Medicare should fund general practice psychologists

The GPs involved in the collaborations seem to be generally well satisfied with the system and do not see it as stealing their income. Nevertheless, continued funding is far from secure.

At present only a minority of GPs can access these services. Detailed costing has not been done, and should be, but those responsible for Medicare may wish to check it out as an example that health service providers other than doctors can be reimbursed for care without cost blowouts and with good clinical results.

Beyond concerns with money, the trials also address a health workforce problem. Psychiatrists are a scarce commodity in unrelenting demand. Rural patients find it difficult to access psychiatric services located primarily in urban areas. Psychologists are more widely dispersed and numerous. There are at least 5000 psychologists in Australia with sufficient clinical expertise to function as mental health specialists and who could provide the style of non-pharmacological interventions that many persons with less severe disorders both need and seek.

The debate about the extension of Medicare to other health professionals is one that must be joined. In the US and Britain, primary care psychology is established as a mental health specialty in which clinical and health psychologists provide collaborative care with GPs and physicians.

The trials of similar services in Australian general practice described here suggest that this model might well be developed across Australia to good effect.

For patients with other serious and continuing illness such as heart failure, these trials give hope that better care can be provided to people in need without the different health professions sharpening their swords and going into battle over turf.