This release appeared on Sunday.
RACGP welcomes telehealth announcement but warns more long-term investment needed
The Royal Australian College of General Practitioners (RACGP) has cautiously welcomed the federal Government’s move to temporarily restore telehealth to peak COVID-19 pandemic settings.
This morning, Health Minister Greg Hunt and Regional Health Minister David Gillespie announced an additional $24 million for a range of measures to give GPs and other specialists more flexibility to support patients.
It comes after RACGP President Dr Karen Price met with Minister Hunt and Minister David Gillespie this week, along with other peak general practice and medical organisations, to discuss the challenges facing general practice and support needed to ensure GPs can stay open and deliver the essential care to Australians at this time.
The announcement outlined the following measures:
· an additional $24 million for temporary changes to telehealth to give GPs and other specialists more flexibility to support patients, including the continued supply of personal protective equipment (PPE) and online support
· the introduction of temporary specialist inpatient telehealth MBS items (video and phone) and initial and complex specialist telephone consultation items, including longer telephone consultations for GP’s (level C) until 30 June 2022. These services will be available nationally, rather than targeted at Commonwealth hotspots
· expanding the MBS item for GPs caring for COVID positive patients in the community through face-to-face consultations to include patients that have tested positive through a rapid antigen test (RAT)
· packages of personal protective equipment (PPE) to GPs, Aboriginal Community Controlled Health Services and GP Respiratory Clinics to support GPs providing face-to-face care. Over 20 million units of PPE will be provided for primary care over the next three months, including nine million p2/n95 masks for GPs.
· Healthdirect will develop a national assessment, triage and notification infrastructure to connect people who test positive with the care they need and advice, based on guidelines developed by the Royal Australian College of General Practitioners, (soon to be available in multiple community languages). This is expected to commence in Queensland on 17 January 2022 with other states to follow.
RACGP President Dr Karen Price said that the announcement was a step in the right direction.
“It’s positive news that the Government is listening to the Royal Australian College of GPs on telehealth and need for more support to manage the increasing number of COVID-19 positive patients in the community,” she said.
“GPs and patients have embraced telehealth during the pandemic, and it is here to stay. Video and telephone consultations have changed the way we deliver healthcare and I believe many patients will continue to utilise telehealth for years to come post-pandemic as a compliment to face-to-face care.
“We have strongly advocated for Medicare rebates to remain for longer telephone consultations and for good reason. Telehealth use in Australia is largely phone-based. Between March 2020 and March 2021, video consultations comprised only 2.4% of telehealth services. Video consultations are not suitable for many patients including older people unaccustomed to the technology or those with unreliable internet access.
“Last year, when the federal Government removed Medicare support for phone consultations lasting longer than 20 minutes, we warned that this would disadvantage vulnerable patient groups.
“The stark reality is that many of the patients who benefit the most from telehealth are also the most disadvantaged when it comes to internet connectivity and reliability.
“Discouraging longer phone consultations is particularly disadvantageous for Aboriginal and Torres Strait Islander people seeking to undertake a health assessment, patients in rural and remote areas, older people, and those with multiple chronic conditions.
“So, we called on the Government to reinstate Medicare rebates for longer phone consultations as part of the permanent telehealth model.
“A six-month restoration of these rebates is welcome; however, we must not stop there - this must be a permanent fixture of telehealth for years to come and the RACGP will continue fighting to make that happen.
“Otherwise, we risk undoing a lot of hard work that has improved care for patients including those in rural and remote areas, Aboriginal and Torres Strait Islander patients and patients with chronic disease.”
Dr Price said that telehealth was needed by patients across Australia more than ever before.
“With COVID-19 cases escalating in many communities across Australia, particularly New South Wales and my home state of Victoria, telehealth is a great solution for people at greater risk of severe illness if they contract the virus including older people, those with serious underlying health conditions and the immunocompromised,” she said.
“For many health conditions, telehealth provides the perfect avenue. So don’t hesitate to ring your GP and book an appointment, the worst thing you can do is avoid or put off care you need now.
“The Healthdirect direct triage service, which the RACGP has been consulting closely on, will also help ease the pressure on practices across the nation which have been flooded by calls from COVID-19 positive patients. This service will act as a point of contact for anyone with a positive result to receive assessment and information on what to do.
“Importantly, it will also link to community care pathways developed in different states and territories to ensure GPs have the information required to help manage COVID-19 positive patients at home.”
The RACGP President also welcomed the Government acting on RACGPs calls for additional PPE to help GPs provide face-to-face care to all patients, including those who are seeing COVID-19 positive patients.
“PPE is critical for GPs in a time of high community prevalence and in case of providing face-to-face care for COVID-19 positive people,” she said.
“It’s also welcome that this is being prioritised for rural, regional and remote areas, where we know access to PPE can be challenging. We also know that general practice is a critical workforce for public health and our members must have protection provided which is commensurate with the risks of the continuing pandemic.”
Dr Price also urged people to continue their usual care.
“The data shows that people tend to avoid or delay care during times of high community transmission, and restrictions. This is very concerning because it leads to delayed diagnosis and worsening health conditions down the track, and puts even more pressure on our overloaded health system,” she said.
“So, if your health concern does require a face-to-face consultation, remember that practices have robust systems in place to minimise the chance of you contracting COVID-19. So please look after your health and don’t put off any consultations with your GP, we are here to help.”
~ENDS
Here is the link:
https://www.miragenews.com/racgp-welcomes-telehealth-announcement-but-707513/
The frustration with the lack of certainty and stability is reflected here a well.
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
Tue 4 Jan 2022 03.30 AEDT
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.
Assoc Prof Vinay Lakra, the Royal Australian and New Zealand College of Psychiatrists president, said most of the reforms were welcome, but that fixing some gaps meant others appeared.
“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.
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Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636
More here:
I can do little other than suggest that a Government who can waste $38Billion on a financially leaky Jobkeeper could find the funds to sort this issue out fully and permanently. Is that too much to ask?
David.
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