The health minister, Mark Butler, has announced that from 1 January PCR tests for Covid-19 will require a referral from a medical practitioner.
Before then the tests have been available to anyone with symptoms, including through walk-in testing sites.
So what will the changes mean for testing going forward?
What are the new rules for PCR tests?
Covid-19 testing is being brought in line with other respiratory illnesses, with PCR tests largely being targeted to patients where a confirmed diagnosis is critical. For example, someone at high risk of serious disease would need a confirmed Covid-19 diagnosis in order to quickly be prescribed antiviral drugs that can prevent severe illness and death.
In the new year, people seeking a free PCR test must get a referral from a medical or nurse practitioner, such as their local GP.
Free PCRs will still be available without a referral at a limited number of state- or territory-operated Covid testing clinics or respiratory clinics, but these clinics may turn away people considered low-risk of Covid complications.
The announcement has caused some concern given GP clinics are already under pressure, bulk-billing doctors are hard to find, and state testing sites and GP respiratory clinics are being wound down.
So how do I get a PCR test now?
If you are in a low-risk group for Covid complications, you are encouraged to use rapid antigen tests [RATs] if you have symptoms and to isolate according to existing advice.
Low-risk people who are in contact with high-risk populations are also encouraged to take a RAT if they have symptoms and stay home when feeling sick. If symptoms persist after a negative RAT, these people should seek a PCR test through a GP.
People who are considered low-risk who seek a referral for a PCR test may be refused.
What if I am in a vulnerable group?
People at higher risk – including older Australians, First Nations people, people with disability, people in remote communities, people with complex underlying health conditions and the immunocompromised – will be prioritised for PCR testing, and the government hopes they will get their results more quickly with less demand for PCR testing from the general population.
People in these groups who want a PCR test should contact their GPs, or attend a state-run testing clinic or respiratory clinic for a referral or test.
A NSW Health spokeswoman said people at higher risk should make a plan with their GP now on what to do if they get Covid-19 symptoms, including what test to get, and get a test referral form to have on hand in case symptoms develop.
There will still be targeted programs through the health department to PCR test people in residential aged care homes when there is an outbreak. First Nations and remote communities will still be able to access the remote testing program at health services and they can also be tested for other respiratory illnesses at the same time.
Will I have to pay for my test?
No. PCR tests will remain free for everyone who a medical practitioner believes needs one. The new guidelines make it clear that “anyone whose GP or nurse practitioner requests a PCR test for them will be bulk billed”.
But you may have to pay for the GP appointment for the referral, depending on the bulk-billing policy of the clinic.
There is concern from medical groups such as the Australian Medical Association (AMA) that some vulnerable people may have a tough time accessing an appointment to get a referral for a PCR test, especially bulk-billed appointments.
Patients can also attend a GP respiratory clinic for testing, in which case both the appointment and the test are bulk-billed. Patients can show up to these clinics and to state-run testing sites without a referral from a medical practitioner.
People who are healthy, low risk, and who do not live or work with high-risk people may be turned away from these free testing sites. Whether these clinics accept low-risk walk-ins for testing will be up to the health policies of individual states and territories and will depend on resources.
What if I need antivirals?
If your PCR or RAT test is positive and your doctor recommends that you take antivirals, you will need a prescription.
You should not be charged for appointments to prescribe antivirals as two temporary Medicare items have been introduced to support medical practitioners with treating positive patients.
If you live in Queensland, New South Wales, South Australia or Victoria, you can call the national coronavirus helpline on 1800 020 080 for an initial assessment of your eligibility for oral antiviral medication. The helpline will help connect you to a doctor for further assessment and a prescription.
If you are eligible for the available antivirals, you may have to pay up to $42.50 for a script or $6.80 if you’re a concession card holder.
What are the main concerns about these changes?
More details about how the federal government will work with the states and territories to ensure timely access to testing – particularly for those who need fast access to antivirals – is critical, AMA president Steve Robson said. He does not want to see a situation where vulnerable people can’t afford a GP appointment or can’t get a quick appointment and are left paying for RATs, which are expensive and less accurate.
“We are in a situation where we have to really think how do we protect the vulnerable, with really worrying death figures in aged care still at a time where people will want to visit aged care over Christmas,” he said.
“Is the government going to leave all of this up to the state and territories to figure out? At the moment you need a positive RAT or PCR test to access antivirals, so will this policy change to ensure access to the vulnerable?
“The government has really failed to communicate the detail around this, or to announce it alongside an education campaign about who should access tests and how to access them.”
Dr Nicole Higgins, president of the Royal Australian College of General Practitioners president, agreed it was concerning that many testing sites were being rolled back.
“The RACGP will work constructively with the government on any initiatives that will aid this because the pandemic is far from over and we must not be complacent when it comes to Covid-19 testing,” she said.
