Private hospital operator to close 17 out of 20 psychology clinics

ABC NEWS (Australia)

Returning now to the closure of Ramsay Health Care's psychology clinics. The private hospital operator's decision to shut 17 of its 20 psychology clinics by September has sparked concerns about the treatment options left for patients.

Transcript

00:00One of the most important things in mental health care is the therapeutic relationship

00:06between the clinician, in this case the psychologist, and the patient.

00:11And there's obviously going to be massive disruption for thousands of people on that

00:14front.

00:15It's unclear what the pathways to new care will actually be here.

00:23Maybe some of them will continue, maybe through telehealth it seems to be hinted at by Ramsey.

00:29But telehealth is a poor substitute for face-to-face care.

00:33It's often necessary as better than nothing, but it's not ideal.

00:39And of course this disruption puts patients at risk of relapse, of their conditions worsening,

00:46and of course then long delays in getting access to other forms of care.

00:51Ramsey says that this decision reflected in part growing demand for support that is easy

00:58to access and flexible, as well as rising costs, uneven demand, and operational complexities.

01:05What do you make of that?

01:06Well there's no doubt there's been a very big increase in need for care in mental health.

01:13We published a Lancet Commission last year in the teenage and young adult area, the youth

01:18mental health crisis, basically a 50% increase in need for care over the last 15 years.

01:24The federal government is responding to that by emphasizing this in their reform package

01:30in the election.

01:31So there'll be $700 million put into strengthening and building new dimensions to the youth mental

01:38health system, which is very, very welcome.

01:41But this needs to go a lot further, not just for young people, but also for older adults.

01:47There is a strengthening of that too in the election commitments, but these are salary based

01:53models, team based models based on evidence.

01:56And they're going to be available in more outer metro and rural and regional areas.

02:02A lot of the people working in the Ramsey system and the private medicine system, private psychology

02:07system, are located in affluent suburbs.

02:10And so people are really missing out in these other parts of Australia.

02:13So a private model, a subsidised private model won't work for those parts of Australia.

02:18And we need a much more salary based, team based model, which is much better for patients

02:23anyway.

02:24Yeah, well, you've just said there that there is a need for more access to mental health facilities.

02:31We know that there are already significant wait times.

02:34So why would there be a need financially for Ramsey to be closing clinics?

02:41Yes, that's a fantastic question, actually.

02:44The only thing I can think of that might partly explain is they do have to rent premises.

02:49So the cost of the facilities, the cost of reception, and all the things that go with

02:54that might be part of the explanation.

02:57They probably think they can get away with a much cheaper model, which is telehealth.

03:02And it's a devolved model and the responsibility for the kind of fabric is put back onto the

03:07practitioner.

03:08That's the only dimension that I can think of.

03:12But you'd have to ask Ramsey what the commercial drivers were for this decision.

03:16But it seems like a purely commercial decision, which has really not really thought about the

03:21needs of the community or the patients.

03:24What kind of an impact do you expect this could have on the public system?

03:29Well, the sort of patients that see private psychologists, especially in middle class and

03:34affluent areas, are a different population from the people with more serious forms of

03:39mental illness who depend on the public mental health system, which is extremely hard to

03:43access because it's so underfunded and struggling in so many parts of Australia.

03:49So but there would be some overlap.

03:52And if some of these people do have more serious conditions or deteriorate because of this

03:56disruption, they could well find themselves in emergency departments and in the public

04:00mental health system.

04:01But the real likely effect mainly is to add to other waiting lists and to disrupt and cause

04:10a significant impairment in the conditions of these patients, unless it's been thought

04:15through.

04:16Now, maybe Ramsey have got a plan, but I just don't know.

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