Harry Jenkins (Scullin, Australian Labor Party) Share this | Link to this | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for Lindsay has moved as an amendment that all words after ‘That’ be omitted with a view to substituting other words. The question now is that the amendment be agreed to.

Chris Bowen (Prospect, Australian Labor Party) Share this | Link to this | Hansard source

Like many honourable members I have been grappling with the issue of the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 since it first appeared on the national agenda. I have read most of the submissions to the Senate Community Affairs Committee’s inquiry on this topic, and I have read the committee’s report. I have watched or read most of the speeches made in this House and in the other place. I have read the letters and submissions from people in my electorate who have argued the opposite sides of this case with equal passion. I thank the people in my electorate, whatever their views, for taking the time to write to me. I did receive slightly more letters and emails against this bill than I did for it, and if I am to believe the opinion polls a solid majority of electors support the bill. However, this is not a popularity contest. In matters such as this I agree with Edmund Burke, who said:

Your representative owes you, not his industry only, but his judgment; and he betrays, instead of serving you, if he sacrifices it to your opinion.

That is a sound principle, even though when Edmund Burke said that in the 1700s there were no female members of parliament and his quote reflects that. As tempting as it is to ignore some of the more distasteful things that have been said in this debate, I feel obliged to disassociate myself from them on the parliamentary record. For instance, I was disappointed to hear Senator Joyce’s contribution in the other place. Senator Joyce pointed out that there is a risk that women will die because they take RU486. He went on to say that there would be blood on the hands of members and senators who vote for this bill. This was a particularly unfortunate contribution. Any medication has its risks. Indeed, childbirth has its risks. If RU486 were to be introduced in this country, it would be for the woman to discuss with her doctor the relevant risks of each type of abortion. I do not regard this as an argument to vote against this bill, and the emotive and inflammatory language that Senator Joyce has used has done nothing to add to the quality of this debate.

Let me now turn to the argument advanced by a small minority that the present minister for health, who is in the chamber, is particularly unsuited to judge this drug on its merits because of his religious beliefs. This was an argument most graphically advanced by Senator Nettle by wearing a T-shirt into Parliament House which read: ‘Minister Abbott, Get your rosaries off my ovaries’. I found this T-shirt to be particularly offensive and this argument to be flawed. I do not wish to dwell on this point but simply say we all have our own moral compass, which is informed by different factors for each of us. For some it is informed by religion; for others, by more secular passions and backgrounds; for all of us, by our experiences. I believe that an individual is as entitled to call upon their religious beliefs to inform their views as to what is right and wrong as they are to call on a more secular philosophy. There is a separation of church and state, but there is no separation of religion and conscience. Whatever Minister Abbott calls upon to inform his conscience is his right. In any event, Minister Abbott is a temporary holder of the office of the minister for health. The argument should be based on good governance, proper process and the best way forward, not on the traits of any particular minister at a particular time.

The less that is said about the contribution of the member for Hughes the better. I do not wish to dwell on this point either, other than to say that I found the member for Hughes’s contribution to be particularly offensive and her so-called clarification in the House earlier today particularly unsatisfactory.

Much has been made in this debate of the fact that in the Senate a substantial majority of women senators voted in favour of this bill. Some senators put the argument very strongly that this is a matter for women and women’s rights. Senator Stott Despoja, in particular, implied that male senators did not have the same perspective nor, I believe, the same right to vote and speak on this bill. It is true that men and women have a different perspective on this matter. Clearly, this is a matter of great importance to women. Of course, in many cases, women make their decision on abortion alone. They have been abandoned by their partner, they do not feel they can talk to their partner because of a history of violence, or their sexual partner is not their life partner and they have no wish to enter a relationship with that man. Of course, in other cases, tragically, pregnancies are aborted as the result of rape or incest.

But let us not forget that thousands of couples struggle with the issue of abortion every year. Thousands of husbands and wives struggle with the moral, ethical and medical dimensions of abortion. Whatever the reasons that couples consider abortions, let us remember that men also grapple with this issue. Only South Australia keeps figures on the marital status of women who have abortions. Thirty per cent of these women are married or in a de facto relationship. There is no reason to believe that these figures would be different in other states. I simply want to make the point that, as vitally important as this issue is for women, it should not be forgotten that this debate also affects men throughout this country.

I said at the outset that I have been open minded throughout this debate. There have indeed been times when I have leaned the other way to the way I will be voting. I have applied the following tests to my vote: would the introduction of RU486 increase the number of abortions carried out in Australia? And would be introduction of RU486 potentially reduce the trauma for women who feel it is necessary to undergo an abortion? On the basis of these tests, I have decided to vote in favour of this bill.

Experience in the United Kingdom, the United States, Sweden and Germany indicates that the number of abortions using RU486 has increased but that the total number of abortions has not. Similarly, in New Zealand there has been no increase in the number of abortions—there has been a slight decrease. There is no evidence that countries that have RU486 available have a higher rate of abortion, and there is no evidence that the abortion rate goes up when a nation allows RU486. This stands to reason. I believe that very few women take the decision to abort a pregnancy lightly. It is something they struggle with, something they grapple with. I do not believe that women will decide to have an abortion simply because an arguably less intrusive method of abortion is available.

