The DoHAC has committed to putting its weight behind nationally consistent prescribing laws on ADHD medications … but not much else.
The RACGP was one of the only professional bodies welcoming any aspect of the federal government response to the ADHD Senate Inquiry, after the Department of Health and Aged Care elected to support just one of 15 recommendations.
That lone supported recommendation was that the Commonwealth use the Ministerial Council on Health – i.e. the Health Ministers’ Meeting – to expedite the development of uniform prescribing rules to ensure consistency between state and territory jurisdictions.
In the body of its response, DoHAC noted that the Poisons Standard is implemented by individual state or territory governments and that the Commonwealth is technically unable to force a standard for prescribing arrangements across the country.
All its support for the recommendation means is that it will “commit to raising this issue through a Health Ministers’ Meeting for its consideration”.
To be clear, the recommendation is just to make prescribing laws consistent; there is no explicit support for GP-led prescribing of ADHD medications, just for cross-border consistency.
“Enabling GPs across Australia to better support people living with ADHD will increase access to assessment and treatment, improve the health and wellbeing of patients, as well as reducing wait times and costs, and easing pressure elsewhere in the health system,” RACGP president Dr Michael Wright said.
Currently, GPs can change doses of and co-prescribe stimulant medicines for ADHD with a non-GP specialist in every state bar WA but can only change drugs in the NT, SA and Tasmania.
There are also different maximum periods for specialist review and different rules around real-time drug monitoring.
Dr Wright said he had heard of patients waiting for months and paying hundreds of dollars out of pocket to confirm their ADHD diagnosis with a psychiatrist.
“And then [the time and cost of] having to go back to see a psychiatrist for scripts that could be easily and safely prescribed by their GP,” he said.
“This reduction in regulation is important to allow patients to easily access care that they need – with a GP who knows them at their local general practice.”
Of the other 14 recommendations, nine were supported in principle and five were just “noted”.
Among the supported-in-principle group were reviewing MBS items with a view to improving accessibility of assessment and support services for ADHD, co-designing a national framework for the condition and developing pathways for healthcare professionals like GPs to assess ADHD under the banner of the scope of practice review.
According to the government, the reviewing of MBS items related to ADHD are already adequately covered by MRAC and the MBS Continuous Review.
In its response to the scope of practice recommendation, DoHAC said the final report from that review had “found that virtually all health professions in the primary care sector face some restrictions or barriers to working to their full scope of practice, that are unrelated to their education” but did not commit to any specific action.
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The recommendations which were simply “noted” included that DoHAC improve specialised health services in institutionalised settings and that the Department of Social Services provide ongoing funding for disability advocacy organisations.
The Senate Community Affairs References Committee on assessment and support services for people with ADHD was proposed by Greens senator Jordan Steele-John and delivered its final report over one year ago.
Mr Steele-John called the delayed response “unacceptable” and said it was not reflective of “the urgency of the situation, nor commit to the scale of changes needed”.
The Australasian ADHD Professionals Association, a cross-disciplinary group representing all professionals working in ADHD, labelled the government response a “slap in the face”.
“After waiting for over a year for a response, it’s incredible that there is just one recommendation that the Government feels is worthy of support,” association president Professor David Coghill said.
“I think that is hugely disrespectful to all of the people who shared their advice, insights and experiences”
The Australian Association of Psychologists were similarly damning of the response, calling it “a glaring failure to prioritise the mental health needs of Australians”.
It called for GPs to be allowed to prescribe ADHD medications as well as the introduction of a dedicated MBS item for ADHD assessments and higher Medicare rebates for psychologists.
