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RACGP: Rural and remote patients left behind by telehealth cuts

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The Royal Australian College of General Practitioners (RACGP) has once again urged the federal Government to make Medicare rebates for longer telehealth phone consultations a permanent fixture of the nation’s telehealth scheme so that patients living outside of major cities can get the care they need when they need it.

It comes following reports of a study released by technology company Phillips, which found that 40 per cent of people living in rural and remote areas had internet speeds that were less than 28 kilobits per second. This makes conducting telehealth video consultations challenging, if not impossible, given that the minimum recommended speed for video calls is 600 kilobits per second. In addition, other people are not confident using the technology or find the cost of purchasing a smart phone or laptop prohibitive.

The latest Medicare Benefits Schedule, which came into effect on 1 July, has removed a patient rebate for GP phone appointments longer than 20 minutes, but kept patient rebates for video calls of the same duration (20-40 minutes) and longer (>40 minutes). *

2.5 million Australians are not using the internet due to issues including access and affordability. It’s estimated that 1 in 4 people in Australia are being “digitally excluded” and unable to properly take advantage of digital technology.

RACGP Vice President Dr Bruce Willett said that rural and remote patients were being left behind.

“Longer phone consults are essential for patients in rural and remote communities,” he said.

“While I am pleased the college has been able to ensure telehealth has been added as a permanent fixture of Medicare, we maintain that scrapping patient rebates for longer phone consults is 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. 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.

“Removing Medicare rebates for longer consults is not only particularly detrimental for patients in the bush but also older patients across Australia, Aboriginal and Torres Strait Islander people, and those with disability or limited mobility. This is troubling as these patient cohorts already have poorer health outcomes than the general population. We are effectively denying healthcare access to those who need it most.

“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.”

To support safe, high-quality care for all Australians, the RACGP firmly believes that phone consultations must be:

  • available for all GP consultation lengths and types
  • valued at the same level as face-to-face and video items
  • linked to a patient’s usual GP, with some exceptions for services provided by GPs with special interests upon usual GP referral.

The RACGP’s submission to the Australian National Audit Office’s (ANAO) audit of the expansion of telehealth services outlines several challenges the new Government must face head on to improve our telehealth system. This includes learning from mistakes made in implementing telehealth services and making longer phone consultations a permanent fixture of Medicare.

Original content from AAP. Note: Content has been edited for style and length.

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