The federal government’s $41.70 current offering for expectant mothers towards antenatal consultations is not enough, according to The Royal Australian College of General Practitioners (RACGP).
In a letter to Health Minister Greg Hunt, the peak doctors’ body suggested the Medicare designated amount for antenatal care does not reflect the growing complexity of antenatal consultations, and puts financial strain on those who cannot afford more consultations.
RACGP President Dr Karen Price says antenatal care in general practice is crucial for the health and wellbeing of mothers and babies, and that consultations must be affordable.
“GPs play an important role in providing antenatal care across Australia, particularly in areas where there is a lack of other specialists such as rural and remote communities,” she said.
“Many expectant mothers also prefer to see their usual GP for antenatal care because they know and trust them and want their support during what can be an uncertain and anxious time.”
Price pointed to the fact that in the past few years, significant advances in medical science and technology within the area of antenatal care have occurred, and Medicare patient rebates have not aligned themselves with the cost of providing these modern antenatal care.
“We have greater awareness of mental health issues and the health impacts of domestic violence,” she said.
“GPs are trained to spot the signs and start conversations to support expectant mothers experiencing these issues, but of course it can be extremely sensitive and having more time to spend with these patients is critical.”
In Australia, expectant mothers are extensively monitored for health problems and potential complications, such as diabetes and anaemia as part of their antenatal consultations. GPs give advice on a range of factors including nutrition, physical activity and help new mothers-to-be prepare for childbirth and breastfeeding.
The consultations generally last under twenty minutes — a period which Price believes is too short.
“Antenatal care is often highly complex,” she said, particularly for vulnerable and disadvantaged patient groups, including those in rural and remote communities, Aboriginal and Torres Strait Islander patients and culturally and linguistically diverse patients. Current Medicare funding for pregnant patients does not allow for longer consultations.
Last year, Dr Wendy Burton, RACGP Antenatal Care Specific Interests Network Chair, surveyed more than a thousand GPs on the state of antenatal funding.
She found that almost all (99 per cent) of respondents felt the current Medicare rebate for an antenatal attendance was insufficient, while 89 per cent cited that antenatal care had become more complex over the course of their career.
“Antenatal care has exponentially grown with the amount of information we are encouraged to obtain and impart,” one respondent said. “Women are also more informed and expect more information and discussion around obstetric topics.”
“I struggle to do a low-risk antenatal appointment in under 20 minutes due to trying to do a good job in supporting and preparing the women,” another said.
Other respondents said they had many patients who would love the convenience and longitudinal care that GP shared-care offers, but could not afford the gap fee.
“I can’t offer this service for free,” one respondent said. “It’s very frustrating to hear how much the local antenatal clinic receives for each appointment compared to our paltry [Medicare patient rebate of] $41.”
“We need better funding if we are to follow antenatal guidelines (local or national). The lack of time or complexity-based funding disadvantages pregnant women in a way no other group is disadvantaged.”
Price noted that during the pandemic, GPs began seeing more patients for antenatal care to help ease the pressure on the overburdened hospital system.
“High-quality antenatal care is essential for the health and wellbeing of both mother and child,” Price emphasised. “It ensures a healthy start to life for a new baby.”
“The Government needs to act now to fix this problem and ensure affordable access to high-quality antenatal care for all those who need it.”