Letters
Health services administration General medicine Mental health
Volume 197 - Issue 11

Better Outcomes or Better Access — which was better for mental health care?

Authors:  Sebastian P Rosenberg and Ian B Hickie

Med J Aust 2012; 197 (11): 619-620. || doi: 10.5694/mja12.11247
Published online: 10 December 2012
To the Editor: Harrison and colleagues present data which confirm that inequitable distribution of mental health care is increasing under the Better Access program.1 They discount our promotion of the central role of general practitioners in the more restricted Better Outcomes program2 and our advocacy for GPs to resume those key activities despite lack of support under the Better Access program.3 The fatal decision that accompanied ...
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To the Editor: Harrison and colleagues present data which confirm that inequitable distribution of mental health care is increasing under the Better Access program.1 They discount our promotion of the central role of general practitioners in the more restricted Better Outcomes program2 and our advocacy for GPs to resume those key activities despite lack of support under the Better Access program.3

The fatal decision that accompanied the transition to Better Access was to remove the GP payment for managing a completed episode of care. In response to GP advocacy, it was replaced with an enhanced payment for a one-off management plan and referral to an allied health practitioner (“glorified referrers”).

A progress report on the National Action Plan for Mental Health 2006–2011 shows that, from 1997 to 2007 (as reported by consumers), visits to GPs only for mental health care fell (14% to 10% of services) while visits to mental health professionals rose (12% to 22%).4 Since November 2006, GPs have written almost 3.8 million Mental Health Treatment Plans, but only 1.4 million of these have been reviewed.5 Consequently, the downgrading of payment for making these plans was inevitable.

The Better Access program is still booming, costing over $50 million per month. If these increases in Medicare-driven patterns continue, the community is entitled to ask: (i) who is centrally responsible for coordinating and managing these common episodes of mental health care? and (ii) who cares about the increasing inequities in service provision?

Authors

  • Sebastian P Rosenberg1
  • Ian B Hickie1
  • 1. Brain and Mind Research Institute, University of Sydney, Sydney, NSW.

Correspondence: sebastian.rosenberg@sydney.edu.au

Competing interests

No relevant disclosures.

References

View this article on Wiley Online Library

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