Mark Butler says general practice in crisis, defends cut to psychology sessions

Parts of Australia’s health system are “in crisis” as the government cuts Medicare-funded psychology sessions and bulk billing rates fall in general practice.

Health Minister Mark Butler has admitted that general practice is in the worst shape it has been in the 40-year history of Medicare and said the drop in bulk billing rates will ripple “through” of the healthcare system.

The latest Medicare figures show the bulk billing rate fell from 87% to 83.4% between July and September this year as GPs across the country were forced to stop billing mass of patients to try to keep the practices open.

Mr Butler’s admission comes days after he announced major changes to the Better Access initiative, meaning that the Medicare mental health care plan, which currently offers 20 deductible psychology sessions a year, will would be reduced to 10.

It was doubled from 10 in 2020 as part of the Morrison government’s Covid-19 emergency measures.

The decision to cut sessions to 10 has drawn criticism across the mental health space, but Butler said it was the only way to stop distortion and improve access for everyone.

“This program has been around for a number of years, and for many years it has had a 10-session limit … the average person used four to five of those sessions,” Butler told ABC Radio.

People like Professor Ian Hickey said then (of doubling sessions) that those extra sessions in a sector with a limited workforce would have the effect of cutting other people out, meaning other people wouldn’t be able to get any kind of support . .

“And the assessment I released on Monday showed exactly that, which had the impact of cutting more people out of the system. Most of those people were in some of the poorest communities, where the assessment said there was the greatest need.”

Butler said tens of thousands of Australians had potentially missed out on mental health support because of the “distortion” of the expanded scheme.

“I couldn’t stand by and let something that clearly distorted the system in a way that meant a lot of people who needed support didn’t get it,” he said.

Butler said he will work closely with industry and lobbyists to reform the Better Access system.

On Monday, the Australian Psychological Society said it was “deeply disappointed” by the decision to cut the 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,” he said.

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 those needs.

Originally published as Mark Butler says general practice in crisis, advocates cut to psychology sessions

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