Showing posts with label Better Access program. Show all posts
Showing posts with label Better Access program. Show all posts

Monday, October 17, 2011

SWSLHD and Bowral's Health - 33

McGorry’s mental health minefield


Professor Patrick McGorry is fending off a barrage of bitter and very personal dissent over his approach to mental health.

AT THE eye of the stormy debate around mental health funding sits one man: the 2010 Australian of the Year, Professor Patrick McGorry.
While he’s lifted the profile of mental health among the general public – and been referred to as ‘the most powerful psychiatrist in the world’ – many of his peers have showered him with criticism since the 2011–12 federal budget.
That’s when funding was diverted from  the GP-led Better Access program to early intervention youth services, leaving GPs concerned that there would be a gaping hole in primary care services for mental health patients.

Professor McGorry, an adviser to the government on mental health funding and founder of the Early Psychosis Prevention and Intervention Centres (EPPIC) and headspace programs, has been accused of bias towards his early intervention models and conflict of interest over his advisory position to the government.

There is also doubt about the stated benefits of EPPIC and headspace, which have scored almost a quarter of the $2.2 billion mental health package.
And there’s concern around early intervention treatment that involves giving antipsychotic medication to young people merely at risk of psychosis.
“We need to get broader advice to government, we need the right advisers, who truly understand developmental principles and a lifespan approach,” says Professor Louise Newman, director of the Centre for Developmental Psychiatry and Psychology at Monash University.

The criticisms have grown increasingly personal in recent weeks. Professor McGorry was attacked by a prominent American psychiatrist, Professor Allen Frances, chair of the DSM-IV Task Force, who accused him in the Psychiatric Times of having a “messianic blind spot” and being an “unreliable evaluator of scientific evidence”.

Professor McGorry says these kinds of criticisms are “false and baseless” and “those making them have not been able to substantiate them in the face of facts”.
He vehemently refutes suggestions of a conflict of interest over his advisory role with the government.
“It is unclear exactly what improper behaviour I’m being accused of here,” he says.
“It is also unclear what criteria would disqualify my participation in the expert group due to my involvement in non-profit youth mental health organisations that would not also disbar all other members of the expert group on the grounds of their professional or organisational affiliations.”

The government says Professor McGorry was just one member of the Mental Health Expert Working Group, which was made up of experts from a range of health and non-health sectors, plus consumer and carer representatives.
“While these consultations helped to inform the development of the government’s record mental health package, decisions on the specific content... were solely a matter for the government,” said a spokesperson for Mark Butler, Minister for Mental Health.

With regard to claims of bias over the high proportion of funding that youth mental health received in the budget, Professor McGorry said three-quarters of the mental health budget went to areas other than youth.
“I would also note that when the Independent National Health and Hospitals Reform Commission considered this issue, they made early intervention models the first two of their 12 mental health recommendations.”

Most psychiatrists’ criticisms concern whether the benefits of the early intervention programs have been overstated. Nearly two-thirds of pyschiatrists in a recent poll thought the government’s focus on EPPIC was inappropriate.1

Professor Frances has described it as a “massive new experiment in early intervention”. Others question Professor McGorry’s claims that the programs are backed by solid evidence.
“They’ve made a lot of promises and raised a lot of expectations and these have not been borne out in the studies,” says Professor David Castle, head of psychiatry at Melbourne’s St Vincent’s Hospital.

In response, Professor McGorry argues early intervention programs like these have been used in hundreds of centres internationally for many years with great success.
“Consequently, there is very good evidence that early intervention for first-episode psychosis is more humane, effective and cost-effective.”

Adelaide University Associate Professor Jon Jureidini says he is concerned the early intervention programs have been misrepresented.
“I don’t think there’s anything wrong with either EPPIC or headspace as models, but there are other approaches to youth mental health, and these two approaches have not been proven to the extent where they dominate the funding,” Professor Jureidini says.

Concerns about the efficacy of the early intervention approach are not shared by the Royal Australian and New Zealand College of Psychiatrists (RANZCP), which has called them “essential” in a recent Senate submission on mental health funding.
“The government must commit to the full implementation of a national youth primary care service (headspace or similar) and a national network of Early Psychosis Prevention and Intervention Centres,” the RANZCP submission stated.
One controversial issue is whether the EPPIC treatment model involves giving antipsychotic medication to young people at risk of psychosis.
A trial by Professor McGorry of antipsychotic drugs on people aged 15–40 who were “at risk” of psychosis was recently cancelled.
“A lot of people are very, very concerned about the potential for over-labelling, over-medicalising and over-treating youngsters,” says Professor Castle.
“In America there’s been a 400% increase in bipolar diagnosis in children, and these kids do not all go on to get bipolar disorder. There’s a danger this sort of stuff will happen here.”

