REBECCA WHITE, ASSISTANT MINISTER FOR HEALTH AND AGEING: Yeah, thank you so much. The Australian Labor Government is committed to strengthening Medicare, including making it possible for more women to access the health care that they need. From the 1st of July, we're making changes to Medicare so that more women can access timely care with fewer out-of-pocket expenses. And that's particularly true for women who might be dealing with endometriosis or perimenopause or menopause, who have often had their symptoms dismissed in the past or not been able to access the care they need because cost has been a factor that prohibits. This change will make sure that more women can access the care they need, the treatment that they need sooner and hopefully support more women to be able to live a fulfilling life knowing that they've got the appropriate medical care that they require.
Sadly, in Australia, we've seen far too many women have their symptoms dismissed. They're just told it's that time of the month or that time in their life without anyone properly considering that there might be an underlying medical condition that needs treatment. The Australian Government's been working consistently to strengthen Medicare, including women's health services, so that when women do present to a GP, the GP has the information they need, but also is appropriately reimbursed through the Medicare system so that we can have longer consults so women can get diagnosed more quickly and can get the treatment they need sooner. We know that about one in nine Australians suffer with endometriosis- sorry, endometriosis and on average it takes about seven years for a diagnosis. We want to shorten that time. We want women to be able to speak to a health professional who can provide the care they need, provide a longer consult and find a way to support them so they can live a healthy life with the treatment they need.
JOURNALIST: In terms of accessibility, what will this mean? Will it allow more women to be able to get care whereas potentially cost might have been a barrier, so forth?
WHITE: So we're making a significant investment in Medicare. All up this is about a $75 million contribution that'll start from the 1st of July, making it more affordable for women to see a doctor to access the health care that they need. We know that cost has been a barrier for some women accessing health care. We also know that they often feel that their consultations with a GP are rushed because they don't have enough time to explain what's happening to them. So by providing a new Medicare item that provides for a 45-minute consultation that is charged under Medicare, it's going to mean that there are fewer out-of-pocket expenses for women and they get the time they need to sit down with their GP and really talk about what's happening in their body.
JOURNALIST: And so these changes, is it for someone who is specifically presenting with endometriosis or who can actually benefit from this?
WHITE: Yeah, so there are some changes to Medicare that will support GPs in the work that they do and also some changes that will support gynaecologists in the work that that they're doing with patients who've been referred to them who might be dealing with things like endometriosis. It's really important to understand that across the country now we are standing up pelvic pain clinics as well as the work that's happening through general practice to make sure women have more choice about who they see if they are dealing with any symptoms that might relate to pelvic pain, menopause or perimenopause. We understand that a lot of women have suffered in silence and that's happened because of the stigma surrounding a lot of these conditions. We're really determined to make it possible for more women to access the health care they need and for that to be affordable and available to them closer to where they live.
JOURNALIST: Why do you think it's taken so long for women's health to be taken seriously and could the Government have done this a bit sooner?
WHITE: Well over the last three years the Labor Government's been working really hard to improve access to health care for people right across our country including women. It's why we've made such a significant investment in Medicare because we understand that people who go to their GP is the first port of call and we need to support our GPs with the resources they need and also the education to make sure that they can better support patients. So this is a partnership with our health practitioners right across the country and it is something that we've been dedicated to develop over the last three years and will continue to roll out over this term of government. I think over the last few decades women’s health has been neglected and this is an indication how this Government’s act - very determined to start to address this and turn it around because women present for about 60 per cent of all GP appointments across the country. They are reaching out for support from their GP. We want to make sure that their GP is supported to provide the care they need.
JOURNALIST: How will this improve access for women who might not have otherwise made an appointment or have not thought that they could actually access treatment?
WHITE: We're doing our best to make sure people know that this is available to them. I think a lot of women do struggle in silence and there is a lot of stigma about this by raising it publicly and talking about it openly and talking about things like endo and perimenopause and menopause and just reassuring people these are common. Unfortunately a lot of people struggle and they struggle alone. If they reach out to their GP, they can get help and the Australian Government is determined to make sure that they can access more affordable health care.
JOURNALIST: As part of this there are menopause health checks, what are involved in those?
WHITE: You might be better talking to Dr Isham about those.
JOURNALIST: And what do women need to be able to do to actually access this from July 1st?
WHITE: So women- any woman who would like to access the extended 45-minute consults with their GP just needs to ring their general practitioner and make an appointment. There are also pelvic pain clinics around the country where women can reach out to see if they can meet with a doctor there. We are trying to make it easier for women to access the health advice and the healthcare that they need either through a pelvic pain clinic or through their local GP practice. So I just encourage women across the country, if you do think you might be struggling with these symptoms and that something like this might work for you, to contact your GP.
JOURNALIST: What does the rebate work out to be for, say, one appointment?
WHITE: I couldn’t tell you off the top of my head, but I can certainly find the information out for you.
JOURNALIST: That’s okay. Would it be dependent on where you go or it's a single figure?
WHITE: It's an item number, so it would be consistent.
JOURNALIST: Okay. Okay, and so you don't need specific referrals for this?
WHITE: No.
JOURNALIST: Would you like to- first, your name and title, and then did you want to start with a statement about what this means or go straight to questions?
