Tammy Tyrrell (Tasmania, Jacqui Lambie Network) Share this | Hansard source

One of the good things to come out of COVID was telehealth. Telehealth has been a game changer for Tasmanians. You used to hear stories about people driving hours to get an appointment, meaning they had to miss a day or so of work—not to mention getting on a plane and travelling to Melbourne or Sydney with a sick kid just for a one-hour doctor's appointment. Now people can talk to specialists from the comfort of their home, and get a treatment plan carried out by doctors in Tassie. It costs an arm and a leg to see a specialist, but you can usually count on the Medicare rebate to take the sting out of it.

That could be about to change. The Medicare Benefits Schedule Review Advisory Committee recently recommended axing Medicare rebates for initial consults with a specialist via telehealth. If it's a specialist you've seen before, that's fine; but if it's the first time you're seeing a +specialist, the committee is saying you shouldn't get a rebate. This doesn't just apply to a cardiologist or an orthopaedic surgeon; it applies to an appointment with a psychiatrist too. Getting rid of these Medicare rebates will disproportionately affect Tasmanians. People in inner-city Melbourne, Sydney and Canberra with access to specialists will be fine, but Tasmanians don't have the same access to health care that mainlanders do. In Tasmania you can be waiting months or years for an appointment with a specialist.

Last year, Tasmanians were twice as likely as their mainland counterparts to claim the Medicare rebate for an initial psychiatry appointment via telehealth. We rely on telehealth to see a psychiatrist more than people in any other state or territory. The majority of people who need it most are young, and most are young women. One of my constituents was in this boat. She needed an appointment with a psychiatrist for a potential medical diagnosis. She was initially referred to a psychiatrist in Tasmania but was told there was a 12-month waiting list. She got a second referral to access a psychiatrist on the mainland via telehealth and had an appointment—and, importantly, a diagnosis—within three weeks. A Tassie girl can't get an appointment at home but she can get one in Sydney via telehealth. That's sad. But here's the kicker: the telehealth appointment had cost the young woman almost $1,000 up-front. She got just under half of that back from Medicare.

For most people in Tassie, paying that kind of money up-front is unthinkable. Some people are never going to be able to pay that—they just won't go to the appointment. Some people might be able to borrow a few hundred dollars here or there, knowing they can pay the money back once the rebate comes in. But these people now face a difficult choice of paying a grand to get an appointment in three weeks, with no rebate, or waiting 12 months to see a specialist in Tassie and get some of that cash back. I think that's bloody wrong.

By the time you go to a specialist you're already in the thick of it. You need help and you need it quickly. If we get rid of Medicare rebates for these initial telehealth consults then we're telling people that you can only get immediate help if you can afford it. If you can stump up a grand to see someone in three weeks, great. If you can't, you sit on the waiting list for a face-to-face appointment and hope that nothing bad happens in that time. Access to health care shouldn't depend on your bank account balance. The fact that it costs a grand to see a specialist is a whole other problem that I'm not even going to get into today.

Getting rid of Medicare rebates for initial appointments via telehealth will put help even further out of reach for everyday Tasmanians. Right now this is just a recommendation and it's not set in stone. I get that not everything can be done on telehealth. If you've got a weird rash on your arm, it's a bit hard for a doctor to see what's going on through a bad internet connection. But we're not talking about weird rashes. We're talking about things like psychiatrist appointments for acute mental health problems. If you're depressed, or even suicidal, and you summon the energy to book an appointment with someone that can help, that's something we should be patting you on the back for. But if you're in Tasmania and you're told to wait 12 months, that's a lifetime away and that could be a death sentence. Don't make that harder. Don't make it further out of reach. The ones who need it the most are the ones who can afford it the least. They deserve help as much as any wealthy Sydneysider does.