Psychologist Access Is A Mind Game
The Age
Saturday May 5, 2007
IF YOU live around Hawthorn or Kew, finding a psychologist that Medicare will pay for is a breeze. If you live in Reservoir or Footscray, it's quite a bit harder. And if you're unlucky enough to live in a country town such as Ararat, you miss out altogether.
When the Government announced a $1.9 billion funding package for mental health services last year, it was hailed as a big fix for Australia's ailing mental health system.But now there are concerns that the package is skewed to helping wealthy and urban Australians and will do little to help the mentally ill in poor and remote areas. With the Labor Party positioning access and affordability of health care as a key election issue, it could become a political problem for the Government.But a more important reason to fix the problem, argues Kate Carnell, chief executive of the Australian General Practice Network, is the growing concern over the mental health implications of the drought for rural Australians.The problem with the $1.9 billion package is its reliance on extra Medicare rebates for visits to a psychiatrist and - for the first time - Medicare rebates for psychology visits, Ms Carnell says.Access to Medicare is generally a good thing, but because health practitioners follow the market, Medicare rebates tend to favour those in wealthier, urban areas where health workers congregate, she says.This is starkly demonstrated by the distribution of Medicare psychologists. Hawthorn and Hawthorn East, with 55 Medicare psychologists, have more than the Northern Territory, with just 22.Rob Grenfell, one of two GPs sharing a single full-time position in the Wimmera town of Natimuk, says the package allows a GP to refer a patient to a psychologist. But if there is not one available, there is not much point. There are no psychologists in Natimuk, which has a population of about 600, and while there are two in nearby Horsham, there is a waiting time of up to six weeks, Dr Grenfell says. He has done extra mental health training to try to meet some of the demand himself.The president of the Australian Psychological Society, Amanda Gordon, says access to mental health services is much better now that psychologists can use Medicare, because psychiatrists are even more concentrated in leafy suburbs.Ms Carnell argues the Government should take the average spent by every Australian under Medicare and in areas where spending is below average, unspent dollars should be given to GPs to employ workers in areas such as mental heath. The Government has introduced some initiatives along these lines. Under the More Allied Health Services program, about 60 GP divisions get money to provide their patients with allied health workers.
© 2007 The Age
