‘Demoralising’: Hobart obstetrician slams maternity funding model

Respected Hobart obstetrician Dr Irena Nikakis admits to being at her wit’s end over what she describes as the chronic underfunding of women’s health in Australia.

Doctor Irena Nikakis in her clinic at Fertility Tasmania in Hobart. Picture: Linda Higginson

Respected Hobart obstetrician Dr Irena Nikakis admits to being at her wit’s end over what she describes as the chronic underfunding of women’s health in Australia.

Since the recent decision of private operator Healthscope to cease maternity services at Hobart Private Hospital from August, Dr Nikakis has been on “heart-wrenching” reassessment of her own future in the medical speciality.

Dr Nikakis said while she would always remain professionally close to pregnancy and childbirth - though her work as a gynaecologist and IVF specialist - her association with obstetrics could well be coming to an end.

“It would be disappointing, because it’s why you study for so hard and for so long,” Dr Nikakis said.

Doctor Irena Nikakis. Picture: Linda Higginson

“It’s hard to think this might be the end of the road, after all the years in undergraduate study, six years training to specialise, and then finally practicing.

“So hopefully it’s not the end of the road for me.”

Last month Healthscope announced it would stop offering maternity services at Hobart Private Hospital from 20 August, ostensibly due to ongoing recruitment challenges.

While the federal government recently announced it would hand over $6m in funding to the Tasmanian government to support the expected increase in demand for maternity services across the public and private system, Dr Nikakis called for a comprehensive funding overhaul of the notoriously low-margin service.

“The costs are borne by Medicare and the private health insurance funds, so it all comes down to financials, doesn’t it?” she said.

“If the cost to the hospital for delivering a baby isn’t even on par with a minor surgical procedure, then why would you keep offering maternity care?

“So there’s a lot of financial pressure on the private hospitals, and a lot of maternity units are closing around the country.

“Which is tragic, because it eliminates choice from women, and it puts pressure on public maternity units that are already stressed.

“Even though we say women’s health is a priority, I don’t see anything being done about it.

“So it starts from the top, with Medicare acknowledging the costs of doctors seeing maternity patients and reimbursing accordingly, and then the private health insurers.”

As Tasmanian maternity medics prepare to meet Royal Australian and New Zealand College of Obstetricians and Gynaecologists president, Dr Gillian Gibson, in Hobart later this month about the ongoing challenges faced by the sector, Dr Nikakis said she would continue to contemplate her own career in obstetrics.

“Healthscope’s decision has put thoughts in my head, I have to say,” he said.

“It’s a very rewarding specialty, and we have so much to offer women, but unfortunately the politics of it all makes it very hard work.

“I think it’s the overall approach to women’s health needs to change

“We always seem to take second place, and it’s always a bit demoralising seeing the health rebates for women services versus any other specialty.

“We should be on par, but right now it’s not even close.

“As a doctor, you are trying to look after women and do the best for your patient, but that’s sometimes very hard when the ways and means are not forthcoming.

“It all comes down to the financials at the end of day, and while it has to be cost-effective, we should never be compromising care.”

Originally published as ‘Demoralising’: Hobart obstetrician slams maternity funding model