Dr Rachel David discusses private maternity care on radio 6PR

Transcript
Station: 6PR
Program: Perth Live
Date: 22/7/2024
Time: 4:25 PM
Compere: Oliver Peterson
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia

 

OLIVER PETERSON:

A story we touched on this time last week was that private hospitals in Australia, we’re told, are on the verge of collapse as closures begin. Now, we are very well aware that there are thousands and thousands of people waiting for surgery in public hospitals at the moment for elective surgery, and our system is, fair to say, overstretched, but it is being flooded, we’re told, with private patients. There has been a whole bunch of private hospitals across Australia which have shut their doors or shut down mental health wards, like we had here in Perth at Bethesda in Cockburn. We had the two maternity wards of Saint John of God, one in Mount Lawley and one in Bunbury. And there is a belief that perhaps, in the next 5 to 10 years, in fact, there may be no more maternity services offered in private hospitals at all. Here’s a little of what Dr Michael Page, the president of the AMA here in WA, had to say about all of this when he joined me last Monday.

[Excerpt]
MICHAEL PAGE:

A bit of a chicken and egg situation there, Ollie. I mean, because the private health insurers are not funding certain services in the way that they previously have, people are then choosing to drop their private health insurance as a result. So, you know, and then of course, that puts the private health insurers in a bind if their membership is declining. So, it’s a bit of a cycle. But at the moment, the impression is certainly that the private health insurers need to do more to keep the private hospitals viable.

[End of excerpt]
OLIVER PETERSON:

Dr Rachel David is the CEO of Private Healthcare Australia, and she joins me on Perth Live this afternoon. Dr David, thank you for your time.

RACHEL DAVID: Hi, Oliver.
OLIVER PETERSON: Do you need to do more as Dr Page says?
RACHEL DAVID:

Well, look, I think if you actually look at what the health funds have done, they’ve increased their payments to private hospitals by 11 per cent over the last year. And, really, we all understand that private hospitals, like every other business in Australia, have been knocked around by the pandemic and the lockdowns and the subsequent issues with inflation and the economy that have occurred. But I do take issue with this notion that the system is in a state of collapse. It really isn’t. Of the 72 hospitals I saw in the papers that apparently closed, 60 of them were small, doctor-owned day surgeries that closed as others opened. The remaining 12, seven of them are still open because other groups took them over, which left five which we were really concerned about. So five, all of which were in rural and regional areas.

Now, we know, as I said, that private hospitals are doing it tough, but some of the shroud-waving that we’ve seen is just scaring people, and it really is nonsense. There is no chance that the private health system is in a state of collapse as has been suggested.

OLIVER PETERSON: What about the maternity services? So you’ve got the two Saint John of God hospitals here in Perth shutting up their maternity wards, and they’re not the only ones in Australia. Is private maternity care becoming an unaffordable option, one, for patients, and two, something that the businesses, the private hospitals, just can’t make any money off?
RACHEL DAVID: Look, it’s not really a matter of money, Oliver. It’s a really complex situation that’s been building up over a long period of time. There are a lot of factors here. One is demographics that people, because of the economy and just because of changing demographics, they’re not having as many children. The second issue are the very high out-of-pocket fees that obstetricians charge for management of a pregnancy in the community. And because of the rules around private health insurance, they’re not allowed to cover for that. They’re only allowed to cover for the hospital part. So we’re talking about fees of, on average, $6,500. And, you know, a couple, young couple with a mortgage, it’s very hard for them to stump that up without some kind of external support. Then, we have the really- the difficulty of workforce shortages of obstetricians, which is a really tough problem to fix. And then, finally, you’ve got the health fund issue, which is that, about five or so years ago, the previous federal government brought in a system where they tiered all the product…
OLIVER PETERSON: Yes.
RACHEL DAVID: …into gold, silver, bronze and basic. We told them at the time that would create a pool of very high claimers, with very high claims for gold, and that the price of those premiums would inflate rapidly. And in fact, we looked at the data for last year and we found that one person- one obstetric case last year, we paid out $477,000 for one patient, one obstetric patient with gold hospital cover. So we think that system really needs to be looked at again. It has had a lot of unintended consequences, and one of the unintended consequences is that obstetrics is only available in top hospital cover and it’s becoming very expensive.
OLIVER PETERSON: So then how would you change it again? Would it be almost an opportunity to get health insurance and pick your coverage rather than that being a gold, silver, bronze? You might say have a silver or bronze package, but an add-on could be those obstetric services.
RACHEL DAVID: Yeah. And I think some of the- I think we do need to look at it again. There are some complexities, including how health funds, together, share the risks of high claims and difficult patients. By difficult, I mean people with challenging illnesses. And, so that is quite a complex issue. But what really needs to happen here is that every player in this system, be it the medical specialists, the hospital owners, the health funds, and the federal government, that pays the Medicare rebates, needs to get around the table and take some responsibility for sorting this out. If the fingers are just pointed in one direction, like your previous commentator who said this was all to do with health funds not paying people enough, we’re not going to get anywhere.
OLIVER PETERSON: Dr David, I appreciate your time. It is a complex matter.
RACHEL DAVID: Thank you.
OLIVER PETERSON: Private Healthcare Australia’s CEO, Rachel David.
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