In the lead-up to the May Budget, the Minister for Finance had his razor gang go through government spending, taking savings wherever they could. In the health portfolio, the cuts were mainly targeted at programs that, for various reasons, were under-spending the funds allocated.

In some cases the savings made were quite small – $2.5 million from telephone counseling and web support programs providing mental health services, $0.5 million from the program that provides support for day to day living in the community for people with a mental illness, and $3 million from the program that provides incentives for training doctors to work in rural areas.

So why did the razor gang miss $34.5 million in savings from a program that, in the 20 months it has been operating, has provided only 6,352 services and spent only $425,497?

In November 2006, after a major push by then Health Minister Tony Abbott, four new Medicare items were introduced to reimburse appropriately trained GPs, psychologists, social workers and mental health nurses for the provision of counseling services to women who are concerned about a pregnancy. Women are entitled to up to three counseling sessions and must have a GP referral to the allied health professionals. The program was funded at $35.6 million over the four years to July 2010.

Medicare statistics show that since the introduction of these items, a maximum of 6, 269 women, but maybe as few as 2, 117, have used these services. On average, 320 GP services are provided each month, primarily to women aged 25-34 years. This rate has been relatively constant since January 2006. Use of the allied health items is minimal, averaging less than 5 per month.

There is no publicly available information on how many GPs and health professionals have taken the required training to be eligible to provide these services, what the needs are of the women who seek their help, and how well these women feel their needs have been met.

At current rates, these counseling services can be provided through to July 2010 at a cost of $500,000, leaving the Treasury with $34.5 million that could be invested in needed areas such as specialist cancer care centres for adolescents, insulin pumps for kids with diabetes, or help for young people caring for parents with a mental illness.

And if more funds are required, they may well be claimed back from the $15.5 million allocated to the National Pregnancy Support Telephone Helpline. The 11 counselors working at the Helpline have received just 4, 492 calls in the first 14 months of operation.

Dr Lesley Russell is a Menzies Foundation Fellow at the Menzies Centre for Health Policy at the University of Sydney /Australian National University.

Peter Fray

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