The Australian Medical Association and Royal Australian College of General Practitioners have called for the urgent reinstatement of cancelled COVID telehealth items.
The latest Medicare Benefits Schedule, which came into effect on 1 July, removed patient rebates for GP phone appointments longer than 20 minutes, but kept them for video calls of the same duration (20–40 minutes) and longer (>40 minutes).
In letters to the new federal Health Minister, Mark Butler, the AMA and RACGP implored the Government to immediately reverse the decision to let the telehealth items lapse, saying the telephone is a safe and effective means of delivering essential care to all Australians, especially during the worsening pandemic.
AMA President, Dr Omar Khorshid said the item for telephone consults longer than 20 minutes with a GP – a key part of the Government’s ‘Living with Covid’ strategy – was critical and must be restored.
“These changes undermine the ability of patients to access their doctors, in particular for GPs to prescribe antivirals for COVID-positive patients and will lead to costs elsewhere in the health system, including in overstretched hospitals,” Dr Khorshid said.
“Prescribing antivirals is time-consuming, requiring a GP to consider complex eligibility requirements, contraindications and drug interactions and then arrange for patients to obtain the medication while isolating – even simple cases take thirty minutes to an hour to properly complete.
“This decision means telephone access to doctors will be significantly limited, hitting vulnerable patients hardest, including those who do not have access to high bandwidth internet and those who can’t operate the necessary IT systems.”
RACGP president, Professor Karen Price, said given the growing number of COVID cases and the unknown impacts of long COVID going forward, enabling access to longer telephone consultations was vital.
“GPs have told the RACGP the removal of Medicare patient rebates for longer phone consultations has reduced access to care and increased health gaps for vulnerable patients,” Professor Price said.
“This includes rural communities, Aboriginal and Torres Strait Islander people, older people, people with disability and mental health concerns, many of whom already have poorer health outcomes than the general population.
“The RACGP firmly believes all Australians deserve access to high quality care. And for this to happen telehealth should be available for all GP consultation types and lengths, with video and telephone items valued equally – nobody should be disadvantaged due to their circumstances.”
The AMA and RACGP have also called on the federal Government to make rebates for longer phone consultations a permanent fixture of the nation’s telehealth scheme, following the release of a new study by the tech company Phillips, which found that 40% of people living in rural and remote Australia had internet speeds that were less than 28 kilobits per second.
Given that the minimum recommended speed for video calls is 600 kilobits per second, this makes conducting telehealth video consultations challenging, if not impossible – not to mention the fact that some 2.5 million Australians are excluded from using the internet due to issues including access and affordability.
RACGP Vice President Dr Bruce Willett said that scrapping patient rebates for longer phone consults was a backward step for patient care that will disproportionately affect people in the bush.
“Put yourself in the shoes of a patient in a small town with multiple health conditions, such as asthma and diabetes, who has to drive a long way to see a GP face-to-face and isn’t comfortable using video technology platforms,” he said.
“For that patient, a longer phone consult is just what the doctor ordered, but unless the recent telehealth cuts are reversed, they are left out in the cold…
“The RACGP will continue fighting for longer phone consults to be a permanent fixture of telehealth because no patient should be left behind. We also want to see Medicare phone items for chronic disease management and mental health services reinstated as part of the permanent telehealth model.”