Senate inquiry ignores GP role in mental health: AMA
THE undermining of GP involvement in mental health care through the slashing of Better Access rebates has been ignored by a key Senate inquiry examining the impact of the government’s cuts to the program, the AMA has claimed.
The claims follow the tabling late yesterday of a report from a Senate committee investigating mental health funding – the same day the controversial changes, which include substantial cuts to GP mental health rebates, took effect.
While the long-awaited report made no specific recommendation on the MBS cuts, it questioned moves to reimburse only 10 visits to psychologists under the Better Access program. Previously, up to 18 visits could be reimbursed.
AMA president Dr Steve Hambleton said the report, including dissenting reports from the Coalition and the Greens, presented a “mishmash of views” that largely overlooked the impact on GP patients of cutting MBS rebates.
“I think GPs are entitled to be disappointed,” he told MO.
“It has missed a lot of issues. I think that the department of health really didn’t assist the committee with the evidence it provided. It seems that the department has listened to the advice of bureaucrats, not doctors.”
The government’s mental health funding overhaul was however broadly attacked from both sides of the political spectrum following the release of the Senate committee report, with the Coalition saying the government had “not fully considered” the impact on patients and the Greens calling for a postponement.
The report questioned whether the alternate Access to Allied Psychological Services (ATAPS) program – which is to receive more funding and be administered through the yet-to-be-operational Medicare Locals – could be expected to service patients previously treated under Better Access straight away.
Greens senator and committee chair Rachel Siewert wrote in the report that she was “greatly troubled” that “there will almost certainly be a substantial period where Medicare Locals and GP divisions will not be fully engaged with the ATAPS program, and consequently will not be able to deliver appropriate mental health care for consumers”.
She added in a statement today that cutting the number of psychology sessions under Better Access “is likely to, in the immediate term, exacerbate existing service gaps for people with severe and persistent mental illness.”
“The current system is not ready for the government’s proposed changes. The government should revise its scheduling for the 2011–12 federal budget changes to ensure continuity of care,” she wrote.
The AMA, along with other general practice groups under the umbrella organisation United General Practice Australia, had called for a one-year moratorium on the MBS rebate cuts for GP mental health visits. Senator Siewert’s remarks did not directly address that demand – one of the key concerns that led to the inquiry in the first place.
Liberal senators also gave no recommendation on the GP rebate cuts in the dissenting report but wrote that any MBS cut “ought to have been discussed and fully canvassed with key provider groups and stakeholders before being arbitrarily inserted into the budget purely as a cost-saving measure”.
Both the Coalition and the Greens said the inquiry aired concerns about problems attracting GPs to work for youth mental health initiative headspace, which told the inquiry its staffing problems would be made worse by the rebate cuts.
Senator Siewert wrote that since headspace was getting more funding, it could “employ GPs directly, ensuring a guaranteed funding base that provides a buffer”.
In its section of the report, Labor repeated its claim that the Better Access changes would “achieve a better balance between the Medicare fee-based model provided through Better Access and the low- to no-cost services directly targeted to hard-to-reach groups through ATAPS”.