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Rebate freeze will leave mentally ill ‘in the cold’

Many people suffering mental illness will be left stranded without treatment unless the Federal Government drops its plan to freeze Medicare rebate indexation to mid-2018, psychiatrists have warned.

The AMA Psychiatrists Group said the prolonged indexation freeze would push up out-of-pocket costs and increase the financial pressure on patients using the private system, which treats about 70 per cent of all mental health patients.

“Given that many patients treated in the private sector find it difficult to access appropriate care in an already stretched public sector, there are concerns that this would leave many patients and their families ‘in the cold’,” the report said.

In the lead-up to the federal Budget, the AMA has intensified the pressure on the Government to dump the rebate freeze, warning it will push up patients costs, reduce access to care, cut bulk billing rates and force some GP clinics to close.

But Health Minister Sussan Ley has indicated there will not be a change of policy in the Budget, though she hinted at the possibility the freeze could end early if a review of the Medicare Benefits Schedule and other efficiency measures delivered sufficient health budget savings.

In a report to the AMA Federal Council, the AMA Psychiatrists Group also expressed alarm at what it said was an increasing push by insurers to demand patients divulge details of their medical records.

The group said patients often gave funds access to their medical records “because they are too afraid of losing their insurance cover if they refuse”.

The group said that both it and the Royal Australian and New Zealand College of Psychiatrists were concerned about the development, which was “eroding the confidential and therapeutic nature of the relationship between a patients and a psychiatrist”.

“In some cases, this can have a clinically detrimental effect on the patient,” the report said.

The RANZCP, supported by the AMA Psychiatrists Group, has launched an investigation into the issue.

In its report, the group also highlighted the valuable work being undertaken by the Private Mental Health Alliance to help inform mental health policy.

The Alliance owns and operates the Centralised Data Management Service, which collects admission and discharge information from all private hospitals operating psychiatric beds.

“The CDMS has become the cornerstone for the provision of high quality mental health care in the private hospital sector,” the group said. “The CDMS is helping the private sector and the Australian Government answer fundamental questions that can be asked of any health system – who receives what services, at what cost, and with what effect.”

The current agreement under which the AMA provides funding to the Private Mental Health Alliance expires in June, and negotiations are underway for a new three-year agreement from 1 July. The Federal Government has deferred a decision on any contribution it might make until after it has fully considered the outcomes of the National Mental Health Commission’s review of services, which was publicly released last month. No announcement is expected until after the May Budget.

Adrian Rollins