As part of its $160m women’s health package, the federal government will audit MBS items for contraceptive services and diagnostic imaging.
As part of a $160 million women’s health package to tackle gender bias in healthcare, the federal government is undertaking an audit of MBS items related to long-acting reversible contraceptive (LARC) insertion and removal, and diagnostic imaging.
While the initiatives introduced in the 2024-25 budget are a “good first step”, there’s plenty more work to be done, says a prominent GP and women’s health researcher.
Speaking to The Medical Republic, Professor Danielle Mazza applauded the government and Assistant Minister for Health and Aged Care Ged Kearney for the initiative, aimed at making the MBS rebates more equitable.
“The LARC issue has been a long-standing problematic area,” she said.
“We know that LARC are the most effective forms of contraception and they are not only important for women for contraceptive services, but also for the management of so many gynecological conditions, like heavy menstrual bleeding, period pain, and endometriosis.
“So it’s really, really, really important that women have access to LARC provision.”
At present, the financials of providing LARC services just don’t stack up for GPs, said Professor Mazza.
“While we’ve got pretty good rates of implant inserters, GPs struggle with IUD insertion for a number of reasons,” she said.
“It’s not really cost-effective to provide the service and while the Liberal Party did increase the rebate somewhat, it was insufficient.
“It’s not enough of a rebate to really encourage GPs to invest in the training and deliver this essential service.”
Professor Mazza said this audit – in combination with the $5.2 million in additional support to cover training costs for GPs, nurses and midwives for LARC services – were “two critical steps” that the Centre of Research Excellence had been advocating for for many years now.
As well as reviewing LARC insertion and removal rebates, the audit will explore gender biases in diagnostic imaging rebates, particularly for pelvic ultrasounds which currently have lower rebates than scrotal ultrasounds.
“The issue here is that pelvic ultrasounds are one of the main investigations that we order in general practice to investigate so many gynecological conditions,” said Professor Mazza.
“When we think about how many scrotal ultrasounds a man will have in his lifetime, it doesn’t compared to how many pelvic ultrasounds [are ordered].
“We order pelvic ultrasounds when there’s unusual bleeding, pelvic pain, issues around miscarriage, pregnancy dating, so women have lots of pelvic ultrasounds.
“It is really unfair that the rebate is lower for diagnostic imaging that women are much more likely to get.”
Professor Mazza said that while the measures announced by the government to target gender inequity were “a good first step”, there were many other issues, rightly pointed out by the RACGP, that needed ongoing attention.
“There is inequity, particularly around issues to do with mental health consultations,” she said.
“We know that women suffer more mental health problems, they’re more likely to seek assistance and present with these conditions, and it’s costing general practice to provide these services.
“So there’s lots more work to be done.
“But I think supporting general practice to provide LARC services and supporting women when they need pelvic ultrasounds is a great first step.”
Professor Mazza said it was not yet clear what the review process would involve.
“It’s part of a broader package focused on women’s health that the government introduced, including item numbers for longer consultations for specialists,” she said.
“This women’s health focus is very much worth it and I’d like to see the government continue to really focus on general practice who are the prime providers of these kinds of women’s health services in the community.”
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The federal government will also make temporary MBS telehealth items for blood-borne viruses and sexual and reproductive health permanent and allow nurse practitioners to refer women for ultrasounds under Medicare, to facilitate the MS-2 Step medical abortion program.
Assistant Minister Kearney said women “deserve a health system that understands their needs”.
“There are many ways that gender bias creeps throughout our health care system, from lack of access to sexual and reproductive health care, to disparities in costs faced by women,” she said.
“We want to see more women to have a better understanding for contraception as well as better access to long-acting reversible contraception.
“This investment will provide much needed training for doctors, nurses and midwives.”
