VIRTUAL medical appointments have become a vital aspect of rural healthcare, but changes to Medical Benefits Scheme (MBS) telehealth arrangements could be an added barrier for rural patients.

North West Allied Health Professionals chair Dr Miriam Grotowski, who works at the Smith Street Medical Centre, said the practice has moved to increased telehealth progressively over the past year due to risks and safety issues associated with the COVID-19 pandemic.

"Its introduction helped manage a very difficult time in the early part of the pandemic and most health professionals realised that telehealth has its place," she said.

She said the majority of local health professionals welcomed the federal health department's announcement in December to make telehealth a permanent fixture of primary healthcare.

But from January 1, multiple changes came into effect for telehealth services that fall under the MBS, with 27 items amended and 128 scrapped.

Doctors can continue to bulk-bill patients for face-to-face and video consultations, but there are limits on what types of telephone appointments are eligible, including first and subsequent visits to see consultant physicians.

Dr Grotowski said some of the changes would have negative impacts for people living in rural areas, like the New England North West.

"Reducing the telehealth item numbers for patients who access specialist care via telehealth because they live in rural and remote areas and have no other easy access, I think that's a negative consequence of the change, absolutely," she said.

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Organisations like the Breast Cancer Network Australia have called on the federal government to defer the changes, which it believes will disadvantage people with breast cancer in rural and remote areas with poor or no internet connection as well as the elderly and other groups with low digital literacy.

Data from Cancer Australia indicates only two to five per cent of monthly specialist services were delivered by telehealth video call in the first part of 2020, compared with 10 to 24 per cent via phone.

Serendipity Tamworth president Susan Goodwin said any sort of help is better than no help.

"Nothing beats face-to-face or one-on-one care and the breast care nurses are still doing that, and of course the radiation therapists and the North West Cancer Centre are still doing the treatments that are necessary," she said.

"As a back up telehealth is pretty much where we're at at the moment."

Dr Grotowski said while it should never be solely relied upon or replace face-to-face consultations unless safety or access issues are of concern, telehealth should be maintained as part of care.

But poor internet connection and phone reception provide a big challenge for local GPs.

"We encourage video consultations where possible but whilst that is my preferred method because you get to both see the patient and hear them, logistically with access in rural areas it's been on and off successful," she said.

"We have patient demographics such as the elderly and some who may not have access to their own phones or devices where telehealth or video conferencing is not an option."

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