'Distressing' telehealth changes spark fears rural and regional cancer patients may miss out on treatment   
ABC News
Dec 30 2021.

Joanne Honeysett says losing access to phone consultations with her oncologist will "affect her greatly".



Accessing treatment close to home in western New South Wales is not easy for breast cancer patient Joanne Honeysett.

Key points:
Changes to telehealth services will come into effect on January 1
There will be limits on what telephone consultations can be bulk-billed
A rural cancer patient has expressed concern about her access to care
She has to drive several kilometres to the top of a hill to get mobile phone coverage for a telephone consultation on her property at Goolma in the state's central west.   

She does not have enough internet reception to contemplate a video consultation with her oncologist who is two hours away at Orange.

"I have to drive 7 or 8 kilometres up a dirt road and sit on top of a hill just to get some phone service where I live," Ms Honeysett said.

"The other alternative is we've put the NBN in the holiday shack that's on the block that we live on that's run by solar and I can do telehealth calls if I'm up, if I'm sitting in the shack and the sun is shining."

Woman looking at camera
Ms Honeysett says she has little alternative to phone consultations.
Bulk-bill changes
From January 1, changes are being made to the telehealth services that fall under the Medicare Benefits Schedule.

Doctors will able to continue to bulk-bill patients for face-to-face and video consultations, but there will be limits on what types of telephone appointments are eligible, including first and subsequent visits to see consultant physicians, some paediatric services and psychiatry.

The Clinical Oncology Society of Australia says the changes will particularly impact on cancer patients who need ongoing, regular consultations.

"That might seem fine on a one-off situation but cancer treatment is chronic, often you're coming and going multiple times a month, and that very quickly becomes very exhausting," Orange-based oncologist Rob Zielinski said.

Man smiling at camera
Rob Zielinski says the changes will "punish" rural and regional cancer patients who can't access reliable internet for video consultations.
"For that person their choice is they either have less medical services or they drive the 100-odd kilometres into a hospital clinic to link up with their specialist," Dr Zielinski said.   

Joanne Honeysett said she had little alternative to telephone consultations.

"If I'm doing a video consultation through my phone I'm sitting in a supermarket car park. It's quite difficult, especially if you're feeling really sick and are quite upset," she said.

"If I have to go to my local oncologist, he's in Orange, it's a 4-hour round trip for me to see my doctor, it will affect me greatly.

"It's a long day especially if you're not feeling well or there are issues [and] it's a very long way for a 20-minute visit.

"It was very helpful that I could talk to my oncologist at home because I was so unwell.

"I would hate for it to stop."

Nurse manager stands next to screen talking to doctor via videolink
From January 1, there will be limits on what telephone appointments are eligible for bulk billing.
Dr Zielinski said the change would exacerbate the divide between rural and metropolitan patients.

"What I'm really a bit distressed about is that the government is assuming that access to video technology, the ability to use it in our vulnerable, is equal, and it's simply not.



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"You're simply punishing and ostracising vulnerable patients and that's what I think is going on."

The timing of the change is also being questioned by doctors, with Australia in the midst of the Omicron outbreak.

"A lot of our patients, if they have to come into a clinic, they're now going to be [in] increasingly populated waiting rooms, where the risk of contracting COVID from one of the other patients substantially goes up," Dr Zielinski said.

"From a timing perspective this is a bit disastrous right in the middle of a Omicron outbreak."


The federal health department provided a statement to the ABC which said the decision to invest in a permanent telehealth system had been widely welcomed, including from regional Australia.

"These changes reflect recommendations by the MBS Review Taskforce and have been the subject of extensive and broad consultation with stakeholders," the statement said.

"This is about improving access to video and telephone services provided by GPs, medical specialists and other health professionals that reflect clinical best practice, and there is flexibility in the system depending on the services required."

WTF would you try to penny pinch on such a vital service....Reginal voters and those who are house bound will suffer most from this bastardry by the Morrison Government....The system should be expanded not restricted???