With the closure of the top end's final private obstetrics practice, women who want private maternity care now face a stark choice: give birth in the public system or leave the Territory.
Seven months after Darwin Private Hospital pulled the plug on private maternity services and now the last private obstetrician in Darwin is closing her practice.
It means the territory will be left with no private obstetricians.
DPH owner Healthscope announced last year that low birth numbers were to blame for closing maternity services. Instead, private patients could deliver in the public hospital and then could access private postnatal care with hotel stay retreat or home packages.
When the announcement was made, Darwin had two private obstetricians, Dr Alia Vemuri and Dr Jenny Mitchell.
“It was exceedingly distressing for our patients, and there’s still lots of anxiety and angst in the community,” Dr Mitchell told The Medical Republic
Dr Mitchell decided not to continue with private obstetric services, instead concentrating on her gynaecological practice.
Dr Alia Vemuri tried to keep her practice going. However, according to ABC News, she found the patchwork response wasn’t enough for her patients. She has decided to close her books from next month as she can’t provide the level of care her patients need without a functioning private maternity unit.
“The public hospital are doing the best that they can do. They’re busy normally, and we’ve just added 350, 400 deliveries a year to their load,” Dr Mitchell said.
“If you want to have a baby in a private hospital, the only option you have in Northern Territory is to leave,” Dr Mitchell said.
Which is what many patients are doing.
Former President of the National Association of Specialist Obstetricians and Gynaecologists, Dr Gino Pecoraro, said this isn’t a unique problem to Darwin.
“We’re seeing this absolutely all around the country at the moment. This is what happened in Gladstone, and ultimately, the public (hospital) was overwhelmed. Doctors resigned from the public and the hospital went on bypass for a year.
“The same thing happened in Cairns. The private closed and the public was overwhelmed. And despite what the politicians tell you, they’re still advertising for people to go and work there.
“It’s happened in other states as well. We’ve got an issue with the provision of maternity services in the country at the moment,” he told TMR.
There are solutions.
“The big thing is that for Australia, you need both public and private systems to work together to meet the need. No one system can do it. What’s happening at the moment is that private maternity is just becoming unaffordable for women,” he said.
Health funds often exclude women’s reproductive rights from all but the most expensive ‘gold’ policies, even though men’s reproductive cover is usually in lower down ‘bronze’ policies. It means that the number of people able to afford the top-tier insurance is decreasing.
“So while you don’t have to pay more for health insurance if you jump out of planes or smoke, if you dare to be a woman who could get pregnant and you want reproductive cover, you have to pay double what a man does,” Dr Pecoraro.
Meanwhile, he said the rebates given to hospitals aren’t enough.
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“The rebates that they get from the private health insurers aren’t enough to meet the costs, let alone to make a profit from it. If they close an obstetric unit and they put in extra joint replacements, they can make a lot more money from that,” he highlighted.
The other issue is workforce.
“We polled all the obstetricians in Australia and asked them what it would take for them to go and work in the regions.
“We had a number of really clear messages that they said the number one attraction to get them to go to the regions is access to a private practice,” he said.
He said they aren’t interested in working under the current public model, which is midwifery centric.
“The obstetricians only get called in at the last minute, so that, unfortunately, is not very satisfying, but also increases their risk of litigation,” he said.
Like all Healthscope hospitals, Royal Darwin Hospital is up for sale. But Dr Mitchell isn’t hopeful that whoever buys it will return maternity services.
“The area that was the birth suite is being converted into other facilities, remodelled and taken over, so there’ll be no way that it could be converted back to a maternity service,” she said.
Dr Pecoraro said for anything to change, it needs a whole of country approach.
“This is too big and too important to be done state or territory by state or territory. We begged the Prime Minister to get involved, and the federal health minister to get involved, and we’re on the record as saying that for years.
“Unfortunately, everything that we’ve predicted is happening,” he said.
