NAPP History and Achievements

The National Association of Practising Psychiatrists (NAPP) was established in 1996 by a collaboration of general psychiatrists, psychiatrist psychotherapists and psychiatrist psychoanalysts led by Dr Gil Anaf, the first President of NAPP, Dr Shirley Prager, Vice President, and Mr Stephen Milgate, Foundation CEO till 2018.

The group mobilised after the newly elected Government in 1996 suddenly stopped funding for all patients in long term and intensive psychiatric treatment. This affected all of our patients, not only those in psychotherapy. The RANZCP became involved in the campaign after being persuaded by NAPP.

We lobbied politicians and health bureaucrats, involved the press, and our patients wrote and spoke to politicians.  Item 319 was a compromise outcome but enabled the most vulnerable patients to maintain treatment with government funding.

Later, with further modifications allowed under Medicare Plus, and following further campaigning by NAPP, most patients were able to access the necessary treatments. Item 319 remains a problem as there are strict guidelines regarding who can receive this rebate and potential diagnoses of individuals claiming with item 319 are therefore recognisable to anyone who can log in to the Medicare files.

The following are some examples of campaigns in which NAPP has been engaged:

NAPP has been involved in fighting the introduction of Managed Care into Australian health, and this opposition proved to be successful over many years. More recently, the health funds have brought in a type of managed care by stealth, which has been difficult to address. Managed care remains an ongoing issue.

NAPP campaigned to enable children to access psychiatric treatment following funding cuts, when a cross-bench committee of the Federal Government renewed Australia’s treaty on the Rights of the Child.  We wrote a document arguing that children had the right to the best available and appropriate psychiatric treatment, without the restrictions previously imposed. We were then invited to speak to the cross-bench committee. NAPP was assured that the restrictions would be lifted, and this remains the case for children under 18 years.

NAPP instigated the NSW Parliament Enquiry into Mental Health services in NSW. Following our address to the cross-bench committee of the Legislative Council on the issue, a motion was created, and accepted by both houses, that an enquiry be established, and a report tabled in Parliament at the end of the twelve-month enquiry period. NAPP, along with all other stakeholders in mental health, addressed the enquiry. NAPP was commended in Parliament for its role in the establishment of the enquiry.

In 2015 NAPP, led by President Dr Shirley Prager, campaigned against the “Health Insurance Amendment (Safety Net) Bill”.  We argued that patients with psychiatric, cancer and other chronic illnesses would be significantly disadvantaged if they could NOT receive funding for their treatments. NAPP lobbied extensively with all members of parliament, and together with the RANZCP represented members and patients in a subsequent Senate enquiry into the Bill. The Bill was subsequently overturned.

NAPP representatives have appeared on television programs such as the 7.30 report, and on many national and local radio programmes to discuss mental health issues and to advocate on behalf of our patients to enable them to have access to effective mental health treatment.

It is unfortunately the case that initiatives to reduce hospitalisation and government spending on health often impact heavily on those with mental health problems. We feel that it is vital that NAPP continue to exist, to notify our members of the changes in health that are often proposed by governments, and changes introduced by the health funds. As a small group, we are in an ideal position to respond independently and in a timely manner, to concerns that arise. We can also add weight to concerns expressed by the College on behalf of our members, by informing politicians about the impact of bills that are to be introduced, which may not be made clear in the material that they receive. This was the case with the proposed changes to the Medicare Safety Net Bill. We can be flexible regarding who we can contact to discuss these important matters.

We exist to advocate for our patients and on behalf of our member psychiatrists in the private and public sectors. There is no other organisation that currently exists with this brief. Whilst there are other larger organisations such as the AMA or the ADF, only NAPP has the focus and the brief to work to maintain the standards of and access to the best psychiatric care for patients. It has been noted that if we leave our advocacy work to other organisations, we find that our patients and practitioners are easily overlooked in favour of other issues of the day.

We ask you to support NAPP by joining us and helping us to continue to work at improving the morale and standing of psychiatrists in both the public and private sectors, and the appropriate access of our patients to a high standard of mental health care.