#328 Communications and Advocacy update

29 July

Here’s an update on a few of the issues AMA Victoria is working on for members, including:

Unfair telehealth compliance activities targeted at Victorian general practitioners

AMA Victoria has recently written to the Federal Health Minister requesting that the Commonwealth Department of Health abandons all current compliance activities into COVID-19 telehealth claims by Victorian general practitioners who are alleged to have fallen afoul of the ‘COVID-19 impacted area’ exception to the ‘established relationship’ requirement for telehealth consultations. 

For more background on this requirement and our earlier advocacy in this area, please see: Communications and Advocacy update - 15 April 2021.

In writing to the Federal Minister, we noted that, although this request isn’t made lightly, it is nonetheless necessary due to the blatant unfairness of Victorian GPs being subject to these compliance activities and being asked to repay any ‘incorrect claims’ when there has been a lack of clarity and communication around the ‘established relationship’ telehealth requirement and most specifically, the ‘patients living in a COVID-19 impacted area’ exception to this requirement. 

Noting that the Federal Government defers to the respective State Government on the meaning of ‘COVID-19 impacted area’, we stated to the Minister that it is clear from our dealings with both the Victorian and Federal Governments that they lack agreement, or are themselves unclear or imprecise as to what the definition of ‘COVID-19 impacted area’ actually is. 

For instance, at one point the Victorian Government wrote to us asserting that, “Victoria is currently a COVID-19 impacted area and has been continuously since March 2020”, only for the Federal Government to respond a few days later that this definition could be ‘misinterpreted’ and that, “(The) intent was to explain that Victoria has had restrictions in place since March 2020 due to COVID-19 impacts – these restrictions vary based on a point in time (i.e. lockdowns) or for specific settings (self-isolation or hotel quarantine).”

In this context of confusion and contradiction, we asserted to the Minister that it is manifestly unfair and, indeed, irrational to subject Victorian GPs to any form of compliance activities based on falling afoul of the ‘COVID-19 impacted area’ exception to the ‘established relationship’ requirement.

As a postscript, we did note that the Federal Health Department has very belatedly produced guidance on this issue: MBS COVID-19 telehealth ‘existing relationship’ requirement–Clarification of exemptions (and urged the Minister to distribute this guidance to all GPs), but that this is of little comfort to those who are currently subject to these all-consuming, totally distracting and anxiety-producing compliance activities.

We will update members on the Minister’s response.

Meeting with the Victorian Department of Health to discuss the proposed Mental Health and Wellbeing Act

AMA Victoria recently met with senior officials from the Victorian Department of Health to discuss several concerns we have around the proposed Mental Health and Wellbeing Act.

Please see here for background on this proposed legislation: Communications and Advocacy update - 14 July 2021.

Our overriding sentiment is that the proposed Act does not empower doctors to treat seriously mentally ill patients in the best way possible. This sentiment is equally shared by doctors-in-training, psychiatrists and other specialists.

We take particular objection with the introductions of the terms ‘distress’ and ‘imminent’ in the context of the principles of compulsory assessment and treatment and restrictive interventions, the flawed definition of ‘chemical restraint’ proposed and plans for the greater use of non-psychiatrist clinicians in making assessment orders. 

Furthermore, we conveyed the view that, given the short timeframe given for consultation, if new legislation must be introduced, it should be largely based on the old Act, and that the prime focus of this exercise should be on amending glaring issues with the current legislation. Further, we posited that psychiatrists should be on the drafting committee for the new legislation.

Additionally, we stated that such might be the burdens imposed on psychiatrists by the new Act (via ‘treatment red tape’), that significant levels of workforce attrition may occur.

On a more philosophical level, we argued that the Act needs to better acknowledge that the human rights that we value as a society for everyone are also to be balanced with the rights to treatment and care, at the specific times where a seriously mentally ill individual may not be able to have the capacity to access treatment effectively and that doctors are tasked with the responsibility to provide this care.

We will be clearly conveying this same message to the Victorian Government in our written submission on the proposed Mental Health and Wellbeing Act.

Health and Human Services Climate Change Adaptation Action Plan consultation session

Earlier this week AMA Victoria, along with a range of other interested stakeholders in the healthcare sector, met with the Victorian Department of Health to discuss the draft Health and Human Services Climate Change Adaptation Action Plan. 

The Draft Health and Human Services Climate Change AAP 2022-26 addresses the impacts of climate change and proposes 14 strategic actions that Victoria’s Health and Human Services system can take during the next five years to address current climate change impacts, reduce barriers to adaptation planning and action, and lay the foundations for transformational adaptation.

We expressed our support for actions to secure climate-resilient health infrastructure and expressed our view that such measures provide opportunities to realise health co-benefits through adaptation measures that mitigate emissions and provide many additional social and economic benefits. 

We also raised the possibility of Victoria adopting an equivalent to the UK Greener NHS Program which has a Net Zero strategy and uses a comprehensive carbon footprint mapping strategy looking at both direct and indirect emissions to target their interventions.

In the coming weeks, we will also be providing a written submission to the Department on the draft Health and Human Services Climate Change Adaptation Action Plan.

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