Professor McGorry, however, has repeatedly stated that antipsychotic medication will not be used as a first-line treatment option.
“A key goal of youth mental health models... is to address the over-medication of people with mental ill health in our overstretched and under-resourced mental health system,” he wrote recently on his website.
AMA president and GP Dr Steve Hambleton supports the need for early youth intervention.
“In general we want to intervene early and it doesn’t necessarily mean early use of medication,” he says. “We don’t want to label people too early, but services like headspace are appropriate for young people. We don’t want to put people on medication up front and Professor McGorry doesn’t want to do that either.”
For many GPs, a crucial issue is whether Professor McGorry’s influence has seen funding diverted to early intervention services at the expense of the Better Access program.
“Everyone would applaud his bringing youth mental health issues to the fore, but we have a right to be very angry about the diversion of funding,” says Dr Brian Morton, chair of the AMA Council of General Practice.

While the RANZCP and AMA acknowledge there may have been problems with evaluating Better Access properly, GPs believe the cuts will be devastating.
“The mental health cuts are going to disadvantage patients, in particular those who have more chronic and difficult issues,” says Perth GP Dr Stephen Wilson.
Professor McGorry describes Better Access as an “excellent program” that has been a “building block for mental health reform”.
“While I personally did not advocate the changes made in the recent budget – nor did I have prior knowledge of the changes – now that this has occurred, we need to review what is really required to provide appropriately skilled care for those with more complex mental disorders for which Better Access was designed,” he says.
“In the very next federal budget, the federal government [should] fund a more specialised tier of service which would draw in clinical psychologists – who are clearly required if the problem is more serious and persistent –  psychiatrists in many cases, and other disciplines as well, notably social workers and occupational therapists.”

Some argue the real need is for more independent analysis of all areas of mental health and a more involved discussion on which ones have the greatest need.
“I would implore people like Patrick McGorry to understand they are a part of a much bigger system,” says Dr Wilson.
“They need to take a step-back view of policy and realise it’s not just their area of work that needs a lot more funding.”

Professor McGorry says his core recommendation is that mental health policy should ensure all Australians of all ages have the same access to quality care for mental ill health, as for physical ill health.
“Those criticising the decisions of the government on mental health reform are perfectly entitled to do so, though it would be good to learn what their alternative plans are, if any, especially for the million young people with mental ill health,” he says.  

Reference
1. Psychiatry Update, 6 October 2011, http://enews.psychiatryupdate.com.au/cgi-bin19/DM/t/nMCS0FVx0FM0j7tF0E7
 

Saturday, October 1, 2011

SWSLHD and Bowral's Health - 21

Stop cuts to mental health funding: doctors’ plea


DOCTORS have made a plea to Federal Health Minister Nicola Roxon to place a moratorium on the looming cuts to Better Access funding in order to provide adequate time for the government to consider the outcome of an ongoing Senate inquiry.

With the inquiry due to hand down its final report on the government’s handling of mental health funding by 20 October, AMA President Dr Steve Hambleton said the 1 November deadline for the introduction of the funding cuts was premature.

“This leaves very little time for serious consideration of the Senate committee report,” Dr Hambleton said.

“Ten days is not enough. The Minister must defer the implementation of the changes to the Better Access program until at least 1 November 2012 to allow proper consideration of the compelling evidence against the cuts,” he said.

Dr Hambleton argued the 12-month moratorium on Better Access funding would provide adequate time for the government “to acknowledge the error of its ways and restore the Better Access funding”.

If the government fails to agree to the requested moratorium, the current rebate of $163.35 for a mental health plan for GPs trained in level 1 mental health skills, will be replaced by a rebate based on timed consultations from 1 November.

The new rebates will be $85.92 for a plan written during a consultation of 20–39 minutes, $126.43 for a 40-minute consult for GPs trained in mental health skills, and $67.65 and $99.50 respectively, for GPs without the training.


Comments:

sergie
29th Sep 2011
6:20pm
A Mental Health Care Plan after 1st November 2011

Dear Mr... Ms... Um...the patient didn't know your name,

This patient, what's his name? - for the medicare rebate, I didn't have the time to get his either - suffers from depression/ anxiety/bipolar disorder/ delusions/ hallucinations/child abuse/ absent self-esteem/ obsessive-compulsive behaviour/ anti-social tendencies/ addictions to alcohol, gambling and pethidine/ dyslexia/ uncontrollable anger/ suicidal ruminations/ wishes to kill someone/ (cross out whichever does/do not apply), carries/rope/ a knife/ gun/hand grenade/assorted explosives wherever he goes (ditto) and has been prevailed upon by his bullied/battered/abused/neglected wife and children to change his ways.

