If you’re reading this, then you have probably found my recent petition and want to argue about the definition of ‘suitably qualified practitioner’. Am I right? Well you’re in luck, because this page has been put together just for you to do exactly that on the comment thread below.

But first, I want to say that I absolutely agree with you. All practitioners in the scheme should be suitably qualified with rigorous training in mental health care. And once we have deemed that a mental health professional is competent, then Medicare should provide patients with a fair and consistent amount of support for those services. As it presently stands, Medicare is confusing and inequitable both in terms of gap fees and low rates of bulk billing. On this page we are asking you to imagine a reformed system where there is just one Medicare item called ‘psychological care’ in the Better Access to Mental Health Care scheme.

In a system of that kind, what level of training is adequate for the delivery of psychological services in Medicare? If your view is that the bar should be set higher, then go ahead and make that case in the comment thread below. Or you might believe that the eligibility standards for practitioners we have in place right now are just fine. Either way, I’d like you to take note that your position is not at odds with our policy or my petition.

To get you all started, you might want to think about the following questions about providers of psychological care in the Medicare scheme. In responding to each question, I’d like you to explain WHY you take the position you do. My sample questions are going to point to a higher standard, because personally, I’d like to see a system with better quality care:

1. Qualifications: What level of tertiary education should be required (e.g., Undergraduate, Masters, Doctorate, or PhD)? A case might be made that advanced training in mental health care is needed to work with the population seen in the Medicare scheme.
2. Psychological Assessment: Given that people referred via Medicare have diagnosed mental health conditions, there’s a need for standards of training for providers in testing, assessment, case formulation, and treatment planning. Competency in this space includes both knowledge and real-world applied skill. What should the minimum benchmarks be for that?
3. Evidence-based care: How can we assure that all mental health care practitioners have reached a basic minimum standard of proficiency in an evidence-based treatment approach, with adequate experience working with the type of population seen in Medicare?
4. Research: How do we ensure that providers of psychological care keep up with evidence-based practice unless they can evaluate the current state of research? I think a case can be made for a basic requirement that Medicare practitioners are capable of critically evaluating the current state of evidence. What do you think?
5. Experience: Having sufficient real-world experience of delivering psychological care to people who are living with complex mental health conditions is important. Some practitioners will have demonstrated competency in placements during training, others may have years of supervised experience working in the sector. What should the minimum benchmark be for eligible Medicare practitioners?

It’s not for me to set the criteria for how we define a suitably qualified practitioner. I believe in democratic process and debate, which in this case means the whole sector must address this issue properly together, to get the system right. Not for your professional group, or for your pay, or to justify your chosen training pathway. No, this is about looking after the interests of people who rely on Medicare for support. It’s their rebate and they deserve proper care. 

PLEASE NOTE: This is at times a highly charged topic and comments on this thread are moderated. If you are speaking as a mental health care professional, then please identify yourself by name to maintain ethical standards and professional respect. I would like to keep the discussion positive and focused on how we can improve the Medicare system to benefit the community. You may be asked to support your view. However, elitism and disrespect has no place here. Thanks in advance.