The first Endometriosis and Pelvic Pain GP Clinic in the ACT is set to start taking appointments in August/September this year. The clinic will be one of twenty to be funded across the country, following the announcement from the Assistant Minister for Health and Aged Care, Ged Kearney, in March. It will be run by Sexual Health and Family Planning ACT (SHFPACT), located just up the road from ANU at 28 University Avenue.
The funding, which will see over $700,000 designated to each clinic over four years, provides a much needed boost to a dire health care landscape, where despite the high prevalence of endometriosis and chronic pelvic pain, average diagnosis times and treatment waitlists stretch several years.
In Australia, one out of five people assigned female at birth are affected by pelvic pain, and one in nine with endometriosis. As it stands, the average time for endometriosis diagnosis is just under seven years, and official diagnosis is available only through an often costly laparoscopy (keyhole) surgery and/or biopsy, where tissue is sampled and then analysed by a pathologist.
In a media statement responding to the funding announcement, the Capital Health Network CEO highlighted how the clinics, as a first line of defence against endometriosis and pelvic pain, will aim to “reduce diagnostic delays and promote early access to multi-disciplinary intervention, care and treatment” in the ACT, as well as increasing awareness of the conditions.
Executive Director of SHFPACT, Tim Bavinton, told Woroni that despite the fact that the funding is “not a lot of money in the scheme of the healthcare system to do it”, the “team wants things to be very different in five years’ time than they are right now for many people.”
ANU student, Remi Prica (they/them) talked to Woroni about their experiences with endometriosis. Prica emphasised the difficulty of getting doctors to take their pain seriously, withstanding ten years of being told painful periods were “normal” before finally being referred to a specialist at the age of twenty-three. Prica has now been on a further specialist’s waitlist for three years.
Bavinton says that SHFPACT will build on their “long experience in reproductive and sexual healthcare” to not just “offer an additional clinical service” but make “sure we have the skilled allied health, nursing, GP and other specialist medical workforce we need working together to support the way patients move through the system, get the right kind of care at the right time, and aren’t left on waiting lists without other supports.”
Another ANU student, Elizabeth (she/her) expressed a similar sentiment to Prica. “When I noticed something was wrong with my menstrual cycle I was told by several different doctors that either I had a low pain tolerance or I was just finally properly ovulating and that’s why it was different.”
Both students commented on how ill-equipped the health care system was when it came to reproductive health, other than childbirth. Elizabeth shared her difficulties in trying to get treatment on campus, citing that her GP at the ANU Medical Centre was “particularly unhelpful”:
“I was after documentation for an Education Access Plan for the chronic condition and despite my records stating suspected endo they refused and told me that I probably just didn’t handle pain well and I should take more painkillers.”
Other than painkillers, Elizabeth attests that the predominant treatment is “experimenting with birth control until it’s manageable.”
For some like Prica, who “can take painkillers and still be crying from the amount of pain [they are] in”, and finds that both painkillers and the birth-control pill affect them “immensely in other ways”, the lack of knowledge and alternate treatment options leaves them lost. According to Prica, “people who had experienced pain like me said the only thing that relieved it long term was giving birth. This is a failing of the health care system.”
Labor’s recent budget provided a much-needed injection to the GP system, where bulk-billing doctors are currently few and far between, but did not expand on Medicare items related to reproductive health. More generally, the Budget included measures dedicated to “streamlining and modernising” the Chronic Disease Management Plan system, which has often been criticised by chronically ill people.
Prica emphasised the financial and social burden of constantly buying painkillers and taking time off work and social events due to endometriosis pain. For students already struggling with their current cost of living, the added need to treat an ongoing and financially-demanding medical condition can make matters significantly harder.
Bavinton confirms that at this point, SHFPACT intends to offer the same financial concession rates for students in the new clinic as they do for their other services. Under twenty-ones and full time students under twenty-five are currently entitled to a free, ACT Government funded nurse service or a concession rate which does leave some out-of-pocket costs. Although Bavinton assures that they “would love to bulk-bill instead… the freeze on the Medicare Benefit Schedule (MBS) rates over the last 10 years has meant this isn’t financially possible.” He encourages “anyone who needs care and is concerned about cost to contact us, we will always try to find a way to get the service provided.”
The funding will go towards supporting clinicians, professional development, as well as health education. Yet as Bavinton notes, “it’s going to take years not weeks to start to address some of the gaps and needs we have, and in the post-COVID years we have big workforce shortages in healthcare.”
The new clinic is clearly just a start in addressing what is a complex and wide-reaching gap in the health system, but as a policy area that has been so broadly neglected, it’s a significant step regardless.
Until the specialised clinic opens, people who are suffering from pelvic pain and painful periods can continue to make appointments at SHFPACT, especially when these are new symptoms.
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