Rebekha Sharkie (Mayo, Centre Alliance) Share this | Hansard source

As the late, great Tammy Wynette sang, sometimes it's hard to be a woman. The Australian Women's Health Alliance says the burden of poor health on Australian women is disproportionate, with a variety of chronic diseases affecting more women than men including stroke, cardiovascular disease, osteoporosis, and issues associated with pregnancy, childbirth and menopause. I could go on. The Royal Australian and New Zealand College of Psychiatrists states that women's health is underresearched, researched inappropriately and excludes female participants, and that women are chronically underserved and underdiagnosed by medicine.

Inequality in women's health starts in training, where medical students often have an hour or less to learn about, for example, menopause transition. This must change. The inequity continues with Medicare creating challenges for GPs to support patients with multiple complex coexisting issues within the format of a standard 15-minute appointment. The RACGP and individual medical professionals in my electorate argue that specific Medicare items are needed to support longer consultations so that GPs, obstetricians and gynaecologists can properly discuss with patients, diagnose and treat complex conditions, including endometriosis and menopause. We need to recognise the huge impact on women's health and wellbeing.

We need greater equity across MBS funding. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists states that the Medicare Benefits Schedule rebate for scanning a gentleman's scrotum is higher than what it is for the arguably more complex female pelvis ultrasound. A Mayo based OB-GYN advises we risk having a public-only system for births because Medicare and private health funds don't compensate them appropriately for women's health procedures. They are paid only $790 for uncomplicated delivery—up to 11 hours of labour and two hours of pushing—with no additional payment for night-time delivery. I'm told that surgeons receive more for a 20-minute cataract surgery. How can this be?

One local hospital in my electorate is unable to provide endometrial ablations for patients on all private healthcare funds because the equipment required for each patient costs almost the same as the funded total payment per procedure per patient. BreastScreen regional services are excellent, but they are restricted if women experience symptoms or have previously had a benign lumpectomy. Many women in the regions miss out because they can't afford the time and the cost associated with accessing a city service. Recently announced public endometriosis clinics in SA are limited to Kadina and Glenelg. Many South Australia women can't access them, noting they were already operating and the books filled up straightaway when they were rebadged as public clinics.

The Victorian parliamentary inquiry into women's pain treatment received submissions from more than 1,300 women and girls, including the Australian Nursing and Midwifery Federation. What we know is that women undergoing full reproductive system removal are offered one line of pain relief and that other gynaecological patients are given paracetamol and told to wait and see, compared to men, who are often given two to three lines of analgesia.

We see shortages and costs limiting women's access to, for example, best practice hormone replacement therapy medications, with only less effective treatments readily available. This potentially critical treatment is being denied some women due to costs, access and a lack of medical training. This can result in women being at higher risk of chronic illnesses, such as cardiovascular disease and osteoporosis, through the impacts of menopause.

What needs to be done? Well, we    need to listen to women. We need to take action to better support them and their health care at all stages. We need to implement the recommendations from the Senate Community Affairs References Committee's report on issues relating to menopause and perimenopause. We really do need to do better. There is a gap with respect to treatment, there is a gap with respect to what professionals receive for reimbursement of costs for services delivered, and there is a gap with respect to pain management. We can do much better in this country. The fact that, if you're doing your medical degree now, you get about an hour to learn about menopause is quite frankly outrageous.

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