Mental health professionals say Medicare cut has had devastating consequences in Australia region


Judith Pomeroy regularly has panic attacks, nightmares and sometimes feels like she has to go hour by hour.

The North Queensland woman needs to see her psychiatrist but hasn’t been able to do so all year because, she said, a change in Medicare has made it unaffordable.

“It took so much of my life,” Ms Pomeroy said.

“It’s taken quality of life because I’m having more panic attacks and my PTSD is surfacing.”

Psychiatrists say the Medicare cut has forced hundreds of patients to cancel or reduce their appointments, leading to the worst patient outcomes some say they have ever seen.

Ms Pomeroy from Mackay had seen her psychiatrist almost monthly for the past three years for chronic anxiety and post-traumatic stress disorder (PTSD).

But like other patients across rural and regional Australia, she said she was told she would no longer have access to wholesale billed psychiatry appointments via telehealth.

“I was in shock,” she said.

“It’s almost like Noah’s Ark”

In January, a 50% charge – known as post 288 – for video consultations by psychiatrists for rural and regional patients was removed from the Medical Benefits Scheme (MBS).

The ABC understands that around 45,000 patients claimed the article in 2020-21.

With a recognized lack of psychiatrists in most regional centers, telehealth has helped fill the gap. (ABC News)

Brisbane-based psychiatrist Dr Bawani Marsden said the last five months had been devastating for patients, as psychiatrists had to choose who, if anyone, they could bulk bill without extra charge.

The bulk patient billing option remains. But without the extra charge, practices say it’s not viable to supply everyone.

A patient discount was still available, but Dr. Marsden said about half of his rural and regional patients canceled because they could no longer afford care.

“Almost a decade we had this support and within weeks there was an announcement that it was going to be taken down,” she said.

“We’re talking rush hour here, we’re coming out of COVID…and they’ve taken a lifeline away from us.”

The federal government said the article was introduced to encourage psychiatrists to use video consultations, and the subsequent adoption of telehealth showed the incentive was no longer necessary.

“To be clear, Section 288 was a load item that was available to psychologists using telehealth, not a service,” said a spokesman for the Minister of Health, Greg Hunt.

“To say that access has been cut off is patently false.

Michelle Eastwell, a registered mental health nurse, shakes her head.

“For our patients, it’s gone from this transparent, private and non-stigmatized way of accessing mental health services to now…” what’s available? ‘” she said.

a woman in a black and white coat with a computer behind her sits in a consulting room, looking at the camera
Michelle Eastwell says cutting a major funding program with just a few weeks’ warning seems “underhanded”. (ABC Tropical North: Angel Parsons)

Ms Eastwell, from the Paul Hopkins Medical Clinic in Mackay, has worked closely with a number of psychiatrists to help more than 200 local patients access telehealth appointments.

She said they had cancellations “left, right and center”.

“It’s distressing because I know how sick some of these people are,” she said.

“Since then, we have struggled to find alternatives. But some continue to slip through the cracks.”

According to the Minister, telehealth appointments are increasing

A spokesman for Greg Hunt said the government has made telehealth universal and permanent and telehealth consultations for psychiatry have increased this year.

A statement from Mr Hunt’s office said there were 150,500 telehealth consultations in the first two months of the year, compared to 14,000 for the same period in 2020.

This was not Judith Pomeroy’s experience.

After saving for months to finally see her psychiatrist this week, she said her mental health had regressed to “square one” in the past five months.

“It took everything away from me every time I had those dates,” she said.

For fellow Mackay, Linda (who didn’t want her last name used), it feels like a dropout from rural and regional patients.

a woman stands with her back to the camera, as she watches a road near a mall
Living with borderline and bipolar personality disorder, Linda has been admitted to hospital in the past and says it can be difficult to find help. (ABC Tropical North: Angel Parsons )

Linda stopped accessing the telehealth service before the switch, but she said the support she received was “unparalleled” and helped her immensely to cope with bipolar and borderline personality disorder.

“My experience has been nothing but positive, so amazing and streamlined,” Linda said.

The Coalition committed $650 million in additional funding for mental health in the March budget, which Labor said it would honour.

With the federal election approaching, the Labor Party has also pledged to reintroduce Section 288.

Minister Greg Hunt said the change was made to reflect recommendations from the MBS review task force.

Concerned psychiatric corps will increase hospital admissions

But the Royal Australian and New Zealand College of Psychiatrists (RANZCP) campaigned against the decision and said the task force recommends finding an alternative solution which has not been made.

a man in a suit smiles at the camera, standing against a plain white background
Associate Professor Vinay Lakra says the removal of Section 288 has been detrimental to the sector. (Supplied: RANZCP)

“We came up with a number of solutions, including a bulk billing incentive… for people with affordability issues,” said RANZCP President Associate Professor Vinay Makra.

“Some of our patients are the most vulnerable in society and the government needs to address this vulnerability factor.”

“If they don’t get that support from a psychiatrist…some will get sick and have to be hospitalized [would] put an additional tax on health and hospital systems that are already under pressure. »

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