I look forward to your comprehensive report and continuing management of this man.

With thanks.
 
tvkdas
29th Sep 2011
7:24pm
I almost 100% bulk bill but have drawn the line in the sand. As it takes me time to do a proper care plan, I will charge a fair fee for the plan as a reflection of this as well as my expertise (which, mind you, they insisted on us "upskilling" through the additional training for the higher rebate and then about face with this plan to decimate the rebate) and I will make it abundantly clear to my patient that it is Julia Gillard and her health minister Nicola Roxon who feel that they do not feel it worthy to support my patient's access to a fair rebate and so they will be out of pocket significantly as a result.
 
ondocfarm
1st Oct 2011
6:46am
Typical AMA, asleep at the wheel, too little too late and now trying to shut the stable door long after the horse as bolted!!

SWSLHD and Bowral's Health - 20

GPs to charge gap for Better Access Program

GPs to charge gap for Better Access Program

The AMA has prepared a template letter that GPs can use to tell patients why they will face out of pocket expenses for mental health services under the Better Access Program.

The letter (link) explains that the Federal government reduced Medicare rebates for
GP mental health services by up to 49 per cent in the last budget, and the changes take effect from 1 November 2011.

The AMA says it supports GPs in charging fees that reflect the cost of providing patients a safe and high quality service, and that this will result in some patients facing an out of pocket expense for the first time for GP mental health services.

The template letter states that the practice unfortunately cannot lower fees to match the significant reduction in Medicare rebates implemented by the Government.

“The fees that this practice charges for our services reflect the cost of providing you with a safe and high quality service and the time that needs to be spent in caring for your health needs,” it says.

It also advises patients that if they wish to let the government know that they are unhappy with its decision, they can contact the Minister for Health and Ageing Nicola Roxon.

A recent survey by the AMA found that up to 50% of GPs would be forced to maintain their current fee and charge patients a gap, and up to 28% of GPs would stop using Medicare GP Mental Health Treatment items.

About six out of ten GPs thought the Budget cuts would lead them to spend less time with patients with mental health problems.

The AMA has meanwhile written to Health Minister Nicola Roxon calling for a moratorium on the Budget cuts to GP mental health services.

AMA president Dr Steve Hambleton said that a Senate Community Affairs Reference Committee – which received more than 1000 submissions – is currently looking into the Government’s handling of mental health services and is not due to report until 20 October.

“This leaves very little time for serious consideration of the Senate Committee report,” Dr Hambleton said.

Wednesday, September 21, 2011

SWSLHD and Bowral's Health - 16

Psychiatrists back Better Access cuts

Psychiatrists back Better Access cuts

Two leading psychiatrists have told the government it is doing the right thing by scaling the Better Access scheme for mental health.

Professor Ian Hickie told a recent Senate Inquiry (link) into Mental Health Services that the cuts – which will see GP rebates slashed by half – were needed to “correct the balance” and were “extremely welcome”.

He said the scheme had never been intended to cover all psychological care outside of hospital, but it was now being used for ‘higher need‘ patients who would be better managed through the ATAPS program.

He also applauded the move to cut the number of sessions from ten to six, saying it would allow more people to be treated for shorter periods.

“We have people who should not be in that care system receiving long-term care while many other people are excluded,” he said.

Professor Hickie was backed up by Professor Patrick McGorry who said any patient needing more than 10 sessions with a GP required “a serious re-evaluation and they probably need more skilled psychological care ... probably on a team basis.”

However AMA president Dr Steve Hambleton (link) told the inquiry the AMA opposed cuts to a scheme that was helping more than a million patients access GP mental health services each year, including over 130,000 in disadvantaged areas.

SWSLHD and Bowral's Health - 15

Better Access criticisms debunked

Better Access criticisms debunked

Criticisms of the Better Access mental health scheme are not justified and it is fulfilling its promise of improving access for patients, a leading psychiatrist says.

Professor Anthony Jorm has admitted he shared the sceptical views of the critics when the Better Access scheme was first introduced but has since changed his mind.

In his submission into the Senate inquiry into mental health which was launched following the Federal government’s planned cuts to the scheme, (see link) Professor Jorm argues that the high cost of the program reflects its popularity with the Australian public and the “previous large unmet demand for psychological therapy”.

He challenges the criticism that GPs are becoming “glorified referrers” through the mental health plans as he insists data shows “patients are generally getting better even though most are not being reviewed by the GP”.