If I had seen any evidence that the availability of RU486 increases the number of abortions, making abortion so easy that more women would be tempted to abort their pregnancy, I would not be voting for this bill. Indeed, opponents of this bill have pointed out the risks in taking RU486 and the frankly horrifying things that can and have gone wrong for women who have taken RU486. When a doctor explains these risks to a woman considering an abortion, I refuse to accept that any woman would see taking RU486 as an easy way out of a difficult situation. However, I do believe that a woman or a couple making the decision to have an abortion should have as many methods available to them as possible.

Reading many of the submissions, especially the submission of Dr Renate Klein, I believe I would be very reluctant for a woman I loved or cared about to have an abortion using RU486. But at the end of the day this is a matter between a woman in consultation, in some cases, with her husband and her doctor.

I should also briefly indicate that I will not be supporting the amendments moved by the member for Bowman or the member for Lindsay. I listened carefully to the contribution of the member for Bowman and I understand his argument that there may be other drugs that come forward which should be subjected to ministerial or parliamentary control. However, I believe those drugs can be dealt with on a case-by-case basis as they arise, as RU486 was in 1996.

I do not feel qualified to determine whether medical abortions are more or less safe for a woman than a surgical abortion. I accept there is some evidence that they are less safe, but I am swayed by the views of the Australian Medical Association and the Royal Australian College of Obstetricians and Gynaecologists that these are matters best left to doctors and the TGA.

I want to briefly deal with the argument put by some, chiefly the Prime Minister, that to refer the approval of RU486 to the TGA would be some sort of abrogation of our responsibilities—that officials who are accountable to the people should be the ones who make these types of decisions. I accept the motives of the people who put this argument, but I respectfully disagree. It is the role of this parliament to set parameters for decisions. If this argument were taken to its natural conclusion, we would not have a Director of Public Prosecutions; the Attorney-General would determine who was prosecuted. We would not have an ASIC; the Treasurer would determine which companies got investigated. We would not have a Reserve Bank; the Treasurer would set interest rates. I could go on.

I will conclude my remarks, because I know that many honourable members wish to make a contribution, and it would be unfair not to try and let them speak before the time for this debate expires tomorrow. This is a bill about process. I have not gone into my personal views about abortion or my personal views about when human life begins. They are irrelevant, I believe, to this debate. Abortion is legal in Australia, with certain restrictions. RU486 is another way of achieving an abortion, and I believe this drug should be treated in the same way as others. It should be treated in the same way, for example, as the morning-after pill, which has been available in Australia for some time—largely without controversy. The morning-after pill changes the hormonal nature of the uterus so a fertilised egg cannot implant in it. It is a drug that must be taken very early in the pregnancy but which also has the effect of expelling a fertilised egg. I have not seen enough evidence to convince me that RU486 should be treated differently to the morning-after pill. It should be dealt with by the TGA and the drugs advisory committee, which I believe is appointed by the minister, in the normal manner. I support this bill.

Tony Abbott (Warringah, Liberal Party, Leader of the House) Share this | Link to this | Hansard source

Let me say that this debate is not about abortion, but the only reason we are having it is because it involves abortion. The proponents of the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 say that the existing law is a de facto restriction on abortion rights. The opponents of the bill say that up to 100,000 abortions a year is far too many and that if people want an abortion there is ample opportunity already to have one. There is much to be said for Bill Clinton’s dictum that abortions should be safe, legal and rare. It seems that many others in this chamber, including proponents of the bill before us, agree. The problem though is that in Australia today abortion is anything but rare; it is all too tragically common. I challenge the proponents of the bill to explain how extending the means of abortion might actually help to reduce its incidence.

We have 1,600 road deaths in this country a year, we have 2,800 deaths attributable to the misuse of alcohol every year and we have 19,000 deaths attributed to smoking every year. These we take extremely seriously, as we should, and we have strategies in place to reduce the number of these deaths. But somehow up to 100,000 abortions a year is accepted as a fact of life—almost, by some, as a badge of liberation from old oppressions.

I have been taken to task by some for using the phrase ‘up to 100,000 abortions a year’. We do not know exactly how many abortions there are. The Australian Institute of Health and Welfare estimates 84,000 a year; my department, using the best available statistics that it has, estimates 91,000 a year; but in an academic paper Dr David Grundmann, a well-known practitioner in this area, estimated that there are 105,000 abortions a year. I would like to have precise figures, but whenever people say we should ascertain precisely what the figures are it is said that this is impossible, for privacy reasons. The truth is that many people do not want accurate statistics, because they would rather not know. I suspect that, for all of the scientific language, for all of the careful tiptoeing around this issue, in their hearts most people understand that this is an ugly business.

