Doctors rebel on abortion changes
December 16, 2004
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”.