The Royal Australian College of General Practitioners (RACGP) has warned that urgent reform of Medicare is needed so that GPs can better tackle the nation’s mental health crisis.
It comes following a groundbreaking report from the General Practice Mental Health Standards Collaboration drawing on a survey of GPs across Australia with Level 1 Mental Health Skills Training and all GPs with Level 2 Focussed Psychological Strategies (FPS) skills training. The survey revealed:
- a pressing need for a more equitable Medicare Benefits Schedule (MBS) to help GPs care for people with mental health issues. The rebate for mental health item is marginally lower than a standard consultation of the same length
- just 9% of GPs reported being able to receive a “suitable financial return on their time” dedicated to treating mental health conditions, with many respondents (45%) concerned about being audited for billing too many long consultations.
RACGP President Adj. Professor Karen Price said that GPs needed more support so that they could help patients in need.
“This damning report confirms what we already knew. Under the current MBS structure, a GP’s time spent helping someone with mental health issues is worth less than other areas of medicine,” she said.
“That is deeply concerning when you consider that Australia is facing a mental health crisis, with the fallout from the pandemic and restrictions including hard lockdowns affecting many people in communities across Australia. GPs are up for the task of treating people with mental health concerns, but we need to be properly supported to do this work.
“Medicare rebates need to reflect the realities of assisting people with mental health issues, rather than effectively penalising us for carefully taking the time to get to the bottom of what is really going on. Action is needed now, the rebate gap that exists between mental health and other consultations must be removed so that GPs can better deliver high-quality mental healthcare.
“One type of disease should not be privileged over another. It’s vital to remember too that mental health rarely exists on its own and contributes significantly to other chronic conditions.”
GPMHSC Chair and RACGP spokesperson Dr Morton Rawlin said that time was of the essence for reform.
“The high prevalence of mental illness, along with the burden of disease associated with it, is likely to get much worse,” he said.
“Structural barriers of access, time, and cost of undertaking further training, as well as the emotional, economic, and practical viability of delivering mental health services are closely intertwined and need to be addressed concurrently.”
Dr Rawlin believes major reform is needed so that GPs are appropriately remunerated for the additional time required to coordinate care and follow-up patients with mental health conditions.
“Removing this disparity will give GPs a clear signal that their time spent on mental health is valued,” he said. “Likewise, removing the disparity between mental health and other consultations, such as de-coupling the number of Medicare Benefits Schedule-rebated sessions available for a patient to see a psychologist from the number of rebated sessions available for a patient to receive Focussed Psychological Strategies from their GP will motivate more GPs to actually use [these strategies] in their practice.”
During the 2022 federal election campaign, the RACGP advocated for:
- a new service incentive payment, or SIP, to support regular and continuous care to improve the health of people with mental health conditions
- increasing the value of a patient’s Medicare rebate by 10% for GP consultations lasting longer than 20 minutes and introducing a new rebate for consultations lasting more than an hour.
The RACGP’s Vision for general practice and a sustainable healthcare system outlines a model of care that aims to address many of the nation’s long standing healthcare challenges. The economic benefits of implementing the Vision show that it is a sound return on investment.
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