DOCTORS have forced the Health Department to dump a
secret plan to tighten the guidelines for women seeking a taxpayer-funded
abortion after the first trimester of pregnancy.
Documents obtained by The Australian confirmed the Health
Department formally raised the issue in August, seeking doctors' agreement to
restrict the most common abortion procedure billed to Medicare to women who were
less than 12 weeks pregnant.
Under the proposal, doctors would agree to use a different Medicare item
number (16525) for abortions carried out on women after 12 weeks of pregnancy
that carried tougher restrictions, including allowing for terminations only in
the event of "gross fetal abnormality or life-threatening maternal disease".
Obstetricians and gynaecologists raised concerns yesterday that the plan
would restrict access to abortion services and risked forcing women whose child
died in the womb after the first trimester to have labour induced rather than a
"less traumatic" procedure of curettage.
The Health Department confirmed a plan was raised to introduce an explanatory
note that "would remind doctors that this item number is for a termination
procedure that is normally undertaken when a woman is in the first trimester of
pregnancy", and confirmed the only alternative Medicare item No16525 "has some
restrictions on the procedure".
"The profession advised it could not support the addition of an explanatory
note without further extensive consultation," Medicare Benefits Branch medical
officer Jane Cook said. "Explanatory notes do not have any legal standing. They
are included in the Medicare Benefits Schedule to assist doctors in deciding the
appropriateness to bill certain items."
However, the Australian Medical Association questioned whether doctors could
ignore any explanatory memorandum, saying they risked committing fraud if they
billed the wrong procedure.
Health Minister Tony Abbott was on leave, but a spokesman said the Health
Department denied the proposed change was suggested by the outspoken
anti-abortion minister.
AMA spokesman Andrew Pesce confirmed last night the Health Department had
raised the proposed changes with the National Association of Specialist
Obstetricians and Gynaecologists.
"The unintended consequences of such a change could include forcing women
whose child died in the womb in the early stages of the second trimester to have
labour induced and give birth vaginally," he warned.
Planned Parenthood Australia founder and president of the International
Society of Abortion Doctors, David Grundmann, said the plan was "nonsense".
"Curettage can certainly be performed up to 15 or 16 weeks," he said. "It's
alarming because the Health Department is promulgating an idea that is false and
trying to change something that's worked for 30 years."
Opposition health spokeswoman Julia Gillard said Mr Abbott must explain if he
knew of the proposal to change abortion guidelines, saying women had "a right to
know".
Currently, there are two item numbers that define Medicare payments for
abortion: No 35643, defined as "evacuation of the contents of the gravid uterus
by curettage or suction curettage, and item No16525, defined as "management of
the second trimester labour, with or without induction, for intra-uterine fetal
death, gross fetal abnormality or life threatening maternal diseases".
