The Royal Australian College of General Practitioners (RACGP) has reaffirmed calls for GPs to play a more significant role in attention deficit hyperactivity disorder (ADHD) diagnosis and treatment to improve affordability and access to care.
President Dr Nicole Higgins will today tell a public hearing of the Community Affairs committee’s investigation into barriers to consistent timely, and best practice assessment of ADHD, that long waits for specialists and high costs are a significant barrier for patients living with ADHD.
The RACGP’s submission to the inquiry calls for:
support for an expanded role in the diagnosis and treatment of ADHD for GPs with an interest in this area
consistent rules across all states and territories on which clinicians can diagnose and prescribe stimulant medications for patients
funding to support effective shared models of care and appropriate funding for long consultations.
RACGP President Dr Nicole Higgins called for action.
“Too many people with ADHD are not getting the help they need, when they need it,” she said.
“Unfortunately, access to care is limited, with many public sector mental health services not providing any ADHD services. What this means is that the burden falls on the private sector – leading to long wait lists and some missing out on care because they simply can’t afford it. One GP recently told the College it would cost their patient over $700 for a telehealth ADHD diagnosis from a specialist. Other media reports put the cost at around $3,000, a huge sum particularly when you consider the high cost of living pressures squeezing many households across Australia.
“So, we know what the problems are, and I will tell the committee today that a key part of the solution is providing greater support for GPs. With a helping hand, GPs across Australia can step up to help patients, psychiatrists, and paediatricians to help diagnose and manage this condition. This will require the right kind of training and funding as well as regulatory changes for prescribing and the development of shared care arrangements between GPs and other health professionals.”
Dr Higgins said that timely reform was crucial.
“As things stand, patients face a postcode lottery,” she said.
“We must cut red tape and enable GPs to play a more active role. There are simply too many rules on diagnosis and prescription of stimulant medication that vary by jurisdiction, and they are holding us back. To take one example, in my home state of Queensland GPs can diagnose ADHD and start children and teenagers on stimulant medication prescriptions from ages 4 to 18. However, in New South Wales, GPs can only diagnose and initiate prescription for 6 to 18-year-olds with permission from the Health Department. Each jurisdiction operates under different rules, so we really need consistent rules nation-wide that reflect best practice so every patient can access the care they need.
“Getting the funding component right is also essential. If we have local, state, and federal governments working together to coordinate funding for models for care that would make a tremendous difference. In addition, higher Medicare rebates for relevant services would improve access and help more people get the support they need in managing their ADHD. It’s vital that we reduce costs and give more people access to coordinated care between different health professionals, and that includes GP management plans, as well as team care arrangements.”
More patients are seeking referrals to a specialist for ADHD diagnosis, with 78% of respondents to an RACGP poll in March 2023 saying they had seen a substantial increase in the number of patient inquiries about referrals in the previous 12 months, and 16% reporting a small increase.
The recently published ADHD clinical guidelines have given GPs a comprehensive, evidence-based resource to guide the diagnosis and management of ADHD.