BUPA: Stop disadvantaging Defence personnel by restricting their choice of Psychologist

BUPA's contract specifies an arbitrary distinction and significant rebate differential between sub-types of psychologists, while all other health professionals (eg. Podiatry, Physio, OT, Speech Therapy etc.) have one simple fee structure. For example, for a 51-90 minute consultation, psychologists with clinical, neuro or forensic endorsement are rebated $303.14 while all other psychologists (some with many years experience, ADF experience, certification in EMDR, Schema therapy etc) are rebated $164.83 for the same service. Interestingly, the Australian Psychological Society's recommended fee for psychological services is $254 for a 46-60 min consult. The rebate is significantly lower for most Psychologists (45% lower) and there will be a shortage of providers to service this population. Many psychologists are deeply offended by this baseless and unnecessary distinction and are doubtful as to whether they will continue providing services under this contract. There should be a single fee structure for all psychologists providing services to ADF personnel.

Firstly, there is no research evidence that psychologists holding these endorsements are more effective. Secondly, a psychologist holding an endorsement does not necessarily hold any further qualifications or training than other psychologists. When the registration system for psychologists moved from the state-based systems to being federally managed by AHPRA, many members of the Australian Psychological Society were automatically endorsed in areas of their choosing (without holding the now required masters/doctorate degrees). Therefore, some clinical/forensic/neuro psychologists hold the same level of training and qualifications as ‘generalist’ or ‘registered’ psychologists. In fact, a large portion (65%) of psychologists (without endorsement) hold postgraduate qualifications such as masters, PhDs or training in particular techniques such as EMDR (the current gold standard treatment for veteran trauma). The quality, skills and knowledge of a psychologist cannot be deemed by endorsement status alone.

According to data from the Psychology Board of Australia (as at 31 March 2019), there are 35 583 registered psychologists in Australia with 10 073 of these holding endorsement as clinical, neuro or forensic psychologists. BUPA's fee structure is sending a negative message to over 25000 psychologists, their families, staff and clients. Many psychologists are also BUPA customers and will likely reassess their health cover options in light of this issue.

Psychologists tried to address this directly with the former contract holder Garrison Health/Medibank to no avail. BUPA then adopted the contract as is and continues to devalue many very experienced psychologists.

We need the BUPA CEO and Minister for Defence to review this fee structure immediately and ensure that ADF funds are being used appropriately (as there is no evidence that endorsed psychologists provide better service or outcomes, how can the ADF ethically spend public money on rebating these psychologists 45% more than their colleagues).