Are We Accepting the Death of Private Obstetrics?

Are you losing count of the closures of private maternity units in recent years? It seems that we can’t go two months without hearing about another case of private unit closure and subsequent crisis in the already overwhelmed public system.

NASOG’s fight in Cairns has current media attention, but this is not a Queensland specific issue. We have also seen announcements related to closures in Victoria, Tasmania and NSW.

Are we quietly sitting by and accepting the death of our chosen specialty’s private practice?

Have we made an unconscious decision to hand over the care of Australia’s future mothers to an overstretched and underfunded public sector?

Do we actually believe that obstetric care is only necessary in 5-10% of cases so under resourcing in rural and regional areas is fine?

And if the majority of our colleagues are sitting on the sidelines, why?

I know that private obstetric practice is getting tougher, I’ve been saying it for years and the numbers are there to back it up.

BUT the numbers also show that Australian women still want to choose the style of care that suits them. Our own review of the MBS data shows that the number of patients seeking an initial appointment with a private obstetrician have barely changed since 2012. But what has changed dramatically is the number who then continue with private care.

In the seven years to 2016/17, on average only 12% of women who had an initial consultation with a specialist obstetrician did not pursue private obstetric care. 

By 2019/20 this had percentage increased to 46%.

And by 2021/22, increased further to 52.5%*


Because Medicare and Private Health Insurance patient rebates have not kept up with the real costs of practice. More families just can’t afford to pay all of the out-of-pocket costs on top of their, already high, private health insurance premiums.

The public sector felt the pressure of those families decisions to the tune of approximately 55,155 additional maternity patients in 2022.

Those costs are borne by the States, but the solution lies with the Federal Government.

The public maternity system needs a robust private sector so that patient care can be delivered to the level that Australian women want and deserve. This can only be achieved if Federal and States Governments work together with the profession to find a meaningful solution.

The Federal Government needs to increase the Medicare rebates for patients and remove the private health insurance premium discrimination against women’s reproductive health.

NASOG has not wavered from these points since first putting our proposal to Government in 2021. We are determined to bring balance back into the system before there are serious costs for mothers and babies.

In the past week, NASOG annual membership renewals have been sent. If you believe that specialist private practice is worth fighting for, make sure you renew by 30 June.

If you are not a member, I urge you to sign up now.

We need to show the decision makers that we are a united specialty and will keep fighting until we have a revived private sector.

NOW is the time to back NASOG in the fight for our speciality!

Otherwise, we will see the death of private obstetric practice in Australia, not with a bang, but a whimper.

A/Prof Gino Pecoraro OAM
(with apologies to TS Eliot)

*Calculated from MBS data obtained from  The number of claims for item 16404 (subsequent attendance) was subtracted from the number of claims for item 16401 (initial consultation).

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