Last week, I joined College representatives in Canberra for the Council of Presidents of Medical Colleges meeting and Mental Health Australia Expo at Parliament House. We met with parliamentarians, including the Assistant Minister for Mental Health, key stakeholders and media to highlight the urgent need to address Australia’s psychiatry workforce shortage.

The College used this opportunity to reinforce the priorities outlined in our Australian Federal pre-budget submission. Our submission calls for smart, targeted and urgent investment in specialist training so people can access affordable mental health treatment, particularly in regional and rural communities.

Key proposals include:

• Expansion of federally funded psychiatry training places
• $2.14 million investment to extend the RANZCP Psychiatry Interest Forum program to June 2028
• Development and delivery of a 2–3-year pilot of the NCP and APED frameworks for psychiatry
• Introduction of a new MBS item for medical practitioners who have completed the Certificate of Postgraduate Training in Clinical Psychiatry.

These proposals aim to strengthen the pipeline into psychiatry and improve access to specialist care across the country.

We also supported the submission through a range of media engagements to raise awareness of the challenges facing the mental health system and the solutions the College is proposing. This included coverage across ABC Radio Victoria Statewide, ABC Radio NSW Statewide, ABC Radio Adelaide, ABC TV news breakfast, The Daily Telegraph and Herald Sun, 7NEWS Australia and Health Services Daily.

Ethical billing and transparency

Last year, the Australian Government raised concerns regarding affordability of specialist medical services and the billing practices of non-GP medical specialists. In response, the Council of Presidents of Medical Colleges (CPMC) invited member colleges including RANZCP to respond to their Professionalism Standard Ethical Billing and Fee Transparency consultation.

In our submission, the College emphasised the importance of ensuring that any framework supports:

• Patient welfare, fairness, and cultural safety
• Fee transparency and informed financial consent
• Fair, reasonable, and justifiable fees that reflect the costs of practice and the complexity of care
• Access to care through compassionate and ethical billing practices.

We also highlighted the importance of recognising contemporary clinical practice and the system-level pressures affecting specialist services. While individual practitioners play an important role in supporting transparency and affordability, broader issues relating to workforce supply, funding models and service availability also require coordinated system-level responses. I would like to thank every member whose insights helped inform the College’s response. 

The Professionalism Framework on Ethical Billing and Fee Transparency has now been released. It establishes shared expectations across the medical profession regarding ethical billing, fee transparency, and informed financial consent, reinforcing the profession’s commitment to patient-centred care.

The CPMC also committed to working with the Australian Government to improve the Medical Costs Finder website so that patients have clearer information about the cost of medical care. The College will continue to advocate for policies that protect access to high-quality psychiatric care while recognising the complexity and value of the services you provide.

Advocacy across the jurisdictions

The College's advocacy has also continued across a number of important policy areas including in shaping the ongoing reform of ADHD care. In Victoria, we supported the state’s investment of $750,000 to train 150 GPs to manage ADHD. While expanded primary care capability is important, the College has emphasised the need for clear pathways to specialist psychiatric care for more complex presentations. We raised strong concerns regarding proposals to allow virtual emergency departments to refill ADHD prescriptions, highlighting the importance of maintaining appropriate clinical oversight and continuity of care.

In South Australia, we welcomed a Government’s commitment to build new mental health assessment units and open additional beds at Modbury Hospital. The College also joined other medical colleges to issue a three-point plan to all parties ahead of the state election.

In New South Wales, our focus is on ensuring mental health care is accessible, well-resourced, and integrated into broader health services.

College advocacy has also led to a significant victory for patients with bipolar disorder, with the successful inclusion of lamotrigine on the PBS, an important development that will improve access to evidence-based treatment for many patients.

Regulatory updates for members

Members should also be aware of several regulatory developments relevant to clinical practice.

Late last year, the Australian Department of Health, Disability, and Aging contacted the College for feedback on proposed updates to the Pay Doctor Via Claimant (PDVC) system also known as gap-only billing. The proposed revisions included replacing cheque payments with Electronic Fund Transfer payments. And a new $695 Medicare fee threshold was proposed for PDVC usage, which would mean that no psychiatry patients would be eligible for gap-only billing. The College submission welcomed the switch to electronic payments, but strongly opposed the introduction of a payment threshold. We will continue to advocate for reduced out-of-pocket costs, greater equitable access, data-driven service reform and increased funding for mental health services.

The Therapeutic Goods Administration (TGA) has increased its compliance activities relating to the advertising of therapeutic goods. Members are encouraged to ensure that advertising and public communications comply with relevant TGA requirements, the regulation of therapeutic goods in New Zealand, and the College’s existing guidance on medicines and health service advertising. I urge all members to familiarise themselves and adhere to TGA guidelines on which therapeutic goods can and cannot be advertised to the general public, Medsafe guideline on the regulation of therapeutic goods in New Zealand, as well as our earlier guidance on medicines and health service advertising.

The College has also been engaging with the Department of Health and Aged Care regarding Medicare Benefits Scheme (MBS) claiming rules when a provider is overseas at the time a service is delivered. Current legislation does not permit Medicare claims to be submitted if the billing provider is overseas when the service is delivered, even where aspects of treatment may be delegated to other practitioners (as per the rTMS PPG). Despite this delegation, the MBS Compliance team has clarified that Medicare claims for any treatment rendered while the provider is overseas are not permitted, regardless of whether the treatment is delivered by a nurse or any other practitioner. We will continue to engage with the Department of Health and share further updates when available.

The College will continue working closely with governments, regulators and stakeholders to advocate for a mental health system that is accessible, sustainable and able to meet the needs of our communities.

Thank you to the many members whose expertise and insights continue to inform the College’s advocacy.

Stay safe and stay connected.

Dr Astha Tomar
RANZCP President