The Royal Australian College of General Practitioners (RACGP) has welcomed today’s report into universal access to reproductive healthcare and called on the Government to end Australia’s “postcode lottery”.
The Committee’s recommendations include:
· ensuring there is adequate remuneration for GPs, nurses, and midwives to provide contraceptive services, including the insertion and removal of long-acting reversible contraceptives
· improving access to workforce training for the insertion and removal of long-acting reversible contraceptives
· continuing current Medicare Benefits Schedule telehealth items for sexual and reproductive healthcare, including pregnancy support counselling and termination care.
RACGP President Dr Nicole Higgins welcomed the report and called for action.
“More must be done to break down barriers and ensure all women have strong access to reproductive healthcare no matter their postcode or income,” she said.
“As a Mackay GP, I know my patients who require a surgical abortion must travel over 1000 kilometres for care and that is not acceptable. Today’s report contains many promising recommendations the Government can and should act on without delay.
“It is great news the report has recommended training support for GPs for the insertion and removal of long-acting reversible contraceptives as well as adequate remuneration for GPs, nurses, and midwives to provide contraceptive services, including the insertion and removal of LARCs.
“It’s also very positive to see the committee calling for the Government to put in place options to make contraception more affordable. This is a particularly salient issue given high cost of living pressures squeezing many households across Australia. Anyone should be able to choose the contraceptive options that best suit them without having to worry about their hip pocket. The recommendation for a separate Medicare Benefits Schedule item number for contraceptive counselling and advice will help achieve this if it is set at a level that reflects the work involved. In addition, I welcome the committee recommending the Government review Medicare arrangements which support medical termination consultations with the aim of ensuring adequate remuneration for practitioners to deliver these services.
“The RACGP welcomes the committee recommending Medicare Benefits Schedule telehealth items for sexual and reproductive healthcare, including pregnancy support counselling and termination care, be made a permanent fixture of our telehealth system. The Health Department has temporarily extended these items until the end of the year and said a long-term decision will be made following a post implementation telehealth review. Let’s not wait for more reviews, let’s act. As chair of the RACGP’s Doctors for Women in Rural Health Committee Dr Christie Rodda has noted - these telehealth items provide choice to women in communities where healthcare access is harder. So, let’s make them permanent now, it’s the right call.”
Dr Higgins called on the Government to go even further in the years ahead.
“There are other steps the Government can and should take to improve reproductive healthcare in Australia,” she said.
“We can start by adding medicines for medical termination to the Prescriber Bag or ‘doctor’s bag’ of emergency use medicines. The RACGP also welcomes the committee recommending improved access to a broader range of hormonal contraceptives that are not currently Pharmaceutical Benefits Scheme subsidised, including newer forms of the oral contraceptive pill, the emergency oral contraceptive pills and the vaginal ring. Looking ahead however, we are calling for copper IUDs should be available on the PBS, and the Medicare rebate for insertion of an IUD should also be increased to reduce or eliminate gap fees.
“The committee has suggested subsidising the non-hormonal copper IUD to improve contraceptive options for people with hormone-driven cancers and people for whom hormonal contraception options may not be suitable. We believe this is a good first step, but as I said the Government should go even further and place copper IUDs on the PBS for all people who choose this option.
“We also call on the Government to amend rules to allow GPs to bill MBS Level C and D time-based attendance items for antenatal attendances that extend beyond 20 minutes. Currently, there is a fixed Medicare Benefits Schedule fee for antenatal appointments no matter how long that appointment takes, so people who need a longer antenatal appointment receive a much smaller rebate compared to someone attending for a general appointment.
“Providing financial support to GPs who want to train in surgical abortion, which is the only option to terminate a pregnancy after nine weeks, should also be front of mind for the Government. I look forward to working with the Government to make this a reality.”
The RACGP made a submission to the Senate Community Affairs Committee inquiry into universal access to reproductive healthcare. Dr Higgins and Professor Mazza also appeared at a public hearing and both are members of the National Women’s Health Advisory Council.