WA News Guest Opinion / Editorial Spreading Finite Resources
Spreading Finite Resources
Written by Ms Learne Durrington
Wednesday, 06 December 2017

Dear Editor,

The services we have commissioned are provided by registered and clinical psychologists within a virtual clinic, and are delivered face-to-face, by telephone, or web-based: in all cases treatments are clinician-led. These evidence-based services are already making a significant difference to the lives of some of the most vulnerable people in WA, whose access to appropriate treatment was previously limited or non-existent, due to availability, affordability and/or location.

WAPHA is accountable to the Commonwealth for commissioning psychological intervention services to treat mild to moderate mental illness within primary care across all of WA. As such, this represents the bulk of our investment. This is in addition to the Commonwealth’s Better Access program.

Recognising concerns raised by some GPs, WAPHA has widened the referral criteria, allowing GPs to decide if a patient is financially disadvantaged, rather than the services only being available to Health Care Card holders.

By applying a policy of treating more people earlier, we aim to prevent their illness progressing to the stage where it requires more intensive, prolonged treatment.

We also have a smaller funding allocation to help GPs with time-limited case management of patients with severe illness who have other complex needs. This does not extend to long-term treatment, which is a state responsibility.

Indeed, most severe and complex patients are managed in state-run mental health services. In some cases, this is in shared-care arrangements with GPs, however, in metropolitan Perth, shared-care is the exception rather than the norm.

However, we are aware of a small number of committed and resourceful GPs, such as Dr Ralls, who have developed a range of bespoke funding and other arrangements that allow them to provide long-term care for some severe and/or complex patients, essentially independent of the public system. The cessation of the Commonwealth operated ATAPS and Mental Health Nurse Incentive Program has impacted on the viability of such arrangements.

We acknowledge the subsequent difficulties Dr Ralls and other GPs face in accessing treatment for their patients with severe, complex and persistent mental illness, including problems accessing state-based alternatives. We recognise this important population, albeit small, risks falling through the cracks created by gaps in service delivery.

While Primary Health Networks, of which WAPHA operates all three in WA, have been charged by the Australian Government to reform primary mental health services, our mandate does not extend to long-term treatment, nor can we fund services that substitute for what should be provided for by state services. This includes long-term care of people with severe and persistent disorders.

What we can do is continue to work closely with all parts of the health sector to promote integration, continue to liaise with other health agencies and continue to listen to GPs and advocate on your and your patients’ behalf to improve the system and, ultimately, the lives of even more people.

Learne Durrington, CEO, WAPHA