WA Health Minister backs urgent calls for telehealth item numbers

Anastasia Tsirtsakis

10/03/2020 4:29:21 PM

As suspected coronavirus cases place more demand on GP workflow, the need to expand the MBS item numbers has been called a ‘no brainer’.

Roger Cook
WA Health Minister Roger Cook says flexibility in the form of telehealth is crucial to ensure coronavirus is contained. (Image: AAP)

Western Australia’s Health Minister Roger Cook has backed the call from GPs for the expansion of telehealth to be able to assess patients suspected of having COVID-19 (coronavirus), declaring that equipping the health workforce to meet the needs of the community is of the ‘utmost importance’.
‘Reducing community transmission and keeping all of our medical workforce engaged in all aspects of care for the public will be paramount,’ Minister Cook wrote in a letter addressed to Federal Health Minister Greg Hunt.
The action follows a meeting convened by Minister Cook with WA general practice representatives on Saturday 7 March, where a discussion on the potential impacts of coronavirus revealed the importance of telehealth for the delivery and maintenance of primary health services in the event of community transmission.
Minister Cook went on to write that he is ‘deeply concerned the Commonwealth will not provide the necessary flexibility in an MBS item’.
‘Flexibility is crucial to ensuring telehealth helps to keep patients out of waiting rooms, away from COVID-19 clinics, and allow practitioners to continue to work if they themselves are in self-isolation,’ he wrote.
The Health minister highlighted that the need to expand telehealth is especially important in WA, given it is ‘the most geographically isolated health jurisdiction in the world’.
‘The decisions all governments make now, in these the most challenging of circumstances, will ultimately be remembered by our communities and we do not have the luxury of time to find perfect answers,’ Minister Cook concluded.
On Tuesday 10 March, one day after receiving Minister Cook’s letter, the Minister Hunt confirmed during a joint press conference with Chief Medical Officer Professor Brendan Murphy that the Federal Government is ‘now in the advanced planning and design phase for telehealth items’.
‘We continue to work with the medical community and again we want to thank them,’ Minister Hunt said.
‘If over the summer the firefighters and emergency service workers were our national heroes, over the coming months our medical workforce, our health sector, will be the heroes. We owe them a great deal and our job is to assist and support them.’
Dr Sean Stevens, Chair of RACGP WA , attended the meeting over the weekend. He told newsGP he was impressed with Minister Cook’s swift action on the matter.
‘We’ve been very impressed with the engagement that we’ve had with Minister Cook and his department,’ Dr Stevens said.  
‘They have involved the RACGP and the other primary health players and we’re meeting regularly. His understanding of the need for this item number, and indeed telehealth for all attendance Medicare items, has been brilliant.’
A number of GPs have been calling for the expansion of telehealth for some time, but the Federal Government has been delaying on what Dr Stevens says is ‘needed yesterday’.
‘It is a no brainer to have this, to have telehealth and telephone item numbers on MBS,’ Dr Stevens said.
‘Practices are already setting up private billing for telephone and telehealth consultations. But for many patients, they get bulk billed if they come to the surgery, so they’re refusing to do these sorts of things over the phone. So the workflow on practices and the volume of calls that we’re getting is unmanageable.  
‘But if we can divert people from attending the clinic and actually do this work over the phone, then everyone wins: the patient is kept safe, the public’ is kept safe, the doctors are kept safe, staff are kept safe.
‘I can’t believe that it’s taking so long to get something up and running that should really have been done much earlier in this crisis.’
While an MBS item number for coronavirus is certainly a priority, Dr Stevens said it is a prime example of why it is critical that all attendance item numbers, not just those for GP specialists, be made available.
‘Any medical care that can be provided by telephone or video conference is to be encouraged,’ he said.
‘Our GP patients who are seeing immunologists or oncologists or endocrinologists, they need to be kept safe because these people are often elderly and often at high risk of disease, at high risk of getting sick if they do catch COVID-19.
‘It only makes sense; it’s not going to be any extra money on the health system because these are consultations that would be happening otherwise, but it’s just a public health and safety measure.’
That sentiment was shared in Minister Cook’s letter.
‘To be clear, these are patients who would otherwise be attending in-person for medical assistance. We should not be concerned at how, or from where, this service is provided. Only that it is,’ Minister Cook wrote.
‘Indeed, any medical practitioner should be eligible to claim their usual item numbers by teleconference during the duration of the COVID-19 pandemic.’
Global figures
According to figures published online, there have been more than 114,400 confirmed cases of coronavirus worldwide, and more than 4000 deaths, with the majority reported from mainland China. More than 64,000 people with the virus have since recovered.
At the time of publication on Tuesday 10 March, Australia has had 100 confirmed cases of COVID-19 including three deaths:

  • New South Wales – 54
  • Victoria – 12
  • Queensland – 12
  • South Australia – 6
  • Western Australia – 4
  • Tasmania – 2
Ten cases, including one death, have been associated with the Diamond Princess cruise ship repatriation flight from Japan.
Of the initial reported cases, 15 all had a direct or indirect travel history to Wuhan, China, while 18 cases are reported to have had a direct or indirect travel history to Iran.
Twenty-seven cases are reported to have had a recent travel history; however, another 27 cases, including two deaths, had not travelled abroad, further highlighting the risk of community transmission.
Of the 100 Australian cases reported, 22 are reported to have recovered.
Italy has recorded the second highest number of cases outside of China, with 9172 confirmed cases and 463 deaths. In response to the rapidly rising numbers, the Italian government placed its population of 60 million on lockdown, effective from Tuesday 10 March. 
With NSW now responsible for more than half of the cases in Australia, Dr Catherine Hull from Sydney's Ryde Hospital, who was quarantined after a colleague tested positive, has called for similar measures to be taken across NSW. She has suggested people in the state’s major population centers be quarantined for two weeks.
But Professor Murphy does not think mass quarantine is warranted, given the current low level of community transmission.
‘If we had more sustained community transmission, then we wouldn’t hesitate to make recommendations about public gatherings, schools and the like,’ he said. ‘We only had that one issue of community transition in Ryde.
‘I can imagine how the doctor would feel motivated to do more strenuous measures. But we are reviewing this every single day.’
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