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Reproductive healthcare telehealth items extended


Jolyon Attwooll


16/05/2023 3:17:20 PM

The move has been welcomed, particularly for women in remote areas, but advocates are calling for the items to be made permanent.

GP in telehealth consult
Advice from the MBS Review Advisory Committee on the implementation of telehealth is due later this year.

Sexual and reproductive telehealth items will continue at least until the end of this year, the Department of Health and Aged Care (DoH) has confirmed.
 
In a statement to newsGP, the DoH said temporary GP telehealth items for blood-borne viruses, sexual reproductive health services, and non-directive pregnancy counselling will now remain in place at least until 31 December 2023.
 
The DoH also confirmed the items will remain exempt from the ‘established clinical relationship’ rule, as is the case with GP nicotine cessation items and temporary COVID-19 related telehealth measures.
 
The RACGP has lobbied for the continuation of the items, which were due to end on 30 June.
 
The news was welcomed by Dr Christie Rodda, the Chair of the RACGP’s Doctors for Women in Rural Health Committee, who said the move gives choice to women in communities where healthcare access is harder.
 
‘However, it is essential that these be made permanent in order to continue to provide options for women in rural and remote areas to access termination of pregnancy and other sexual and reproductive health services,’ Dr Rodda told newsGP.
 
‘Despite legislative changes over recent years, there are still relatively few practitioners providing termination services on the ground in rural and remote areas.
 
‘Providing medical termination of pregnancy [MTOP] remotely by telehealth is safe, acceptable to many women and helps fill a gap in the health system.
 
‘By removing the need to have had a previous relationship with the practitioner, these telehealth item numbers have allowed all women to access termination services with Medicare funding.
 
‘That goes some way towards easing the financial barriers of accessing a TOP. It also encourages the development of novel and more viable service models, which increases options for women.’
 
In its statement, the DoH said advice from a post implementation review of telehealth carried out by the MBS Review Advisory Committee is due later this year.
 
‘This work is expected to inform future consideration of whether the temporary arrangements should continue,’ a DoH spokesperson said.
 
Professor Danielle Mazza, Chair of General Practice at Monash University, also believes the extension does not go far enough – and queries the need for a review.
 
‘I am very concerned about the potential for this to not become a permanent aspect of the item numbers available to GPs to manage sexual and reproductive health consultations, particularly abortion,’ she told newsGP.
 
‘We have very well documented abortion deserts across the country.
 
‘Telehealth is one of the few significant initiatives that the Government has put in place to improve access to what is an essential service, particularly because medical abortion is so time sensitive.
 
‘What is their evaluation going to tell them? Is [it] going to tell them that the access gaps have been plugged and filled? No.
 
‘I don’t know why we need to wait for an evaluation. Telehealth has become standard practice internationally for the delivery of medical abortion, and medical abortion is very well suited to a telehealth model.’
 
The Level B phone consultation (item 92734) is the most used GP telehealth item in the suite, and according to a Services Australia Medicare report was used 153,022 times from July 2021 to the end of June 2022, incorporating a time when lockdowns still occurred.
 
That usage has dropped more recently, with the item used 39,249 times in the nine months from 1 July 2022 to the end of March this year.
 
Professor Mazza believes that making the items permanent will boost their impact.
 
‘If there are only small numbers of women utilising these item numbers, then the problem is that they haven’t been promoted,’ she said.
 
‘We need to be building knowledge of and access to these item numbers, not clouding them with uncertainty.’
 
The RACGP recently made a submission to the Senate Community Affairs Committee for an inquiry into universal access to reproductive healthcare, with Professor Mazza also appearing alongside college President Dr Nicole Higgins at a public hearing. Both are members of the National Women’s Health Advisory Council.
 
Within the submission and at the hearing, the college said the continuation of the item numbers would help promote safe and affordable access, along with a broad range of other recommendations.
 
While many telehealth MBS numbers were made permanent when the previous Federal Government first announced that widespread telehealth would be ongoing, the sexual and reproductive health items were only confirmed on a temporary basis.
 
Dr Rodda also said that women in rural and remote parts of Australia deserve clarity on their item numbers’ status.
 
‘We still have a very long way to go to see affordable, accessible reproductive healthcare available to all women in Australia, irrespective of their geographical location,’ she said.
 
‘We must keep moving forward on this issue.’ 
 
The DoH said updated resources with additional detail on the extension will be published on the MBS Online website ‘as soon as possible’.
 
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