Dear Select committee,
I am a GP in Perth Hills and I have a special interest in child health and well
being and a particular interest in developmental disorders such as Attention
Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). It
is well recognized that early recognition and early intervention can have life
changing effects for these young people as well as their families which are
often affected by significant behavioral challenges that require specialist
Allied health input.
Over the last 18 -24 months there has been a worsening in access to any child
developmental services. This does not seem to matter what post code a patient
comes from or whether they can access services in a private capacity. It has
now reached a crisis point where no private paediatrician’s that I am aware of
are taking referrals and parents cannot find private allied health services to
assist their children while waiting to find a paediatrcian.
This is an absolute travesty as this is wasted potential time. As GPs we want
to help but we are completely hamstrung. We can assist with referrals but can
not do anything about the wait time publicly or do anything when private
services refuse to accept referrals because their books are full. For patients
who’s parents do not have the ability to seek private referrals they just have
to wait. Unabel to access any medicare rebateable items in the private sector
because they have not seen a paediatrician and have not received a diagnosis.
They are receiving no support, no interventions and this has a detrimental
effect on their learning capacity as they enter school. I have an extensive
list of playgroups, websites, apps and information that I supply to my
patient’s parents but what they need is actual appointments with the specialist
allied health providers and paediatricians.
I am based in outer metropolitan Perth in the eastern suburbs and aside from
one private paediatrician and the public Child development service, there are
no other developmental pediatricians for our patients to access. There are some
local speech pathologists and Pediatric OTs however they are full and unable to
take on any more patients. If the outer metro is hard to access services I can
only imagine that our rural counterparts are screaming out in desperation.
I have completed my Diploma in Child health and yet I can not do anything more
than what I have already listed. We need the state government to improve the
access to Paediatric speech pathology, OT and developmental paediatricians.
Psychological support and family therapy to support these families would be an
enormous help.
Restrictions on Stimulant based medication prescribing hampers GPs from
co-prescribing and increases the wait time as patients are requried to see
their paediatricians for ongoing scripts. A template or guide to assist in when
referral back to the paediatrician would be useful and then allowing authorised
GPs to continue to prescribe may help reduce some of the wait time. If I needed
to undertake any additional training courses to assist my patients I would
happily do this.
Is there a way that GPs can help families do the assessments and receive their
diagnosis earlier. Wait times of 18 months for a paeditrcian review through CDS
is meaningless- any assessment completed at time of referral is invalid by the
time the child gets seen and this results in further delays as they have to
undertake the assessments again.
It is truly a dreadful reflection on our system at present as this particular
area highlights with a spot light that the most vulnerable and most financially
disadvantaged children are even further disadvantaged. These areas need to be
improved if we want to see an improvement in childhood literacy and learning.
The impacts on the teachers is profound as many of these children cannot access
any supports, do not yet have a diagnosis and so they have no additional EA’s
in the classroom to help manage these children.
This is such an important area and it needs to fixed as soon as possible. The
12 months in the terms of reference would seem like far too long and I truly
hope that a report can be created and solutions found before then.
I implore you and plead with you on behalf of all my patients to please improve
these services dramatically and as quickly as possible