The Victorian government is making moves that will allow specialist general practitioners (GPs) to diagnose and treat people dealing with attention deficit hyperactivity disorder (ADHD).
This comes after New South Wales, Western Australia, South Australia and Queensland made similar moves. The governments of Tasmania and the Australian Capital Territory have also committed to reforming ADHD care.
It has traditionally been difficult for ADHD patients to get quality care in Victoria. Parents are forced to wait months to get an appointment with a specialist for their children, while adults pay thousands of dollars for private assessments. The issue is magnified in rural areas.
However, the Victorian government is working reforms that would make things easier for its people, and it would herald a new era of ADHD care delivery across the state.
The move has been endorsed by the Royal Australian College of GPs (RACGP). They have been calling for reforms that will improve access to specialist GPs who can deliver high-quality care to ADHD patients in Victoria.
The RACGP estimates that up to 163,000 Victorian children and 320,000 adults may be living with ADHD. Many of them have struggled to access proper diagnosis and treatment.
People in rural or lower-income areas are affected more than anyone else, as most of them cannot afford the cost of getting help, let alone the travel required.
The situation has discouraged many people from getting proper diagnosis or treatment. But without proper answers, daily life can become more stressful for both children and adults.
The RACGP’s Dr Anita Munoz believes part of the issue has been that specially trained GPs have not been allowed to do as much as they are capable of doing.
The Promise & Limits of Telehealth
At the same time as announcing these reforms, the Victorian Government revealed plans for the Victorian Virtual Emergency Department (VVED) to provide prescriptions for ADHD medication through telehealth consultations.
The service was initially designed to manage urgent but non-life-threatening medical issues through video consultations. It clearly states that it does not handle routine prescription refills.
However, the new government plan could allow patients to receive up to six months’ worth of stimulant medication for ADHD without a face-to-face meeting with their usual GP or psychiatrist.
This decision surprised the RACGP and the Royal Australian and New Zealand College of Psychiatrists (RANZCP). They have since called for the government to urgently discuss the changes with them.
Their concern is not necessarily about telehealth in general. There are many reputable telehealth providers, as seen in Medicompare, that offer structured ADHD assessments and follow-up care for patients.
However, there are concerns that the policy will reshape competition in the telehealth market.
Doctors, specialists and other medical professionals are under no illusion about the importance of virtual care, particularly for people in remote areas.
However, they are concerned about how stimulant ADHD medications will be managed safely under this new system, considering that they’re tightly regulated and require careful monitoring.
Mixed Messages & Missed Consultations
Medical leaders were particularly disappointed that the telehealth prescribing plan was announced so soon after a public commitment to work together on ADHD reform.
Less than 24 hours after speaking about a careful and measured approach, the government introduced another major policy change without first getting the input of the colleges.
The plan to allow patients to receive up to six months’ worth of prescriptions for ADHD hasn’t gone down well across all quarters.
The snub in decision-making felt like a step backwards for medical professionals on the frontline and left many of them disappointed. There is an agreement that people are struggling to get quality ADHD care in Victoria.
Medical professionals have acknowledged the frustration of patients who have to wait hours or travel long distances to receive treatment.
However, they argue that the solution is not to bypass doctors who treat these patients, but to build a strong care model in partnership with GPs, psychiatrists and paediatricians.
