Additional funding for abortion access all but ruled out
Health Minister Mark Butler has all but ruled out additional federal funding to address unresolved issues about abortion access in public hospitals, insisting the issue remains a matter for the states and territories.
The federal government has announced a $573 million package for women’s health, vowing to significantly lift Medicare rebates for long-term contraceptives.
It will also introduce a new rebate for menopause health assessments and fund the inclusion of two new oral contraceptive pills on the PBS.
The wide-ranging package forms the basis of the government’s long-awaited response to Senate reports on reproductive access and menopause, with no new money or policies expected to be announced beyond the weekend’s commitment.
But that means one of the major recommendations of the reproductive access inquiry — that all public hospitals within Australia be equipped to provide surgical pregnancy terminations — is unlikely to be addressed with additional federal funding.
Greens senator Larissa Waters, who spearheaded the establishment of the inquiry, said the omission was a “glaring gap” that women would “feel let down by”.
“I’m worried that the federal Labor government are nervous about touching this because they think it will be a culture war, and they’re worried about setting off the kind of Trumpist backlash from the opposition,” she said.
“I think when you’re silent about aspects that are core to women’s health, it doesn’t fix any of those problems. You need to have a bit of courage and put your cards on the table.“
Larissa Waters says the government should take a bold approach to expanding access to reproductive care. (ABC News: Matt Roberts)
In 2019, Labor took the issue of equitable access to abortions to the election, promising to tie public hospital funding to the provision of terminations and other reproductive healthcare service in a policy platform that was later dumped.
Mr Butler has ruled out revisiting the policy in the lead-up to this election.
“Tying state government hospital funding, which is such a crucial part of our health system, to some sense from Canberra about what the operational arrangements should be in every one of the 700 public hospitals — given that we have no line of sight about the workforce that they employ and a range of other important things like that — it’s just not our approach to things,” he told ABC’s RN Breakfast.
“Our approach has been certainly to brief states and territories about this important report, because this is essentially their area of jurisdiction, but also to work on those areas that we have responsibility for.”
Abortions can be provided either through medical or surgical terminations, depending on the circumstances of the pregnancy and relevant laws.
Minister for Women Katy Gallagher said while surgical terminations were the responsibility of the states and territories, the Commonwealth was responsible for medical terminations, which can be administered in the community through pills.
“We’ve seen a three-fold increase in access to medical termination … through Medicare which is really important,” she said.
“There’s always more that you can do, but in our approach to hospitals, we don’t tell them, for example, that they’re to really do any procedure because we don’t operate the hospitals,” she said.
Katy Gallagher says access to abortion services has improved. (ABC News: Floss Adams)
Both Labor and the Coalition have insisted they have no plans to change the status quo on abortion, as they seek to avoid a similar abortion debate to what played out during the Queensland election campaign, with concerns it cost the LNP votes.
In a party room meeting last year, Opposition Leader Peter Dutton sought to shut down backbenchers who had begun to float the issue at a national level, warning his colleagues that it would be a distraction in a federal election context.
Shadow Health Minister Anne Ruston also said surgical terminations was an issue for the states and territories, saying “it’s the way it has always been”.
‘More work to do’ on surgical abortion access: expert
While abortion is legal in Australia, the Senate inquiry heard harrowing stories from women who struggled to access pregnancy terminations.
“At this point, I was considering walking myself into emergency services at the local hospital and threatening to undertake the procedure myself if no-one would help me,” one woman, Bianca, said.
The ABC revealed in November staff at Orange hospital had been directed to stop providing abortions to patients who did not have medical reasons for a termination of pregnancy, before the NSW health minister intervened to reinstate all abortion services.
Danielle Mazza, head of Monash University’s department of general practice, said while the federal government had made significant progress in improving access to medical abortions, there was more work to be done when it came to surgical terminations.
“It’s a very complex issue that requires focus on building the workforce and training as well as the creation of clear and transparent pathways at a state and regional level, and these kinds of areas of focus can proceed,” Professor Mazza said.
“Sure, it’d be lovely to have further budget allocated to these issues, but I think they can proceed nevertheless through collaboration and dialogue between federal and state governments as well as with key stakeholders.”
The government is expected to table its formal response to the Senate reports this week.
