The College’s advocacy efforts across our two countries have continued without pause. In March, the Australian federal budget was released. It contained significant funding for women’s health in Australia. How this investment is put into practice to benefit Australian women, now that the results of the election are known and the re-elected Labor government begins its term, is yet to be seen. The College’s report on advocacy developments is highlighted in this issue of O&G.

It is a difficult health system environment for Fellows and trainees in Aotearoa New Zealand. With a new Minister of Health, ongoing focus on financial savings, restructures and delivery of health targets, alongside huge workforce pressures, especially in our regional hospitals, there are challenges ahead. There have been some wins with Pharmac agreeing to fund both Estradot and Estradiol menopause patches, and to fund the desogestrel (Cerazette) progestogen-only oral contraceptive pill.

Te Kāhui Oranga ō Nuku is continuing to advocate for structured clinical leadership for women’s health at a government level, and to highlight lack of access to gynaecological care, particularly for the management of endometriosis and urogynaecological conditions. RANZCOG provided written and oral feedback on the Pae Ora (Healthy Futures) (3 Day Postnatal Stay) Amendment Bill noting lack of evidence that longer postnatal stays would improve outcomes and raising concern about funding and capacity to implement longer stays.

I acknowledge with sadness the recent death of Emeritus Professor Ronald William Jones CNZM (1939-2025) who leaves a substantial legacy in New Zealand medical history. He established the first dedicated vulva clinic in New Zealand, just one of his many achievements. He bravely spoke out against unethical treatment of women with cervical abnormalities at National Women’s Hospital in the 1980s, resulting in the Cartwright Inquiry, which led to changes to medical ethics and the rights of health consumers. I benefited enormously from Ron’s teaching, mentorship and friendship. More recently, he rang me to say how honoured he was to receive a prestigious award from the American Association for the Advancement of Science, the only New Zealander to have ever received this distinction. Ron’s significant contribution to women’s health in New Zealand is acknowledged in an obituary in this edition of O&G Magazine.

Reflecting on my term as RANZCOG President as I approach the end of my time in this role in October, I want to thank every one of our members and trainees for the support you provide the College. I am so grateful for the dedication of the Board, Councillors, our many committee members and RANZCOG staff. I extend my heartfelt congratulations to President-Elect Dr Nisha Khot, who will take over stewardship of the College later this year.

Advocacy update

Budget

The Australian federal budget was a win for women, through the pledge of a $793 million women’s health package. The package featured investments in many areas of women’s health that the College has been calling for over time. This investment should make medications cheaper, make accessing care easier, and provide more choice.

The new listing of contraceptives and menopause therapies on the Pharmaceutical Benefits Scheme (PBS), while reducing the maximum cap on out-of-pocket costs to fill prescriptions will significantly improve women’s ability to choose the medications that are best suited to them without additional undue financial stress —no small feat in this era of accelerating cost of living. From a health perspective, this expansion of available medications has been a long time coming, and it is something the College has been advocating for through many avenues, such as the 2024 roundtable on medicines and devices shortages. Shortages of key medicines and devices will remain an issue – this budget does not address that persistent problem – and The College will continue making the case that a complete rethink is needed on how to best secure adequate supplies of essential medicines and devices.

Women will further benefit by increases in Medicare Benefits Scheme (MBS) rebates for insertion and removal of long-acting reversible contraceptives (LARC). This makes the choice of a LARC more financially viable for women who may wish to choose that option; again allowing women to have greater autonomy over their own health and power over their reproductive freedom. The College has been heavily involved in consultations with the Australian Department of Health and Aged Care throughout 2024 and into 2025 about how better access to LARC care can be supported, and financial barriers is one area that has been consistently raised.

Furthermore, the expansion of funding for pelvic pain-related MBS items also makes it easier to seek care for such pain and conditions like endometriosis, as does dedicated funding to expand the footprint of endometriosis and pelvic pain-specific clinics. This is also something the College has supported, for example in through participation in the South Australian Select Committee on Endometriosis in 2024.

The budget did not contain specifics to support the specialist health professional workforce. The College was relieved to see money for hospitals, and specifically money to support the maternity wards in Hobart and Gosford in light of the challenges both those communities face. But in the long-term, much more needs to be done to support the range of health professionals – including specialist O&Gs – who staff these hospitals and make it attractive and sustainable to work in currently underserved areas. This is particularly true in rural, regional and remote communities. It is critical that the government tackle the systemic issues fueling workforce shortages and make consistent ongoing investments in upskilling and training for all healthcare professionals, so that women can continue to receive the care they need and deserve, close to home.

Election

The College congratulates re-elected Labor Government and Prime Minister Albanese, as well as all newly elected and returned Members of Parliament and Senators. During the lead-up to the election season and during the campaign, the College was reassured to see support for women’s health across the aisle. Women’s health should not be the territory of any one political point of view, and the College remains committed – as always – to working with any government to advance the health of women and girls.

The College used the opportunity presented by the federal election to socialise a number of key priorities that are important to progress in the next term of government. These priorities were: a movement towards a national free contraceptive plan; a comprehensive approach to tackling systemic gender bias in health care; more support for a sustainable health workforce, eliminating the persistent shortages of medicines and devices, and finally reform of how private maternity and gynaecology services are supported by government.

Prior to Christmas 2024, with the expectation of an Autumn campaign, the College wrote to the leaders of the parties with seats in Parliament as well as the crossbench Independent MPs calling for the consideration of a national free contraception program modeled on the one recently adopted in Canada. While the federal budget includes welcome investments in contraception, true reproductive freedom for women in Australia can only be achieved by removing financial barriers entirely. Both Labor and the Coalition put their policy to the electorate through matching the initiatives in the budget funding package, primarily the additional listing of contraceptives on the PBS as mentioned. The Australian Greens went further in supporting the concept of free contraception, and the College heard from a number of the Independent MPs in the last Parliament with interest in being involved in developing this policy as well.

The College’s advocacy for gender equity predates the election and continues to push the parties to commit to a true review of our health institutions – be that the MBS and PBS, medical research, or in the legislative framework governing private health insurance – to identify and eliminate policy settings that bake in gender bias. There is openness to this across the political spectrum; the next steps are to push for this to actually happen.

With access to reproductive freedom under threat domestically and overseas, and access not always what it should be here in Australia, the College has also been vocal about the need to expand the training and education in sexual and reproductive health care to a wider range of health professionals. This expands access for women seeking reproductive support, and when needed, abortion care, by ensuring that there are skilled and experienced health professionals available to them.

Finally, RANZCOG continued to highlight the urgent need to resolve the crisis in private health care, with much more needing to be done, and urgently, as the new term of government begins. Closures of private maternity wards in several communities put the challenges in stark relief. This isn’t a theoretical problem; it is affecting women now. Our government needs to meet the moment and shore up this vital side of our health care system. The College has called for a serious effort to reform the risk equalisation framework to allow obstetrics and gynaecology services to be provided in a wider range of private insurance products.

Looking ahead

With the campaign behind us and the new term of government getting started, the political environment for the next few years is relatively clear. Significant policy challenges that will affect obstetrics and gynaecology remain. The pressure on private health care remains acute, and there is no clear long-term program from elected leaders to put private practice on a sustainable footing. The College will continue to push for this with the federal government, working with stakeholders to advance the recommendations of our private practice roundtable.