Politics — 06 March 2013

A second Medicare Local has been forced to stop referring patients to the Access to Allied Psychological Services (ATAPS) scheme because of a huge increase in demand, sparking calls for an overhaul of mental health funding.

The squeeze on ATAPS has continued to spread, with Gold Coast Medicare Local (GCML) confirming that in January it had informed GPs in the area that it had been forced to temporarily halt referrals.

The confirmation comes after MO revealed last week that the neighbouring Greater Metro South Brisbane Medicare Local (GMSBML) had similarly been forced to stop taking ATAPS referrals for four weeks because of overwhelming demand.

GCML told MO that GPs “will be notified shortly that there are now services available”.

It said it was encouraging GPs to consider whether to refer patients to the Better Access scheme instead of ATAPS.

GCML said it was able to resume ATAPS referrals by “develop[ing] a centralised intake system which enables better prioritisation of clients to ensure that everyone has access to the most appropriate services that they need”.

When the federal government surprised GPs by almost halving MBS rebates for Better Access in the 2011 budget, Mental Health Minister Mark Butler said the savings would be used to bolster ATAPS, which — rather than being run on MBS rebates — is run on allocated funding via MLs.

GPs had rallied against the change, arguing services should be decided by demand, not by capped funding pools. Last week they predicted more MLs would freeze ATAPS referrals as demand continued to rise in the fallout of the Better Access cuts.

“We warned of this,” RACGP president Dr Liz Marles said.

“We’re extremely disappointed because part of the justification for cutting Better Access was to channel more money into ATAPS.

“It wasn’t that GPs were necessarily over-referring, but [the Better Access cost blowout] was actually reflecting… the number of patients who do present with mental health concerns. The government’s got a problem because they haven’t really wanted to fund treatment to a level that is needed out there.”

AMA Council of General Practice chair Dr Brian Morton said the strain on ATAPS was the result of the government predetermining service levels for mental health.

“It justifies what we said about GPs managing mental health and, secondly, the danger of relying on capped funding or almost capitated funding in the community,” he said.

“The bottom line is you can’t trust government to adequately fund health care.”

A spokesperson for Mr Butler said the government had injected $206 million to double the size of the ATAPS program and noted GMSBML and GCML were both continuing to take referrals to the program.

As first appeared in Medical Observer, 5 March 2013


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