House of Assembly Fifty-Fifth Parliament, First Session (55-1) 55 1 Parliament of South Australia House of Assembly published Grievance Debate Regional Health Services Regional Health Services Ms PRATT House of Assembly Frome Ms PRATT (Frome) (16:13): In delivering my report card on regional health and mental health for 2024, there is no better case than a current systemic failure taking place on the West Coast. I have spoken at length in this chamber about this government's poor workforce planning, a serious and dangerous lack of effort to incentivise and attract rural GPs, the shameful and unprecedented situation of no midwifery services at Whyalla Hospital for 12 months, GP clinics being reduced to part-time services because local councils on Eyre Peninsula and the local health network cannot agree on terms and, finally, the ultimate disgrace of this year: a rural psychologist who has belled the cat on how ineffective this health minister is when it comes to managing the complexities of regional health services. In the house last sitting week, I tasked the minister to nominate West Coast for an exemption 19(2) under the Health Insurance Act 1973. Now this week he wants to claim credit for it because he declares he has known about it all along—he has known since August, even writing to the federal health minister that same month to make it his problem. It is astounding and offensive to discover that while he claims to have had the answer all along, he ignored three pleading letters sent to him by Dr Amanda Rogers, a rural psychologist and the heroine of my story. For six weeks she wrote letters in between consults with her clients. She wrote to the Premier, she wrote to the federal health minister, she wrote to the state's Chief Psychiatrist and she wrote to mental health peak bodies. She wrote very simply that since June something had changed at the billing level and her clients were suddenly having their Medicare rebates declined if their mental health care plan had been assessed and referred by a locum doctor. Her clients from drought-affected farming communities, which include children, were now starting to cancel their appointments for treatment because they could not afford the full consult fee. Dr Rogers has maintained that this was putting lives at risk, but at no stage did she get a response from the Labor health ministers until she went to the media, and I think that says it all. Questions in parliament, department heads called before a committee, and letters from a respected professional did not extract a response from the government until the media got involved. This is what the government and public servants now have to say. Dr Robyn Lawrence in Budget and Finance last week said, and I quote, 'We shouldn't be providing primary care. We have done everything we can. I don't know there is much more we can do.' She is paid nearly $700,000 to come up with that answer. The Chief Psychiatrist, in response to a letter sent to him, noted: …regarding Medicare rebates being rejected for mental health services, which I found very concerning—a highly qualified practitioner— namely Dr Rogers, and that in that light— …our office will do whatever we can to assist to resolve that. I note that that is the only compassionate recognition of this dire mental health situation that the government or a public servant has offered for an entire peninsula of people. The Eyre Far North Local Health Network CEO, Julie Marron, said when asked if the exemption would include rebates for backdated consult fees, 'It is a federal issue and the people that were affected will have to contact them directly to try to resolve that.' That is a CEO saying that mental health patients who are already experiencing distress and have had their rebates declined would have to fend for themselves up against the federal government. In a rushed letter on Friday after a week of scrutiny by the city media, Minister Butler declared the exemption was approved, and in a letter he sent to the media—but not the treating psychologist, of course—he stated that Medicare Benefits Scheme billing could resume 'once the legislative instrument authorising the 19(2) is published on the Federal Legislation Register'. Who knows what that means? No-one is any clearer as to when this exemption will begin or if it will be applied retrospectively; so far it is just an empty promise. In his hurry to blame the federal government, Minister Picton finally wrote to Dr Amanda Rogers yesterday and explained the problem like this: The EFNLHN— the local health network— has taken over the operation of GP clinics in circumstances where private GPs have left the region and there has been no successor, creating sustained market failure of private GP clinics in these areas. Well, what is he actually doing about it after nearly three years in the role? So where does this leave our heroine, Dr Amanda Rogers? On the phone today she said: What have I actually got to tell my clients? Nothing has changed. They are still cancelling their treatment. The Medicare rebate is still invalid. There has been no direction to practice managers on the EP and the government hasn't informed locums or patients of what is going on. Patients are out of pocket, sometimes up to the amount of $1,400 since June. Dr Amanda Rogers has my respect and admiration for never giving up. She knocked on every door to bring awareness to a systemic failure that threatened lives, and now she waits to learn when this exemption will commence. We both hope it is before the Labor federal government goes into caretaker mode.