The missing “evidence” that demands an inquiry

The increasingly desperate efforts by the APS to deny the evidence that it only ever advocated for one Medicare rebate for the relatively small cohort of its members with clinical psychology qualifications – a fact revealed in the APS submissions to government in 2006 obtained under Freedom of Information legislation – seem to be taking us ever deeper into fantasy land.

Now we are told by our highly paid Executive Director via APS Matters that “Abbott had already made up his mind before the APS submissions were made.”

We can’t help but regard that as an insult to members’ intelligence.

A colleague who attended a function which Abbott attended (well before he became Prime Minister) tells us the exact opposite. At this function, Abbott was asked directly how he had formed the opinion that clinical psychologists were the best providers of mental health care. According to this witness, Abbott replied that he had relied on the advice of the APS.

Abbott expounded further that as a minister making such decisions he was forced to rely on the information provided by peak organisations like the APS for guidance.

That story echoes the experience of lobbyists and others who routinely work with ministers and their staff. Politicians  typically have a background in law – or in Abbott’s case journalism – rather than anything even remotely relevant to mental health. They seek out and rely on advice from the principal organisations in the area. The suggestion that Abbott made a unilateral decision affecting psychologists without a thorough briefing from the APS is beyond laughable. Politicians simply don’t buy unnecessary fights with bodies like the APS.

And the logic doesn’t add up:

  •  If Abbott decreed prior to May 2006 that clinical psychologists were the gold standard of psychological expertise, alone worthy of a higher rebate than their colleagues, there would be documentation. You’d expect it to be in the APS files as well as departmental files and it too would be retrievable via FOI. Where is it?
  • And even if one blindly accepts the Littlefield hypothesis, and Abbott had made such an extraordinary decree, why did Littlefield  fail to challenge the ministerial view? Peak bodies like the APS have a responsibility to their members, their profession/business and the public. They have the sort of public influence which politicians take very seriously indeed. The suggestion that any peak body worth its salt would meekly accept a ministerial or bureaucratic decree just doesn’t wash.
  • And if this hypothetical decree from Minister Abbott exists, then where is the response from the APS? Where are the APS submissions arguing for a generalist tier, or for that matter any other tier than the one for the APS College of Clinical Psychologists?

How can members regard Littlefield’s lame accusation that members are yet again being “misinformed” as anything other than misdirection and blame-shifting? The scenario that Littlefield advances is simply not plausible.

With every dubious “explanation” that the current board deploys to stack the vote in favour of the governance review, the case against the APS and its leaders grows ever more compelling. They have let the bulk of their members down. They have let the profession down. They have let the public down.

Members are entitled to ask why, in the 10 years since we are assured Minister Abbott suddenly appointed himself as the sole, unquestioned authority on the practice of psychology, the APS has not once ventured to correct what is a policy failure and an intolerable abuse to the stature and reputation of the majority of its members.

There are wider issues of professional responsibility and social justice here too, in that a body like the APS should keep in mind the human suffering caused by bad policy and the compounded financial disadvantage which is inflicted on vulnerable and distressed patients who receive less from Medicare to support their access to care.

While everyone goes looking for a letter from Abbott prior to May 2006, or argues about why the APS can’t show you due to political sensitivities, those vulnerable people in our society are abandoned in a state of neglect due to bad policy which remains unchallenged.

What we need to contemplate now is a rigorous inquiry into the conduct of the APS. We can see how members have been misinformed. The even bigger question is this: was the government misinformed? And as a result, was the taxpayer fleeced?

 

4 thoughts on “The missing “evidence” that demands an inquiry

  1. Isn’t it time Four Corners investigated this whole fiasco? Taxpayers and “Generalists” have clearly been fleeced since 2006 with this Dual Medicare Rebate? If government funds are being used to pay some psychologists 47% more for doing the same work, then clearly things need to be investigated sooner than later. If not Four Corners, then at least the Fair Work Commission.

  2. I know ( because I was present at National Branch Chair meetings) that the APS leadership suggested, prior to Mr Abbott, that they push for clinical psychologists to be approved for Medicare rebates and their argument was that it would open the door for all other psychologists later. The foot in the door approach. The membership (via the Branch Chairs) did not approve of that suggested policy approach. In my opinion, it is most likely the APS leadership then began to operate without transparency to push the agenda of clinical psychologists as ultimately the only psychologists left standing.
    It was consistent with the then objective for the APS to raise the profile and incomes of psychologists. In my view they have attempted to do that by creating an elite group. The ultimate agenda must be to have a reduced number of psychologists so that their incomes are high. In the same way psychiatrists can charge high rates because they are in demand and they are small in number or an elite. John Ralston Saul discusses this kind of approach in his book Voltaire’s Bastards. That is, a society where specialisation is promoted and communication is devalued. Jargon is developed which obstructs communication. Rigorous training in the use of professional jargon is required. Ring any bells? Psychiatrist Iain McGilchrist does an excellent job of explaining the half brained approach to education that technocrats prefer in his book The Master and his Emissary.
    While it is important we stand up and call out the lack of evidence for the policy decisions which have led to the current situation, we should also understand this phenomena in a critical analytical manner.
    That is, we need to understand the real agenda.
    It is not enough to call out injustice.
    Directors on the APS Board were charged with raising the professional profile and incomes of psychologists.
    They have done that.
    There is a benefit in the goal they had of psychologists who are nor clinical becoming redundant sooner rather than later. The benefit is that psychologists will be almost the elite equivalent of psychiatrists.

  3. Doesn’t Professor Littlefield have a wonderful memory for events 10 years ago? It seems unbelievable to me that a man like Abbot would have given a moment’s thought to mental health so that he would have been open to persuasion by an authoritative viewpoint from the APS. Or then again, maybe he was.

  4. Do you want a retired lawyer to assist RAPS. He is my brother.He said he will help anyway he can. Merran Brown. 

    Sent from my SAMSUNG Galaxy S7 edge on the Telstra Mobile Network

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