(Cth) Introduce a Health Check Item that Covers all Children in their First 2,000 Days

Wei-Hsuan Kai, Emmaby Barton Grace & Jessica Luu
Mar 17
8 min read

Author: Wei-Hsuan Kai, Emmaby Barton Grace & Jessica Luu | Publish date: 17/3/2026

P: There are no health assessments or checks under Medicare that cover all children in their first 2,000 days (5 and a half years).
S: The Minister for Health should amend Section 2.15.2 of the Health Insurance (General Medical Services Table) Regulations 2021 (Cth) to introduce a health check Medicare Benefits Schedule (MBS) item to cover all children in their first 2,000 days (5 and a half years).

Problem Identification:

Section 2.15.2 and Section 2.15.3 of the Health Insurance (General Medical Services Table) Regulations 2021 (Cth) specify that existing health assessment items (177, 224-228, 695-707, 715, 19000) cover certain priority populations, of which children may be included (intellectual disability, refugees, and Aboriginal and Torres Strait Islander). However, there is no dedicated health assessment or check specifically designed for all children in their first 2,000 days.

According to The Royal Australian College of General Practitioners (RACGP), this means that other existing screening and monitoring ‘programs can miss children’, especially those from marginalised populations who ‘face significant barriers in accessing’ health assessments.

Context:

The MBS refers to a list of ‘services that can be subsidised under Medicare’.

A health check, while not clearly defined, can refer to a brief assessment to ‘ identify any early signs of health issues.’ A child health check may focus on monitoring growth, development, and social environment and wellbeing to ensure children are reaching developmental milestones.

In August 2025, the Federal Government announced they would ‘examine the creation of a new Medicare item for bulk-billed 3-year-old health checks to pick up any developmental concerns.’ They suggested that these checks could ‘be undertaken by GPs, child and family health nurses, practice nurses or nurse practitioners’.

Arguments:

The RACGP and the Centre for Community Health noted that many families, particularly those from marginalised populations, experience financial barriers to accessing healthcare, such as health checks. Demant (2025), an Australian academic, found that ‘concerns about cost were the most prevalent reason for not accessing needed care [in Australia]… especially… for services with limited or no Medicare coverage… [and] general practitioner services.’ Australian academics Bull et al. (2022) suggested that children from these backgrounds are more likely to experience poorer health, increasing the importance of removing financial barriers to early assessment.

According to American researchers Lipkin & Macias (2020), the absence of a comprehensive health check for children during their first 2,000 days ‘can deprive… child[ren] and famil[ies] of the benefits of early identification and intervention.’ While some screening tests are already funded for children under Medicare, academics Oberklaid et al. (2013) argued that health checks can allow for more comprehensive and proactive care, by ‘providing information for parents about normal development’ and ‘responding to parental concerns.’ Oberklaid et al. (2013) explained that screening tests ‘rely on a clear distinction between those who have and do not have the target disorder.’ They noted that this does not reflect the reality of ‘developmental and behavioural difficulties, which exist on a continuum’ and may not correspond to a specific diagnosis.

While there are currently calls to introduce an MBS item for health checks for three-year-olds, Oberklaid et al. (2013) highlighted that ‘in the first 3 years of life, measures of development do not reliably predict future progress or ability.’ In comparison, they emphasised ‘the diagnosis of these conditions becomes more stable after the age of three’, therefore making it important for health checks to extend beyond 3 years of age.

State-funded maternal and child health (MCH) services, which provide health checks and developmental screening, are available across Australia. However, Bull et al. (2022) noted that MCH services are not equitable across states and territories, with large variation in access to and numbers of services, especially for rural and remote areas and culturally and linguistically diverse (CALD) families. Riggs et al. (2012) noted that Victorian MCH services also have high disengagement rates, with only 65% of children with Australian-born mothers, and only 35% of children with CALD mothers, attending their 3-and-a-half-year-old check-up. Furthermore, ABC News highlighted systemic issues with accessing MCH services, especially beyond newborn checks, in Victoria due to difficulties with funding and staffing shortages.

Advice/Solution Identification:

The RACGP and the Centre for Community Child Health have called for the introduction of a health check MBS item to cover all children in the first 2,000 days. The RACGP argued that this could ‘deliver better health outcomes’ and ‘enable … [health professionals to] provide comprehensive care in early childhood to improve timely access, equity, and outcomes, particularly in rural areas.’

Precedent:

There is international precedent for state-funded health checks for all children in the first 2,000 days. Ireland, Denmark and Norway all provide free health checks with a healthcare professional for children aged 0-5 years.

Public Support for the introduction of MBS items for health assessments for all children in their first 2,000 days:

Broad support for the expansion of state-funded early childhood health assessments (not specific to 2,000 days):

Broad Support for the re-introduction of state-funded four-year-old health assessments:

This list reflects publicly stated positions and should not necessarily be taken as endorsement of this specific brief.

