The $620 million scheme that links doctors and patients via video-link was the centrepiece of Prime Minister Julia Gillard's 2010 election campaign launch.
It was promised the scheme would give patients outside major cities access to a specialist, with a target of 495,000 consultations by July 2015.
However, doctors - who received $6000 taxpayer-funded incentives to equip their surgeries to provide services via videoconferencing - delivered an average of five services each in the first year.
Just 16,000 specialist services were provided in the initial 12 months of the program and GPs provided patient back-up at the other end for 9000 of these services.
Take-up was low even though specialists who take part in telehealth receive a 50 per cent loading on their usual Medicare rebate and GPs receive a 35 per cent bonus.
And it came despite the government spending 43 per cent more than it had budgeted for on incentives for doctors to join the scheme.
A surge in demand from doctors blew the spending out from a budgeted spend of $12.3 million to $17.6 million in the year to June 2012.
Yet the government spent just one-tenth of the projected $30 million on Medicare rebates for patients under the telehealth program in the first year.
After such low initial usage, more than 13,000 services need to be provided every month to reach the government's target of 495,000 consultations.
To achieve that level there would have to be a 140 per cent increase on the average usage so far in 2012-13 of just 5400 a month - a required surge made all the less likely by a looming $184 million funding "redirection" announced in the May budget.
Money was redirected to an NBN program and the government tightened rules so patients had to be at least 15km away from the doctor to qualify for a Medicare telehealth rebate. From November 1 the government also stopped paying the full $6000 incentive up front.
Now a doctor receives $1600 when they make their first telehealth consultation and another $3200 once they have provided 10 services.
Payments will reduce further in 2013-14 and cut out altogether the following year - 12 months earlier than was originally pledged.
In explaining the initial slow take-up, a Health Department spokeswoman said most doctors only started providing services toward the end of the 2011-12 financial year.
"This is a great initiative that will have a significant impact over time on delivery of medical services to people in rural and remote areas," she said.
But Australian Medical Association president Dr Steve Hambleton said: "If you are giving these people money to set up and they are not using it, it needs to be better targeted."There were 21,634 specialist and GP services provided in the four months to October bringing the total for the first 16 months to 46,728, or nine per doctor.
Doctors in Queensland provided the most services - 14,517 via telehealth in the 16 months to October - and the ACT the least at 117.
NSW doctors provided 13,088 services.
Victorian doctors provided 7041 services, South Australian doctors 3374 services, West Australian 6076 services, Tasmanian doctors 2033 services and in the Northern Territory doctors provided 482 telehealth services.
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Autor(en)/Author(s): Sue Dunlevy
Quelle/Source: The Australian, 24.12.2012
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