GPs rubbish psychiatrist’s mental health claims

4 minute read

Professor Ian Hickie has accused GPs of coordinating an industrial campaign to end bulk billing.

University of Sydney Brain and Mind Centre co-director Professor Ian Hickie has caused a social media storm this week, after GPs stepped in to correct his claims that there is not enough mental healthcare in primary health.

The one-time Beyond Blue CEO published an article in Insight+ several weeks ago citing Medicare claims data that indicated that only a third of GP mental health care plans were reviewed.

Associate Professor Louise Stone, a GP with special interest in mental health, was quick to correct Professor Hickie, pointing out that GPs do mental health consults multiple times per day but can’t always reflect that in their billing practices.

Professor Stone and colleagues have since co-authored their own Insight+ article in response.

The psychiatrist, meanwhile, has not walked back his comments.

Instead, he doubled down by suggesting that GPs who are bringing up the relatively low remuneration for mental health consults are taking part in coordinated industrial action for financial gain.

RACGP president Adjunct Professor Karen Price told The Medical Republic that Professor Hickie’s comments were “disappointing”.

“His recent aggressive comments about GPs are deeply concerning and reflect his own biases and lack of understanding about general practice, and I hope in future that he is open to engaging in a professional manner with general practice, as the cornerstone of our health system and integral to Australian mental health care,” she said.

Others have pointed out that Professor Hickie is an equity shareholder in digital mental healthcare platform Innowell and has been on various government committees over the years.

“Professor Hickie is clearly pushing his own agenda while he is advising the government’s review of the Better Access Scheme for mental health,” Professor Price said.

In yet more tweets, Professor Hickie implied that the Strengthening Medicare Taskforce was set up as a result of “organised industry-wide action” and blamed GPs who don’t bulk bill for blocking access to healthcare for low-income patients.

AMA vice president Dr Danielle McMullen, who is also chair of the AMA mental health committee, said the association recognised that GPs provided the bulk of mental healthcare in the community.

“Even with private billing, GPs are still frontline and the cornerstone of our primary healthcare system and generally accessible,” she told TMR.

“As GPs, we do our best to try and minimise out-of-pocket costs for vulnerable patients, but even with the costs that they face at the moment, it still remains the most accessible part of the mental health system.”

Many more on social media have pointed out that, even though it’s getting tough to find a bulk billing GP, it’s even tougher to find a bulk billing psychiatrist. 

Professor Stone, who has arguably been the loudest voice defending GP mental health care, said general practice cost only 2% of the national mental health budget despite handling the most patients.

“On average, we ask patients to pay $9 out of pocket per year for their mental health, compared to psychiatrists with $313 per patient and psychologists with about $170,” she told TMR.

“I’m not sure we are the problem with accessibility and affordability.”

Yesterday, in his second interview in as many days with Australian Doctor, he said “The age of generalism, of non-specific payments for GPs to do something unspecified, is dead.”

5pm update: Professor Hickie responded after deadline to TMR’s requests for comment, saying he stands by his comments. We will publish an interview tomorrow.

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