.png)
March is whizzing by. So far this month, we have:
- Attended national framework reference group meetings to develop the guidelines and roadmap for assessing children's functional strengths and support needs inside and outside the NDIS.
- Met with iCare to discuss psychology services provided to injured workers in NSW. They have welcomed our feedback and are taking steps to remedy the issues we raised.
- Held collaborative meetings with allied health peak bodies and consumer groups.
- Participated in Government digital health working groups.
- Attended state revenue office meetings regarding payroll tax.
- Met with psychology resources providers to expand our member benefits.
- Attended the Plus Paternal Network meeting to advance fathers' and men's mental health.
- Achieved another successful clinical endorsement based on substantial equivalence for an AAPi member. Our resources on substantial equivalence are available here.
- Worked with international organisations on climate change initiatives.
- Connected with more universities to advocate for students and future psychologists.
- Finalised submissions for the review into Experiences of Children and Young People with Disability in Educational Settings, the NDIS pricing review, and the Scope of Practice Review.
On the Scope of Practice Review, AAPi's key messages from this round of consultation focused on ending the two-tier system. The two-tier system has permeated many separate funding schemes and the public sector. It has profoundly and negatively impacted psychology in Australia and is attributed to the false assumption that psychologists without clinical endorsement have lower qualifications and competencies.
The two-tier system has resulted in:
- Lower Medicare rebates for most psychologists have increased out-of-pocket client expenses and lowered psychologist remuneration. It is well documented that high out-of-pocket healthcare costs result in access barriers. This is particularly concerning for socio-economically disadvantaged people with higher healthcare needs. The current cost of living crisis has further compounded this. With MBS data, we can detail how much this egregious decision has cost the clients of Australian psychologists - in the 2022 financial year alone, the two-tier system has resulted in almost $150 million in lower rebates for the most claimed items. What is more challenging to quantify is the clients who missed out on the care they needed altogether due to the cost-prohibitive nature of an inadequately funded Better Access program.
- The two-tier system has been interpreted as a message of value/worth, perpetuating a myth that psychologists without clinical endorsement are less qualified despite many having undertaken equivalent, or more, years of study, and has created an artificial hierarchy.
- Psychologists without clinical endorsement provide more services to rural and remote clients. The two-tier system disproportionally affects those most in need.
- Other funding schemes have followed the two-tier system, creating workforce and access issues.
- Recent research has demonstrated that the two-tier system has resulted in disengagement and reduced motivation to provide supervision, exacerbating workforce shortages and future pipeline issues, particularly in rural and remote regions.
- There has been a marked reduction in non-clinical psychology training programs and non-clinical psychology graduates. Courses continue to close in all psychology areas except clinical psychology postgraduate programs. Without urgent intervention, we face losing many areas of psychological practice and further exacerbating workforce issues.
- The public sector preferences or exclusively employs limited area of practice endorsements. This exacerbates workforce issues, with psychology positions often filled by other professions and reduces career prospects for qualified and experienced psychologists.
- Numerous inquiries, groups and evaluation reports have urged the review of the two-tier system, including the Inquiry into Commonwealth Funding and Administration of Mental Health Services, Mental Health and Suicide Prevention, Evaluation of the Better Access Initiative, the McKell Institute and the MBS Taskforce MHRG.
- There is no evidence to support the two-tier system, and all existing evidence supports equivalent outcomes and services provided regardless of endorsement status. Substantial evidence demonstrates the harm to psychologists and the community.
The two-tier system's lack of professional recognition, disparity in equitable remuneration, and barriers to consumer access have had significant adverse effects. We are urging the Scope of Practice Review to rectify this.
Beyond our big-picture activities, the core of AAPi is the support we provide to psychologists. Each week, AAPi helps hundreds of psychologists with professional and ethical questions, navigate bureaucratic red tape, or find the information they need. Being a part of AAPi means you have a team of people who have your back and work in your best interest every day. We are proud to be a member association, serving and representing psychologists.
Later in March, we will attend NDIS consultations, university meetings, the National Infant and Child Disaster Advisory Committee, additional Scope of Practice review consultations, the Government Mental Health Sector Reference Group forum, and DVA, Open Arms, and WorkCover meetings.
I hope to see you at the AAPi Conference next week!