospital or facility by facility.
"Certainly what is occurring at the moment is patchy, haphazard, subject to the local funding envelopes and availability of local hospitals," Dr Bartone said.
The royal commission is also examining possible reforms to the fee-for-service model of funding primary health care provided by GPs for aged care recipients.
Australian Associated Press