What will happen to Better Access?

With clinical registrations are growing at a rate of 10% a year, and barely any other university courses available, there will be no psychologists other than clinical (medical model) psychologists left in the 10 years time. They may as well rename the APS the ACS (Australian Clinical Society) now.

This phenomenal growth rate will also mean that in five year’s time almost the entire amount of the today’s funding in Better Access will be spent on clinical psychology services.

From July 2015 to June 2016, the total spend on psychological services in Medicare was just over $463 million, with 53% being spent on clinical psychology services alone. In 5 years clinical services are expected to blow out to $407 million. (Dept. Human Services, Medicare data. 2016)

There will be almost nothing left for anyone else unless the government dramatically increases the Better Access funding, which is highly unlikely in the current circumstances. This government is only interested in saving money.

This picture does not include the hundred of thousands of patients who will miss out on psychological services because of the higher rebate! 

We all know that Better Access is the backbone of private practice in Australia, with a huge percentage of the 27,791 registered psychologists employed in small and large practices across Australia. How will they survive if the funding dries up in Better Access all because of the two-tier system?

The original rationalisation for a higher rebate for clinical psychologists was to support their work as mental health specialist psychologists in approved mental health settings, such as acute, community or dedicated public and private mental health facilities.

But that isn’t what’s happening. What is happening is that clinical psychologists are working in private practice doing general work like everyone else and being paid at a higher rate. That’s discrimination and anti-competitive practice.

And it may well be right that any trained psychologist working in an acute care mental health setting should receive a higher rebate – but that work should not be restricted to clinical psychologists only.






3 thoughts on “What will happen to Better Access?

  1. Kay,
    The following information regarding registrant numbers as at 30 June 2016 can be found in the Psychology Board of Australia 2015/16 Annual Report Summary, p.11:

    * Total 2015/16 registrant numbers: 33,907
    * Clinical endorsements held by psychologists: 7,481
    *Total registrants without clinical endorsements: 26,426

    * Total number of endorsements 2015/6: 11,167
    * Endorsements other than clinical: 3,686

    1. Some psychologists hold one or more area-of-practice endorsements.

    Does anyone know the current or most recent number of registered psychologists and clinical psychologists who provide allied health services for Better Access under MBS?

    In May 2008 Prof. Calder reported to the STANDING COMMITTEE ON COMMUNITY AFFAIRS, Mental health services in Australia: “Since the implementation of the Better Access measure there have been 2,185 clinical psychologists registered under MBS for these services and 9,238 registered psychologists also.”

  2. Thanks Kay. Would somebody please provide an answer to Kay’s query, “Can we challenge the validity of the changes if we can’t find out if [when] a vote of all psychologists changed this part of the APS charter?”
    Note that those new to Reform APSm or those who are undecided how to move this issues along, need an answer to this in order to make an informed choice. As a long term APS member since Year 1999, my recollection is that I for one was **never **polled and I never lodged a vote for the APS to award the clinical psychologist faction /college the privileged role they now occupy in the two tiered and medically dominated system. In fact through my long career of 30 plus years in private and university work, I have always urged my representative associations (APS and its counterpart APA in America) to represent **all psychologists in private practice**. (this term includes include all major traditions including counselling, health, psychodynamic, humanistic/gestalt, not just the clinical group). Basically we have a serious anti-competitive situation now and one that discriminates against Generalists (and hence consumers) in the Mental Health industry. If you are a generalist (non-clinical college practitioner) and have not voted or contributed to RAPS, pleae do so now. Send a message, take back your voice in APS governance!

  3. When I joined the APS in 1988 after being a student member for 3 years. I signed the oath that said that I had to behave in a gentlemanly manner and I was to abide by the rule that no psychologist claimed to be better than any other psychologist. My question is:
    How did the APS change the constitution about equality of psychologists when it made clinical psychologists mini-psychiatrists?
    Can we challenge the validity of the changes if we can’t find out if a vote of all psychologists changed this part of the APS charter?
    By the way, I jumped ship from the APS a decade ago to join the Australian College of Clinical Psychologists [ ACCP, a clinical group registered in Canberra long before the APS was registered in Australia] that the APS put out of business by saying that they had the rights to the word clinical. They are very quick to move to litigation. I think the only way to move forwards is for so called generalist psychologists left the APS, but that’s a personal view.
    What is the ratio clinical/generalist?

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