He admits the criticisms relating to a cost blow-out and patient co-payments are justifiable, but argues that co-payments act as a disincentive to the service being overused and without them it could have caused an even greater cost blow-out.

He insists that although uptake is lower in remote areas, the “whole community” has benefited from the scheme and that the “worried well” comprise only a very small minority of Better Access users.

“Better Access has generally fulfilled its promise of improving access, although it needs some tweaking at the edges to reduce remaining inequalities,” he says

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 56

AMA sets up GP voice for Medicare Locals

AMA sets up GP voice for Medicare Locals

The AMA is creating GP consultation groups in each of the Medicare Local districts to “empower” doctors to have a leading role in how the organisations are run. 

AMA President Dr Steve Hambleton said he would be travelling to each of the first 19 Medicare Local areas to help the groups ensure the AMA primary care message is “spread” throughout the communities.

Speaking in Canberra today, Dr Hambleton said that the organisations needed GPs on their boards in order to work, and he had already written to Health Minister Nicola Roxon and chairs of the Medicare Locals to express his concerns.

“Our view of Medicare Locals is that, if they are implemented correctly and with the right intentions, they can work,” he said.

“But doctors have to be core parts of the process.”

The announcement came as the AMA released the results from its latest online poll in which 760 GPs responded about the planned cuts to Medicare patient rebates.

Around a quarter of GPs said they would stop using Medicare GP Mental Health Treatment items following the cuts.

Around 85% said they believed fewer patients would receive vital care and just over half said they thought the budget cuts will lead to them spending less time with patients with mental health problems. 

Doctors also revealed that the average time taken to prepare a mental health plan during and outside a consultation is 52 minutes, not the 28 minutes suggested by the government.

Tuesday, May 24, 2011

SSWAHS = SWSLHD + SLHD and the Medicare Locals - 47

Calls for mental health rebate cuts to be reversed

24th May 2011
Byron Kaye and Andrew Bracey   all articles by this author
FEDERAL Parliament has been urged to seek savings in programs such as the GP super clinics and Medicare Locals in order to save rebates for GP mental health plans which were slashed significantly in the recent Budget.

In a letter to all Federal MPs and senators, the AMA has today requested the rebate cuts be axed, arguing that the decision was made with no prior consultation with the profession and would undermine the Government’s own push to bolster mental health services.

The letter came as Mental Health Minister Mark Butler today repeated his claims that GPs were overpaid for drawing up mental health plans. He was answering questions following a speech at the National Press Club.

Last week Mr Butler pointed to data that showed the average Better Access consultation lasted just 28 minutes and attracted a $163 rebate, while a 40-minute GP consultation attracted a rebate of just $99.
But Associate Professor Helena Britt, head of the Bettering the Evaluation and Care of Health (BEACH) program, said the 28-minute average GP consult for mental health – provided by her and quoted by Mr Butler – was only part of the time practitioners spent on mental health plans.

She said the data included only the face-to-face time between GPs and patients and did not include the time doctors spent outside sessions on related paperwork and liaising with other healthcare workers.
“I don’t know what they’re thinking, but it’s possible that they have not considered these other time issues,” she told MO.
“The 28-minute average… is correct [but] I’ve questioned the interpretation.”

The AMA has similarly questioned the Government’s interpretation of the data in its letter.
“It has always been acknowledged that the justification for the higher rebate was based on additional face-to-face time before or after the service attracting the item, additional non face-to-face time, onerous compliance requirements and the non face-to-face time involved in consulting with other health service providers involved,” reads the letter.

The RACGP last week also seized on the 28-minute figure touted by Mr Butler, with college president Professor Claire Jackson calling for the cuts to be reversed as soon as possible to prevent GPs abandoning the scheme altogether.

The AMA’s letter concludes with a request for Parliamentarians to reconsider the cuts and retain existing rebate levels “to avoid an inevitable campaign of opposition from patients and doctors alike”.
“In our view, patient rebates should be maintained at their current level with the realistic expectation, indeed hope, that the program will become more, not less, available and that Australians will continue to benefit from the GP services involved.”

Under the plans, the current rebate of $163.35 for a mental health plan for GPs will be replaced by a rebate based on timed consultations from 1 November.

Rebates will now be $85.92 for a plan written during a consultation of 20–39 minutes and $126.43 for a 40-minute consult for GPs trained in Level 1 mental health skills.

Those without the training will receive $67.65 and $99.50, respectively.

Monday, August 9, 2010

Does the Southern Highlands Division of General Practice deliver the "optimal service" to the people of the Southern Highlands?

