Western Australia’s private maternity offerings have shrunk in recent years, with the closure of several maternity units in regional and metropolitan areas.
St John of God Hospital Mount Lawley, St John of God Hospital Bunbury and Glengarry Private Hospital have all seen closures in the past two years alone.
The closures preceded recent attention on experienced obstetricians leaving the field. Three obstetricians working out of St John of God Subiaco are reported to be leaving the field by the end of the year, prompting further concern for the State’s maternity services.
Among them was Dr Fiona Langdon who announced via social media that she would be closing her obstetric practice and joining Monash IVF in West Leederville from February this year.
AMA(WA) President Dr Michael Page said there were a number of reasons WA private maternity offerings had reduced, but the main one had to do with the cost of delivering the services.
“Private health insurance rebates are a big problem at the moment, private health insurers are not providing enough rebates, not keeping pace with the cost of providing services,” he said.
“It has put private hospitals under a huge amount of pressure, and so they are needing to look at what services can actually keep them afloat and what can’t, and obstetrics is one of those things that I think, suffered over the last few years.”
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A shortage of staff and reduced demand for private maternity services were put forward as reasons for the recent closure of maternity services.
However, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists pointed the finger at private health insurance providers at the end of last year.
“Health funds frequently underpay private hospitals for obstetric and gynaecological services, failing to acknowledge the actual costs. As a result, when evaluating financial viability, private hospitals tend to favour more profitable specialist services over those focused on women’s health,” the College said in a statement on its website.
The College acknowledged the number of women opting for private maternity care had reduced in recent years, and put this down to “rising premiums and out-of-pocket costs”.
It described obstetric and gynaecological services as being “under threat in Australia due to systemic gender bias”.
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Dr Page said current health systems require private operators in maternity to provide the required services alongside public services.
“The fact is, private obstetrics is too big to be allowed to fail, if the big private obstetric units in WA were to be unviable, there is no way the public system could cope with the volume of obstetric work that would fall on it. So a solution is definitely required.”
Dr Page pointed to comments from Minister for Health and Aged Care Mark Butler who suggested in the Australian Financial Review that under a re-elected Labor government, private health insurers would have to contribute up to $1 billion more each year to help private hospitals remain open.
“A billion dollars, which sounds like a lot of money, is probably not when it is across the whole country and not just for obstetrics, but for other specialties as well, so it’s whether that will be sufficient or not to resolve this problem,” he said.
Dr Page said there were also other issues that may need addressing.
“Some of the reasons that some of these units have not succeeded have also been around the ability to get midwives, the ability to get anaesthetists and those things as well,” he said.
“But fundamentally, we just need to see a bit more money coming from the private insurers into the private hospitals so that we don’t continue to see closures of services.”
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Dr Page said it was not just WA where private obstetric services were reducing.
“It is an Australia-wide thing that we’re saying with obstetrics and other specialties that are increasingly unviable in the in the private system,” he said.
“Obstetrics is a pretty tough job, tough on families, tough on individuals with respect to the style of work, so you can understand why some individuals would choose to do something that’s a bit more manageable.”
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