This article is an update on the status of our application for an MBS item number for professional genetic counselling in Australia.

Background: 
The HGSA initially applied for an MBS item number to the Medical Service Advisory Committee (MSAC) in July 2021. The Department of Health advised that the creation of MBS items for genetic counsellors’ services was more suitable for consideration by the newly formed MBS Review Advisory Committee (MRAC). We were one of the first to submit to MRAC in January 2022. MRAC established a Genetic Counselling Working Group (GCWG) to assess our application. The MRAC GCWG met with senior HGSA representatives in April 2022 - Kevin Carpenter CEO, Alison McEwen President HGSA, Helen Mountain ASGC Chair, Amy Pearn Project Officer, and Toby Gould Health Technology Assessment expert, who was contracted to assist with the application. A targeted consultation was conducted in July 2022, and public consultation was completed in October 2022. 

Outcome: 
On 31 January 2023, Kevin, Alison, Helen, Amy, Toby, and Lauren Hunt COO, were invited to meet with the MRAC committee where we were advised that our proposal was not supported in their final report submitted to the Government. A copy of the final report and a formal response from the Government remain pending. The MRAC committee agreed there was a significant need to increase accessibility to genetic counsellors across Australia, but the booming landscape of genetic technologies and population awareness means that the demand and respective cost is challenging to quantify and may be difficult to contain. In turn, they felt unable to support the application in its current form.

Next steps: 
The MRAC Chair encouraged a more strategic approach to the provision of genetic counselling nationally. Thus, we have been directed to build a close relationship with the new Genomics and Health Technology Assessment Policy division in the Department of Health and the HGSA reached out to initiate this immediately. The HGSA will also consider submitting MBS applications for the provision of professional genetic counselling for specific scenarios and conditions.

Thank you:
The HGSA Executive and Secretariat want to express our gratitude and thanks to Amy Pearn and Toby Gould and working group volunteers, Camron Ebzery, Rachel Williams, Lucinda Freeman, Kirsten Boggs, Marian Rawlins, Jan Wakeling, Elle Martin, Denisse Garza, Simon Troth, Lara Fitzgerald, and Clara Gaff. 
 
We also sincerely thank everyone who made submissions during the consultation processes and wrote letters of support, posted tweets and raised awareness for the application. Your dedication and support are truly valued. 

Debrief:
Sometimes it is helpful to come together to share disappointment and gather our strength for the next round of work. We are hosting a Zoom meeting on Wednesday 15 February at 12:30 AEDT for anyone who would like to join us. You can register to attend here. There will not be a formal presentation, rather, this is an opportunity to reaffirm the identity and value of professional genetic counsellors who are continuing to work towards equitable access to our services for all.