Getting the most out of our spend on psychologists and psychiatrists

Getting the most out of our spend on psychologists and psychiatrists

Tuesday, 9 July 2019

Psychiatrists and psychologists are engaged from time to time to prepare expert reports for our clients, and to attend court to give evidence about their mental health.

As you may be aware, our Board has fixed fees for expert reports and court attendances by psychologists and psychiatrists in criminal matters. The fees are set out in Table S of the VLA Handbook.

The problem with clients missing appointments

We are aware that psychologists and psychiatrists are becoming frustrated with our clients failing to attend scheduled appointments with them. We do not want failure to attend appointments to deter clinicians from accepting our clients. Table S fixes lower fees for missed appointments, and accordingly there is a financial impact on clinicians when clients do not show up. Further, our payment of fees for missed appointments is not an efficient use of our limited resources.

If you schedule an appointment for a client with a clinician, please ensure that the client is able to attend the appointment. Check that they have transport, or whether there is any other reason why they might not be able to attend.

You should contact a clinician as soon as possible if you become aware that your client can not attend an appointment. If you think there is a risk your client will not attend an appointment, consider re-scheduling it.

When fees for psychiatrists and psychologists can be increased

Table OO on the VLA Handbook provides that the fees for expert reports and court attendances may be increased in exceptional circumstances. Table OO does not define the term 'exceptional circumstances'.

Whilst the term does not have a fixed legal meaning, we adopt the approach the NSW Supreme Court took in in Leighton International v Hodges ([2012] NSWSC 458 at [20]), where the meaning of ‘exceptional circumstances’ was summarised as follows:

As a matter of language, something is exceptional if it is out of the ordinary, or unusual. To my mind, the exceptional circumstances […] must be circumstances that are not normal, or usual; they must be something out of the ordinary; they need not be unique; but however one characterises them they are not ‘exceptional’ at large, but ‘exceptional’ because they necessitate disclosure.

Accordingly, exceptional circumstances are out of the ordinary or unusual. Our organisation cannot identify a prescriptive list of circumstances that would be exceptional for the purposes of Table OO, and will consider any application for an increase to fees on the basis of exceptional circumstances on a case-by-case basis.

We can indicate, however, that a psychologist’s or psychiatrist’s decision to not provide an expert report or attend court for the fixed fee is not an exceptional circumstance for the purposes of Table OO.

Reconsideration and independent review

Please be aware that under section 36(5) of the Legal Aid Act, decisions in relation to Table S fees are not subject to reconsideration and/or independent review.

More information

Read Table S and Table OO on the VLA Handbook.

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