News Coverage:

RACGP - “Minister flags support for MBS-funded child health checks”. The RACGP and Health Minister have discussed expanding Medicare support for child health assessments, including a proposal for universal annual checks across the first 2,000 days of life, beyond the current limited item coverage. By: Jolyon Attwooll | Wed 20 Aug 2025 - Read the article here.
RACGP - “Strong GP support for subsidised children’s health checks”. Reports citing the first 2,000 days as critical for lifelong health showed why universal and consistent health assessments for young children are important. By: Matt Woodley | Tue 6 Feb 2024 - Read the article here.
ABC News - “Melbourne babies missing out on child health check-ups due to staff shortages”. The City of Casey was forced to limit MCH services for families with children over eight weeks old due to staffing challenges. By: Matilda Marozzi | Thu 9 Feb 2023 - Read the article here.
ABC News - “Maternal and child health nurse visits slashed in Melbourne's booming outer-west”. The cities of Wyndham and Melton limited MCH services to babies under eight weeks due to population growth, staffing shortages, and limited funding. By: Margaret Paul | Wed 13 April 2022 - Read the article here.

Where to go to learn more:

(2025) RACGP Submission on the Inquiry into the Thriving Kid Initiative | The Royal Australian College of GPs (RACGP) - This submission provided feedback on the Inquiry into the Thriving Kids initiative, outlining various recommendations to improve healthcare for children in their first 2,000 days, including extending health assessment MBS items to cover all children in the first 2,000 days. View the full submission here.
(2025) Final Report | Thriving Kids Advisory Group - This report provided an overview of the proposed national model for Thriving Kids. It also recommended the addition of a bulk-billed three-year-old health check. Read the full report here.
(2024) The First 2000 Days Framework | NSW Health - This framework outlined the importance of the first 2,000 days in a child's life (from conception to age 5) and recommendations for how to best support children during this time. Read the full framework here.
(2020) Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening | Lipkin & Macias - This article provided some clear definitions for terms such as screening and surveillance (also known as monitoring in an Australian context). Read the full article here.
Health Insurance (General Medical Services Table) Regulations 2021 (Cth) - Read the full Regulations here.

Human Perspective:

Trigger warning: Discussion of child developmental concerns

Emily is 4 years old and lives with her mum in a small rural town, where the nearest community health clinic only visits once every few months and the nearest maternal and child health service is hours away. Instead, most care happens through their local GP. When Emily’s mum first noticed Emily showing signs of speech delays, she postponed a longer developmental check that she was worried she couldn’t afford, hoping Emily would ‘grow out of it’. Because there was no Medicare-funded child health assessment that Emily could access, her mum tried to raise the problem at quick GP visits for coughs or ear infections. However, the GP’s answer felt rushed and uncertain, and there was little time to explore Emily’s behaviour, language or social development in depth. She told herself to wait and wondered if she was overreacting, even though the waiting made her anxious. By the time Emily started school, her difficulties with attention and communication were more obvious, and referrals to allied health came much later than they might have. Her mum felt a heavy mix of guilt and fear, wishing she’d had a chance to ask properly and without worrying about the cost.

To protect the anonymity of those involved, this is a fictionalised account drawn from an amalgamation of real-life stories, experiences and testimonials gathered during the research process for this brief. Any resemblance to actual individuals is purely coincidental.

Conflict of interest/acknowledgment statement:

N/A

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Reference list:

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Better Health Channel. (n.d.). Regular Health Checks. Department of Health, Victoria State Government. https://www.betterhealth.vic.gov.au/health/servicesandsupport/regular-health-checks

Bull, C., Howie, P., & Callander, E. J. (2022). Inequities in vulnerable children’s access to health services in Australia. BMJ Global Health, 7(3), Article e007961. https://doi.org/10.1136/bmjgh-2021-007961

Centre for Community Child Health. (2024). Submission to the NSW Parliamentary Inquiry into improving access to early childhood health and development checks. https://www.ccch.org.au/media/jdwppazs/ccch_improving-access-to-early-childhood-health-and-develop-check_nsw_29022024.pdf

Demant D. (2025) Access denied: financial, structural, and personal barriers to health service use in a universal health system. Australian Journal of Primary Health, 31(5), Article PY25061. https://doi.org/10.1071/PY2506

Department of Health, Disability, and Ageing. (2025). Medicare Benefits Schedule - Professional Attendances - A7 - 5. MBS Online - Medicare Benefits Schedule. https://www9.health.gov.au/mbs/search.cfm?cat1=1&cat2=16&cat3=1022&adv=

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Health Insurance (General Medical Services Table) Regulations 2021 (Cth). https://www.legislation.gov.au/F2021L00678/latest/text

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Oberklaid, F., Baird, G., Blair, M., Melhuish, E., & Hall, D. (2013). Children's health and development: approaches to early identification and intervention. Archives of Disease in Childhood, 98(12), 1008-1011. https://doi.org/10.1136/archdischild-2013-304091

Paul, M. (2022, April 13). Maternal and child health nurse visits slashed in Melbourne's booming outer-west. ABC News. https://www.abc.net.au/news/2022-04-13/maternal-child-health-nurse-visits-slashed-melbourne-outer-west/100986614

Queensland Health. (n.d.). Child and adult health check activity summary. https://www.health.qld.gov.au/__data/assets/pdf_file/0022/1318405/CCM-HC-recommendations.pdf

Riggs, E., Davis, E., Gibbs, L. et al. (2012). Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers. BMC Health Services Research, 12(117). https://doi.org/10.1186/1472-6963-12-117