Post by bear on Jan 4, 2022 13:22:06 GMT 7
Telehealth changes ‘devastating’ for psychiatry patients in regional areas
Mental health workers fear for patients’ wellbeing after the federal government removes 50% loading for some rural psychiatric services
Australians in regional areas with severe mental health problems will go without help, after “devastating” changes to the telehealth system, psychiatrists warn.
Recent federal government reforms removed a 50% loading for some rural psychiatric services, meaning some types of consultations providers will no longer be able to bulk-bill. They will have to absorb the costs or pass them on to patients.
Dr Vivienne James, a psychiatrist at Sydney’s Gordon Clinic, says she is “devastated” and her patients will be “distressed” about the changes, which came into effect on 1 January.
“It is simply not financially viable for us to continue seeing these patients,” she said.
“This will leave many patients distressed and, dare I say it, suicidal, as some of these people are extremely isolated and have little support. They will not be able to pay to see us and will have to be discharged back to their GPs.
“Personally, I am devastated by these changes.”
Grahame Gee, a credentialed mental health nurse, said it was “unethical” that he and his colleagues were “blindsided” by the changes, which were announced a couple of weeks before Christmas. His patients have complex mental health needs and many also have histories of physical and sexual abuse and intimate partner violence.
“Most have limited financial means and struggle to pay gap fees,” he said.
“Their recovery depends upon access to this service … I had patients in tears … Others said they would have to cancel their appointments.”
On 13 December the federal health department announced $106m to make telehealth a permanent part of primary healthcare. On 16 December it announced changes to the Medical Benefits Scheme, including two new telehealth items, 17 amended items and the scrapping of 128 items, which included item 288 for video psychiatric consultations through GP referrals.
Guardian Australia revealed how other changes would affect patients, particularly those with cancer.
‘Appalling’ Medicare telehealth cuts must be delayed to protect vulnerable amid Covid surge, doctors urge
“People living in a rural area couldn’t afford to see a psychiatrist, but [the rural loading] allowed them to see a psychiatrist without paying a gap. If you’re bulk-billing and that loading is removed, some providers will pass on the cost to the patients and patients might cancel their appointment.”
The rural loading was introduced about 10 years ago to encourage the use of telehealth in country Australia, an incentive the health department says is no longer needed.
Lakra said that before Covid, the psychiatric community wanted it phased out rather than removed and only phased out if there was another system in place to ensure affordability and accessibility. Covid “hasn’t gone”, he said, and the college wants the MBS item extended for another year.
“Twelve months is enough time to prepare a plan … With item 288 there was not enough time,” he said.
In a statement, the health department said the new arrangements consolidated telehealth into a single national program, “ensuring universal and equitable access”, and that rural patients will have access to other bulk-billing options.
The loading was to encourage the take-up of video consultations and help practitioners adopt new technologies. But according to the statement, there are about 10 times more telephone consultations than there are consultations that attract the loading and more than twice as many video consultations that do not attract the loading.
“This is about improving access to video and telephone services provided by GPs, medical specialists and other health professionals that reflect clinical best practice and provides greater flexibility in the healthcare system, depending on the services required,” the statement said.
“It is backed by an additional $106m over four years and part of a $308.6m investment by the government to support Australia’s primary care system.”
www.theguardian.com/australia-news/2022/jan/04/telehealth-changes-devastating-for-psychiatry-patients-in-regional-areas?fbclid=IwAR2iunPBK3bRhAymRO6Xqi_E1EKNIfrvESPYiXGj2Xv8Q0ZYt1iDwYnGpXQ
Mental health workers fear for patients’ wellbeing after the federal government removes 50% loading for some rural psychiatric services
Australians in regional areas with severe mental health problems will go without help, after “devastating” changes to the telehealth system, psychiatrists warn.
Recent federal government reforms removed a 50% loading for some rural psychiatric services, meaning some types of consultations providers will no longer be able to bulk-bill. They will have to absorb the costs or pass them on to patients.
Dr Vivienne James, a psychiatrist at Sydney’s Gordon Clinic, says she is “devastated” and her patients will be “distressed” about the changes, which came into effect on 1 January.
“It is simply not financially viable for us to continue seeing these patients,” she said.
“This will leave many patients distressed and, dare I say it, suicidal, as some of these people are extremely isolated and have little support. They will not be able to pay to see us and will have to be discharged back to their GPs.
“Personally, I am devastated by these changes.”
Grahame Gee, a credentialed mental health nurse, said it was “unethical” that he and his colleagues were “blindsided” by the changes, which were announced a couple of weeks before Christmas. His patients have complex mental health needs and many also have histories of physical and sexual abuse and intimate partner violence.
“Most have limited financial means and struggle to pay gap fees,” he said.
“Their recovery depends upon access to this service … I had patients in tears … Others said they would have to cancel their appointments.”
On 13 December the federal health department announced $106m to make telehealth a permanent part of primary healthcare. On 16 December it announced changes to the Medical Benefits Scheme, including two new telehealth items, 17 amended items and the scrapping of 128 items, which included item 288 for video psychiatric consultations through GP referrals.
Guardian Australia revealed how other changes would affect patients, particularly those with cancer.
‘Appalling’ Medicare telehealth cuts must be delayed to protect vulnerable amid Covid surge, doctors urge
“People living in a rural area couldn’t afford to see a psychiatrist, but [the rural loading] allowed them to see a psychiatrist without paying a gap. If you’re bulk-billing and that loading is removed, some providers will pass on the cost to the patients and patients might cancel their appointment.”
The rural loading was introduced about 10 years ago to encourage the use of telehealth in country Australia, an incentive the health department says is no longer needed.
Lakra said that before Covid, the psychiatric community wanted it phased out rather than removed and only phased out if there was another system in place to ensure affordability and accessibility. Covid “hasn’t gone”, he said, and the college wants the MBS item extended for another year.
“Twelve months is enough time to prepare a plan … With item 288 there was not enough time,” he said.
In a statement, the health department said the new arrangements consolidated telehealth into a single national program, “ensuring universal and equitable access”, and that rural patients will have access to other bulk-billing options.
The loading was to encourage the take-up of video consultations and help practitioners adopt new technologies. But according to the statement, there are about 10 times more telephone consultations than there are consultations that attract the loading and more than twice as many video consultations that do not attract the loading.
“This is about improving access to video and telephone services provided by GPs, medical specialists and other health professionals that reflect clinical best practice and provides greater flexibility in the healthcare system, depending on the services required,” the statement said.
“It is backed by an additional $106m over four years and part of a $308.6m investment by the government to support Australia’s primary care system.”
www.theguardian.com/australia-news/2022/jan/04/telehealth-changes-devastating-for-psychiatry-patients-in-regional-areas?fbclid=IwAR2iunPBK3bRhAymRO6Xqi_E1EKNIfrvESPYiXGj2Xv8Q0ZYt1iDwYnGpXQ
