ACA supports Medicare Better Access review

By Philip Armstrong, ACA CEO

This week we saw the Minister for Health, Mark Butler and the Assistant Minister for Mental Health, Emma McBride make the courageous, and in my opinion correct decision, not to extend the amount of sessions psychologists can offer clients under Medicare’s Better Access scheme.

In doing so, they sent a clear signal that the mental health system is at a tipping point and that we need to do better, for all Australians.

So why is this the correct decision? Our mental health care system is in crisis and one of the primary reasons is because psychologists are by and large only servicing inner-city, mostly affluent Australians. This was evidenced by the Review into the Better Access Scheme.

Nearly three-quarters of private psychology practices are situated in inner-city suburbs around Melbourne, Sydney and Brisbane, with a splattering in Perth. If you live anywhere else, good luck trying to get an appointment, and budgeting for the massive gap payment that is applied on top of the Medicare rebate.

So yes, Australians who can afford the gap fee and have services available in their suburbs will be the hardest hit.

For the rest of the country, it’s just business as usual. Expanding sessions would have no impact on the lack of current services or high gap fees. That’s if you can find a psychologist in the first place.

In fact, it would have quite the opposite effect. Overstretched services will have fewer sessions available for new clients.

So what’s the solution? I’ve long advocated to expand entry into Medicare for counsellors, addressing the critical issue of access and cost while lowering the burden on GPs and psychologists.

Having counsellors included in Medicare would alleviate the workforce shortage of psychologists and allow counsellors to offer services in low socio-economic and rural and regional areas where psychologists in private practice are rare.

As the head of the Australian Counselling Association, I know counsellors can be found in abundance and where GPs are burning out.

Medicare was created to ensure universal medical and mental health services for all Australians, regardless of income or where they lived. So let’s use Medicare to get better outcomes by including counselling services.

The research is clear, counsellors get equal outcomes for patients, so there is no danger of lowering of standards or outcomes for Australians, just more services at a lower cost.

Let’s get this argument on track; the average Australian is not paying taxes to ensure only inner-city Australians can have access to mental health services at their expense.