Since 2018, 18 private maternity units have closed nationwide, a rate that could see primary care vanish by 2030. Australia’s peak medical defence group is calling for a national maternity viability framework.
Avant is urging the federal government to classify regional private hospitals as essential infrastructure under a dedicated regional hospital sustainability scheme and to prevent the closure of private maternity services.
Its submission, released on Tuesday, made eight recommendations for the Federal Government’s initial consultation paper on private health sector reforms.
It comes alongside similar concerns raised in the AMA’s own submission regarding private maternity care’s viability.
Avant argued regional and rural private hospitals warranted the same government backing as the telecommunications industry, citing Victorian data that showed 70% of the 3300 patients who waited over 24 hours in emergency departments between January and March 2026 were in regional and rural hospitals.
“The objective should be to preserve essential regional health capacity where the wider value of maintaining that capacity exceeds the commercial return available to the individual hospital,” the submission read.
Avant’s chief medical officer, specialist obstetrician and gynaecologist Professor Steve Robson, said private maternity services were an urgent public policy issue that not only reduced choice for families but also further strained the public health system.
“By establishing a targeted national maternity viability framework to identify private maternity
services at risk of closure, steps can be taken before it is too late,” he said.
The proposed framework included interventions such as service-availability funding, workforce measures for regions with lower birth volumes where existing funding arrangements were inadequate, and reforms to private health insurance that currently enforce a strict 12-month waiting period before conceiving for gold-tier benefits.
The submission cited the “immediate” and “profound” impacts of the complete closure of private maternity services in jurisdictions such as the Northern Territory and parts of Tasmania.
Dr Alia Vemuri, the last NT private obstetrician, had to close her practice earlier this year after Darwin Private Hospital’s maternity unit became financially unsustainable.
“[Women] described an anxiety of having to choose between flying thousands of kilometres away by plane at significant expense and away from their support networks or remain in a system pushed to its absolute limits,” Dr Vemuri’s testimony from Avant’s parliamentary roundtable earlier this year read.
“Many Territory mothers reported to me that they felt and still feel to this day like second-class citizens in their own country,” her testimony read.
While the submission recognised government initiatives, including the $10 million investment to expand public maternity on the NSW Central Coast following the closure of the region’s only private maternity service, Avant said these responses often arrived too late.
“There is an opportunity to move from reactive interventions to a more systematic approach that identifies essential maternity services at risk and enables action before capacity is lost,” the submission read.
Multidisciplinary maternity care was backed as essential, but with caveats.
Delivery and postpartum care pose high medico-legal risk, the submission argued, and any shift toward shared or midwife-led models could not come at the cost of fragmented clinical responsibility or reduced access to specialist expertise.
According to Avant data, 38% of complaints against gynaecologists and obstetricians were due to delivery-related complications or injury, with 16% during postpartum due to delays, missed complications, or poor care.
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Avant’s minimum requirements for consistent maternity care included ongoing competency training, prompt access to obstetric specialists, early risk detection, and clear escalation protocols.
The submission also called for a review of MBS items for paediatricians and anaesthetists, pointing to a maternity population both older and at increased risk of complications.
Improving access to mental health care in the private sector was not only a clear “priority” for Avant – its submission went even further than the government’s own proposal, calling for IMG psychiatrists to be allowed to practise not only in private hospitals but also in private rooms.
Professor Robson argued allowing IMG psychiatrists to practise in private hospitals would not only ease the specialty’s workforce shortage but also be essential to continuity of care, preventing fragmentation that could place patients at risk during transitions in care.
“Maintaining continuity of care is particularly important in psychiatry, with international evidence
showing that models supporting seamless transition between inpatient and outpatient care reduce
emergency department visits and readmissions,” he said.
The submission supported implementing the arrangements for an initial three-year period, with a review after 12 to 14 months to assess the initiatives’ effectiveness.
However, Avant made no mention of indemnity arrangements for IMG psychiatrists, despite being Australia’s largest medical indemnity insurer.
Avant stopped short of backing the government’s blanket increase in second-tier benefits from 85% to 100% for the approximately 115 hospitals in MM2 to MM7 regions, which would see insurers pay uncontracted regional hospitals the same rate as their contracted counterparts.
Instead, it argued that money should be directed only where a clear need was identified, and that this targeted approach was essential to maintaining the private health sector’s viability rather than a “financial windfall”.
The submission broadly supported several proposals, including expanding hospital in the home and the development of new models of mental health care.
Read the full submission here.