DR EMILY ISHAM, GENERAL PRACTITIONER: : I think I’ll go straight to questions if that’s okay?
JOURNALIST: [Talks over] Sure, then name and title, please.
ISHAM: So I'm Dr Emily Isham. I'm a women's health GP. I'm a general GP, but I also specialise in women's health.
JOURNALIST: Fantastic. So this announcement, is this something that you think is overdue, would you say?
ISHAM: Yeah, look, I do think this is overdue by many, many years. I think, like Rebecca said, I think that women's health has been kind of overlooked for decades and decades. In fact, for many years, men have been studied for medications and treatments. Their bodies have been looked at primarily and women have been neglected and overlooked. And so we know now that perimenopause and menopause is a significant transition for women. Health hormones and other health parameters change significantly, and if we don't actually treat some of the symptoms of peri and menopause, we can have some significant consequences down the track.
JOURNALIST: So say having longer appointments, what are some of the barriers that shorter appointments bring. I think that kind of talked about not actually being able to look into it too much with the GP?
ISHAM: Yeah so 15 minutes - a shorter appointment that's 15 minutes long or even 10 minutes long really just doesn't give us the capacity to, in depth, go through a woman's experience of their menstrual cycle since they were a teenager, what symptoms they've experienced throughout the years, what has changed in the last few years. There are so many symptoms we need to discuss, including brain effects and mood effects, and that actually takes quite a lot of teasing out. A lot of women have been sidelined and dismissed for many years, and so it does mean that they're not really used to being vulnerable and talking about themselves. A lot of them don't even realise that some of the symptoms they've been living with for many years are attributable to their hormonal fluctuations as they get older. And also it's a really good opportunistic- it's a really good opportunity to go through screening. So things like talking about mammograms and the importance of them, talking about cervical screening, talking about their nutrition. I think that's really important because a lot of women don't eat enough protein. Talking about bone density, talking about their family history and what they might be at higher risk of and cardiovascular risk. Talking about which blood tests might need to be done and other tests that might need to be done because of the symptoms that they've got. And talking about preventative health as well so as to set these women up for a much better second half of life and so that they are able to still be fit and active in their 80s and 90s potentially.
JOURNALIST: What does it mean financially for a GP or a practise also being able to have these longer consults and actually get more back from that?
ISHAM: Well already practises are struggling - well already practises are struggling with the number of patients that are waiting to see a doctor, and for appropriate remuneration to be able to pay all the staff well. So having an item number specifically to encourage GPs to go through these types of histories, to go through these examinations for women, to take the time to do a proper blood pressure, height and weight, and do the referrals that they need for various investigations will make a huge difference because it will actually encourage GPs to spend the time to do that. And it will encourage women to perhaps, now that this is more widely acknowledged, it will encourage women to actually bring these symptoms up. I think there's much more of an awareness about what types of symptoms people can experience for either endometriosis or even polycystic ovarian syndrome, perimenopause and menopause. And I think it's really important that women feel empowered to bring these things up with their GPs and having this acknowledged with item numbers is only going to help that.
JOURNALIST: And can you talk about the menopause health checks and what is involved with that?
ISHAM: Yes, so as I discussed before, with menopause health checks we go through all their symptoms. We go through the Australian Menopause Society checklist to work out what symptoms they're experiencing, and that's often very revealing for a lot of symptoms that women didn't realise. You know, they thought maybe their mental health was slipping because of the stress but they didn't realise, or their sleep is not good because they're not sure if work stress is featuring in their dreams, or whatever's going on. A lot of these things can be attributable to the changes in hormone levels in perimenopause and menopause. So we go through their cognitive symptoms, any other physical symptoms they might be having, and then we do measurements like height, weight. We can make sure that we've got their blood pressure checked and that's in a normal range, their heart rate, that we properly examine them, and then we do investigations that are needed to assess their risk for chronic health diseases.
JOURNALIST: You spoke about already being overrun with patients. I don't know what the wait lists are like. Is there concerns that would get longer though, if appointments are longer and there's more people trying to get in? Does that make sense?
ISHAM: Yeah, that's a good question. I think- I don't think it's necessarily going to- I actually don't think so, because I think it's just- we're going to see these women anyway. I think that these- and these symptoms are to be seen anyway, but I think the fact that there's an appropriate item number to actually spend the time rather than 15 minutes here dealing with the bladder symptoms and 15 minutes there dealing with the memory, it's good to have it all in one, for someone- for one individual doctor to go through everything and check all the symptoms all at once could actually lead to much more holistic care and to address the symptoms in a lot more comprehensive way.
JOURNALIST: Maybe just one more as well. When women talk about years it takes to be diagnosed and things like that, in the room, and they've given that diagnosis, what's that feeling like? Is it- obviously it’s a bit of relief as well as maybe just some validation even?
ISHAM: Yeah, look the number of women I've had who've just burst into tears because they felt validated after years of either being gaslit or dismissed and undervalued in their suffering. I don't think it's necessary to give a name to things all the time, but even just for someone to hear, and hear how hard things have been. How hard the sleep's been, or how hard it's been to keep being a mum and working full-time at the same time, or dealing with tricky bladder symptoms that haven't been able to address for decades. You know, all of these things have been overlooked for so many years. It's so important for women to be actually properly listened to, to have the time to talk about it, their experience, and to have those symptoms addressed.