Landmark inquiry report ignites urgent action to end ‘postcode lottery’ for reproductive healthcare

Pharma News: The Royal Australian College of General Practitioners (RACGP), Pharmaceutical Society of Australia (PSA), Organon, and National Rural Health Alliance have united in welcoming the Inquiry report presented by the Senate Community Affairs Reference Committee on May 26. The report addresses the issue of universal access to reproductive healthcare, calling on the government to put an end to Australia’s troubling “postcode lottery.”

RACGP President Dr Nicole Higgins emphasised the urgent need to break down barriers and ensure that all women, regardless of their location or income, have unfettered access to reproductive healthcare. Dr Higgins, who practices as a GP in Mackay, highlighted the plight of her patients who must travel over 1000 kilometres to receive surgical abortions, emphasizing the unacceptability of such circumstances. She expressed hope that the government would act swiftly on the report’s promising recommendations.

One particularly positive recommendation in the report was the provision of training and support for general practitioners in the insertion and removal of long-acting reversible contraceptives (LARCs). The report also stressed the importance of ensuring adequate remuneration for healthcare professionals, including GPs, nurses, and midwives, who provide contraceptive services such as LARC insertion and removal. Additionally, the committee called for options to make contraception more affordable, acknowledging the financial strains faced by many households in Australia.

Telehealth services were a crucial aspect of the report, with the RACGP expressing support for making Medicare Benefits Schedule (MBS) telehealth items for sexual and reproductive healthcare permanent fixtures in the telehealth system. Dr Christie Rodda, Chair of the RACGP’s Doctors for Women in Rural Health Committee, emphasised that these telehealth items provide essential choice to women in communities where accessing healthcare is particularly challenging. Dr Higgins called for immediate action to make these telehealth items permanent.

While commending the progress made, Dr Higgins urged the government to go even further in the years ahead. She called for the inclusion of medicines for medical termination in the Prescriber Bag or emergency use medicines. Additionally, she expressed support for improved access to a broader range of hormonal contraceptives that are currently not subsidised by the Pharmaceutical Benefits Scheme (PBS), including newer forms of the oral contraceptive pill, emergency oral contraceptive pills, and the vaginal ring. Dr Higgins stressed the need for copper IUDs to be available on the PBS and for an increase in the Medicare rebate for IUD insertion to reduce or eliminate gap fees.

The Senate Committee report also supported the PSA’s call for pharmacists to play a greater role in ensuring safe access to contraceptives. The report noted the importance of all healthcare professionals practicing to their full scope. Dr Fei Sim, National President of the PSA, expressed support for pharmacist-prescribed contraceptives, highlighting that safe access to the latest and safest contraception is a fundamental healthcare need. She cited examples from around the world where pharmacists already prescribe contraceptives without a prescription, asserting that pharmacists can contribute significantly to improving healthcare access for all Australians.

Despite the importance of planned parenthood for maternal and infant health, recent analysis revealed that approximately 40% of pregnancies in Australia in 2020 were unintended. Research indicates that women residing in rural areas are 1.4 times more likely to experience unintended pregnancies, underscoring the persistent barrier of limited access to services.

Additionally, research found that 73% of women who experience an unplanned pregnancy were using contraception, with the oral contraceptive pill the most frequently cited (39%). This highlights the importance of assessing the suitability of contraceptive methods for each individual.

Nirelle Tolstoshev, Managing Director of Organon ANZ, emphasised the critical need for policymakers and stakeholders to prioritise women’s health and sexual and reproductive health. Ms Tolstoshev expressed that the recommendations outlined in the report, if implemented, could significantly enhance contraceptive care for Australian women.

She said “By utilising our entire health workforce – including task-shifting where appropriate – and ensuring shared decision making between patients and doctors through an additional MBS item number, we can unlock access to genuine contraceptive choice.”

The National Rural Health Alliance also voiced its support for the report’s recommendations, particularly the call to address the disparities in sexual and reproductive healthcare faced by rural, regional, and remote communities. Susi Tegen, Chief Executive of the Alliance, welcomed the committee’s recognition of the challenges associated with accessing comprehensive care in these areas, including maternity services, contraceptives, and termination of pregnancy.

Ms Tegen also appreciated the committee’s acknowledgment of cost and inadequate remuneration as barriers to accessing and providing contraceptive care, especially in rural locations. The report’s emphasis on enhanced training and professional support for healthcare professionals in sexual and reproductive health care was seen as a crucial step toward improving outcomes. Additionally, the Alliance commended the report’s commitment to developing specific strategies to cater to the needs of Aboriginal and Torres Strait Islander women, women with disabilities, individuals from the LGBTIQ+ community, and those from culturally and linguistically diverse backgrounds.

In conclusion, the report‘s recommendations and the united voices of healthcare organisations and experts underscore the urgent need to address the “postcode lottery” in Australia’s reproductive healthcare system. By implementing the proposed changes, including improved access, affordability, and scope of practice for healthcare professionals, Australia can take significant strides toward ensuring that all women have equal and timely access to comprehensive reproductive healthcare services.

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