Does the Southern Highlands Division of General Practice deliver the "optimal service" to the people of the Southern Highlands as it states on its website? Or is it merely a subservient tool for the Imperial SSWAHS? The local Division seems to be more intent on acquisitions rather than delivering a service to their GPs.

For example, the SH Division employs staff to provide services that are already delivered by private allied health service providers in the community. Yet, because of its influence over the general practitioners it is meant to support, it exercises a monopoly. That is, it recommends GPs to preferentially refer their patients to the member of staff employed by the Division rather than to the private practitioners in the community. Where is the right to choose their practitioner for the patient?

Socrates is aware from personal experience that the general practitioners he has had to see over his long years (treatment for hemlock poisoning, etc), that the majority of GPs do have a mind to treat their patients with respect and provide them with options. This dialogue of mine today is not about the GPs in the Southern Highlands but about their Division and its Chief Executive. Their Chief Executive has openly stated that he will fight to market the Divisional staff to the area's GPs simply to be able to continue to employ them. Who has employed them - well the Chief Executive. But what processes does he follow in employing the staff, and what qualities and skills do they bring to ensure the provision of "optimal care" is delivered by them?

And can the staff employed by the Chief Executive deliver all the programs that he says (in the website) the Division can deliver to the people of the Southern Highlands. There is no doubt that the Aged Care and the Diabetes Coordinators are well experienced in their clinical fields and the services they deliver are well used. But what about the other services that the Division touts on the website? Mental health services delivered to the aged care facilities in the Highlands, the non-directive pregnancy support counselling, the better outcomes in mental health program, the better access mental health program, the mental health nurse incentive program - who delivers these?

These programs are all funded by the federal government through Department of Health and Aging or Medicare Australia. The qualifications of the practitioners used for these programs are dictated by the Medicare Australia and/or the relevant professional college or association. The Division, however uses its own set of hoops to select who it should anoint to do the work. I wonder what Medicare Australia or the Department of Health and Aging would think about the Southern Highlands Division of General Practice? In particular its Chief Executive and its Board.

Socrates is already aware from his reading of the scroll called "The Highlands Doctor" that, for example, GPs are being encouraged to refer their patients to a person for the "Better Access" program when they could be doing some of the "Better Outcomes" program which is funded by the federal government and the Division is the fundholder. Why use a Medicare funded program to keep their staff member employed? Perhaps it has something to do with running out of the funds for "Better Outcomes" because the funds were used for something better - like employing staff rather than providing a service to the patients referred to it.

The other program that seems to have disappeared off the scroll appears to be the Mental Health Nurse Incentive program - another of the Medicare funded programs. From the more ancient scrolls on the Division's website it would appear that the Chief Executive was employing someone who was hoping to be a Credentialed Mental Health Nurse, the only people (besides GPs and psychiatrists) who Medicare allows to participate in the program's delivery. It appears to be a good program (perhaps even a great one) which allows vulnerable people with a severe mental illness to have care coordination by a credentialed mental health nurse so that they might remain out of hospital and be cared for in their own community.

It would seem that the person employed by the Division was not successful in obtaining the credentialed mental health nurse qualification so the Division could no longer use them. From the official website of the Australian College of Mental Health Nurses the list of Credentialed Mental Health Nurses shows that there are three qualified and approved CMHNs in the Southern Highlands, which is not bad considering there are only about 800 nation-wide. However, the Division, for reasons unknown, is not supportive of the existing CMHNs and appears to have gone secretive as to their reasons why. The information about the MHNIP is no longer public on the website having been placed in the log-in "doctor's secret business" section on their website.

In the meantime, patients who could or should be referred to this program are not able to be referred because the only two CMHN in the Highland currently being used by GPs are unable to take on any more patients, and the other although credentialed since August 2009 has never received any referrals at all possibly due to misinformation provided by the Division to the local general practitioners.

Hmmm! Socrates has to then wonder at the Division's claim:

"Southern Highlands Division of General Practice (SHDGP) is a federally funded not for profit organisation which assists general practitioners and the Health Service to deliver health services to people in the Southern Highlands.

The Division acknowledges the support of the Commonwealth Department of Health and Ageing in respect of funding the Division's activities."

And:

"The mission of the Southern Highlands Division of General Practice is to assist local general practitioners in providing optimum care to health consumers in the Southern Highlands area."

Does it really, Chief Executive, or is the Division just as money grabbing as the so-called "for profit" organisations? Perhaps it is now time for the merger with the Macarthur Division of General Practice where they don't seem to run out of funds for their funded programs, and they employ people but they still seem to manage to work collaboratively with their general practitioners and with the private sector, especially the allied health and mental health nurses, without having to prostitute themselves to the empire of SSWAHS.