Parts of Australia’s healthcare system are “in crisis” as the government slashes Medicare-funded psychology sessions and bulk-billing rates drop across general practice.
Health Minister Mark Butler has admitted general practice is in the worst shape it’s been in the 40-year history of Medicare and said the declines in bulk-billing rates were going to reverberate “right through” the health system.
The latest Medicare figures show the bulk-billing rate dropped from 87 per cent to 83.4 per cent between July and September this year, as GPs across the country were forced to stop bulk-billing patients in a bid to keep practices open.
Mr Butler’s admission comes days after he announced major changes to the Better Access initiative, namely that the Medicare mental healthcare plan – which currently offers 20 rebatable psychology sessions a year – would be reduced to 10.
It was doubled from 10 in 2020 as part of the former Morrison government’s Covid-19 emergency measures.
The decision to cut the sessions back to 10 has drawn criticism across the mental health space, but Mr Butler said it was the only way to stop the distortion and improve access for everyone.
“This program has been around for a number of years, and it has for many years had a limit of 10 sessions … the average person used four to five of those sessions,” Mr Butler told ABC Radio.
“People like Professor Ian Hickey said at the time (of the doubling of sessions) that those additional sessions in a sector with a limited workforce was going to have the effect of cutting out other people, meaning other people couldn’t get any support whatsoever.
“And the evaluation I … released on Monday showed exactly that, that it had the impact of cutting more people out of the system. Most of those people were in some of the poorest communities, where the evaluation said there is the highest need.”
Mr Butler said tens of thousands of Australians had potentially missed out on getting mental health support because of the “distortion” of the expanded scheme.
“I couldn’t stand by and let something that was clearly distorting the system in a way that meant a whole lot of people who needed any support were getting none,” he said.
Mr Butler said he would work closely with industry and lobby groups to reform the Better Access system.
On Monday, the Australian Psychological Society said it was “deeply disappointed” by the decision to cut sessions after a review had called for the program to remain in place.
President Catriona Davis-McCabe said there was a mental health crisis in the country, and Medicare needed to be strengthened.
“Patients face significant costs even with the subsidy, so cutting it completely for millions of eligible Australians reduces affordability when we should be increasing it,” she said.
Mr Butler said the government was considering additional sessions for people with more complex mental health needs, noting the system in question was not designed to focus on people with such needs.