Concern over two-tier system as Bupa plans mental health clinics

Bupa has announced that it will be expanding its health service offering, with plans to open 60 dedicated mental health clinics by 2027.
 
The first Mindplace clinic is slated to open this month and, according to the private health insurer, will be followed by an additional nine clinics by the end of the year, offering both in-person and telehealth consultations.
 
Bupa’s Asia Pacific CEO Nick Stone said it is ‘a critical time’ for private providers to work with Government and public providers to meet the escalating demand for mental health care.
 
‘By launching an extensive network of Mindplace mental health clinics, Bupa intends to play a pivotal role in meeting the ballooning demand for mental health support in our community,’ he said.
 
‘Our ambition is to work in partnership with the services already provided by the public system to ensure all Australians can access the mental health support they need.
 
‘Declining levels of mental health and difficulties accessing care are amongst the most pressing health challenges of our time, so the time is right for us to offer complementary in-person and virtual services, to help provide Australians with more choice in how they manage their mental wellbeing.’
 
But Dr Cathy Andronis, Chair of RACGP Specific Interests Psychological Medicine, is concerned the move only further widens the divide between those who can and can’t afford access to care.
 
‘Bupa’s move into mental healthcare is a reflection of a mental health crisis in Australia, and around the world, especially for younger people. It is acknowledgment of the cost of poor mental health to the individual as well as to the wider society,’ she told newsGP.
 
‘Social determinants are the main cause of mental illness and the increasing corporatisation of our economy with the emphasis on consumption, consumerism and capitalism is likely to be detrimental in the longer term.’
 
Data shows two in five Australians will experience a mental health disorder in their lifetime, and one in five in the next 12 months.
 
However, cost continues to be a major barrier to care, with 19.3% of people reporting that they delayed seeking mental health support in 2022–23 due to cost – up from 12% in 2020–21.
 
Dr Rashmi Sharma, Chair of the RACGP Expert Committee – Funding and Health System Reform, also raised concerns about the affordability of the care being offered.
 
‘This sounds like it will be a private system similar to the majority of psychological services offered now, but under a Bupa banner, and so there will be a financial implication for patients with likely out-of-pocket costs,’ she told newsGP.
 
‘It’s important patients are able to access affordable high-quality mental health care. That’s why we’ve called for a 25% increase to Medicare rebates for GP mental health MBS items.’
 
A Bupa spokesperson told newsGP that the consult fee to see a clinical psychologist at one of their Mindful centres will cost $245, and that those with an eligible health insurance policy can claim against their extras.
 
‘Out-of-pocket costs will differ from policy to policy,’ they said.
 
Bupa has said its mental health service will be open to all Australians, including members and non-members. 
 
The clinics will expand the insurer’s primary care footprint, which currently includes more than 20 medical centres offering GP and allied healthcare services, three of which operate as urgent care clinics, as well as telehealth and integrated chemist delivery services.
 
Over the coming year, additional medical centres are on the cards.
 
Dr Sharma says while the college supports efforts to ensure people have access to mental health care, it is vital services facilitated by private health insurers ‘integrate with, and augment, GP-led care’.
 
‘Services already being provided by a patient’s usual GP, such as mental health care, including focused psychological support, should not be duplicated by private health insurers, as this will lead to fragmentation and inefficient use of health resources,’ she said.
 
Dr Andronis holds similar concerns about the potential for fragmented care. She says when it comes to addressing mental health issues, ‘the evidence is clear’. 
 
‘Access to a known trusted and holistic GP providing longitudinal care is the best way for patients to access the individualised care and services that they need, while simultaneously becoming more empowered and therefore more resistant to mental health illnesses,’ Dr Andronis said.
 
According to Bupa, it is aiming to gradually expand its Mindplace clinics network with an ambition to ‘work in partnership with the services already provided by the broader general practice and primary care services’.
 
‘GPs are the backbone of our health system and would play a vital role in the ongoing management of any patients accessing the mental health clinics. This would not differ from the management or referral process you would find in any other GP clinic,’ a spokesperson said.
 
‘Continuity of care between GPs and psychologists is crucial for effective mental health care, ensuring patients receive coordinated and consistent support throughout their treatment journey. This involves clear communication, shared reporting, and a collaborative approach between both professionals.
 
‘This involves sharing of relevant medical records as is normal practice within the Australian healthcare industry.’
 
However, Dr Sharma says private health insurers like Bupa, who are looking to expand into the primary care landscape, should be placing greater emphasis on collaborating with both the sector and patient groups to evaluate current programs and identify opportunities for improved service delivery.
 
‘It is essential that Bupa liaises with the RACGP along the way, as we don’t want to see duplicated funding and services that make healthcare more confusing and fragmented for patients, as well as the development of a two-tiered health system,’ she said.
 
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Bupa continuity of care fragmented care Medicare mental health private health insurance telehealth