But things do not go away or cease to exist because we find them gravely unsettling. Whether it is 84,000, whether it is 91,000 or whether it is indeed 105,000, it is far too many, and I believe that we should face up to the hard-heartedness of a society where so many women feel that abortion is their only choice. This is a society which is, by nature, generous and sympathetic. It is a society which, by nature, produces advocates for every vulnerable group—and I suppose one of the positives of this debate is that it has allowed at least some members of this House to speak up for the unborn.

We have a bizarre double standard in this country where someone who kills a pregnant woman’s baby is guilty of murder, but a woman who aborts an unborn baby is simply exercising choice. I want to make it clear that I do not judge or condemn any woman who has had an abortion. There would not be anyone under 50 in this country who has not come up close and personal against this issue. I accept that resolutions made in church often wilt under the hot breath of passion—I think I know that as well as any person in this chamber—but every abortion is a tragedy, and up to 100,000 abortions a year is this generation’s legacy of unutterable shame.

Abortion is not just another medical procedure, and abortion drugs are not just another class of routine drug. This drug is rightly treated differently because it does not improve life and it does not extend life; it stops babies from being born. It has been said that this drug is no more dangerous than many other drugs. It may indeed be no less dangerous to a woman, but it is absolutely lethal to a baby, and that is why this drug should keep the current status of special consideration.

I have to say that I have been pleased, in the course of this debate, to hear the member for Moore and others sing my praises as a minister and extol my virtues as a human being. I suppose this is why I pose the question to him and others: why does he trust the head of the TGA, whom he does not know and cannot question, to make these decisions, rather than a minister whom he does know and can question and apparently trusts? I have great respect for the officers of the TGA, but I simply pose the question: why should the head of the TGA, a person whose name would not even be known to most of the members of this House and who has never given an interview, be responsible for making decisions on some of the most fraught questions facing our society, rather than being responsible for simply providing expert advice?

A very distinguished senior colleague and close friend of mine said earlier today in this House that RU486 should only ever be available on prescription. I regret to point out that, once the sole arbiter of the availability of this drug is the TGA, that can never again be guaranteed. His view will have no weight whatsoever—except insofar as it happens also to be the view of the TGA—because then the TGA will be the law to all intents and purposes, not the people in this place.

In the course of this debate there have been many suggestions—some implicit, some explicit, some gratuitously insulting—that ministers who have personal religious views are incapable of making objective decisions. Like the member for Prospect, I think that the proposition that religious people are inherently biased in a way that people without religion are not is silly and offensive. Let me make it clear that scientific questions should be decided on scientific grounds, political questions should be decided on political grounds and only religious questions should ever be decided on religious grounds, even by ministers who happen to take their faith seriously.

But let me also say this: religious faith is not some kind of contaminant to be driven out of our public life. It is not necessary to be a Christian to accept the golden rule on which the ethical tradition of the West is based—that is, do to others as you would have them do to you—but sometimes it does help. It does help in resisting the ordinary human urges to take what we can get away with, and that is why religious faith is so thoroughly a factor for good in our public as well as in our private life.

Let me make it clear: I will certainly be voting for the Kelly amendment. If that fails, I will certainly be voting for the Laming amendment. If that fails, I will most certainly be voting against this bill. Should this bill ultimately succeed, I believe it will be a hollow victory. I doubt that any reputable manufacturer would apply to register RU486 as an abortion drug when it has to be used in conjunction with another drug which is not registered for that use and is not certified as safe for that use by its manufacturer.

So the big issue is not RU486 but what can be done to ensure that the women of Australia have real freedom of choice. That is why I am so pleased that the cabinet will shortly be considering new support for pregnant women facing very difficult decisions.

I believe that, in essence, this private member’s bill before us is a political statement by its sponsors that there should be no external restrictions or controls on abortion whatsoever. I think that society should not be indifferent to the fate of up to 100,000 unborn babies every year, and it will not always remain as indifferent as it currently seems. At the very least, this debate has at least focused attention on how, in this respect, our nation falls so very far short of its best self.

Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for Northern Australia and Indigenous Affairs) Share this | Link to this | Hansard source

I regard the opportunity to speak in this debate as a privilege and a unique opportunity to demonstrate to the Australian community that we are able to deliberate over and debate important national issues without the shackles of party discipline or political self-interest. In that context, it is important to recall why we are debating the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I am not going to canvass the scientific debate surrounding—

Honourable Members:

Honourable members interjecting—

Harry Quick (Franklin, Independent) Share this | Link to this | Hansard source

Order! If honourable members on my right wish to hold a discussion, could they please do it outside and accord the honourable member for Lingiari the respect that he is due. Thank you.

Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for Northern Australia and Indigenous Affairs) Share this | Link to this | Hansard source

I do not intend to canvass the scientific debate surrounding RU486. Others have already done so. Nor do I intend to take up the issue of how the Therapeutic Goods Administration is structured and functions. Others have done that, and I commend to the minister and others in this debate the contribution of the member for Curtin, because of her analysis of the role of the Therapeutic Goods Administration and the way in which drugs are approved in this country, the transparency of those arrangements and how they are reviewable as a result of the decisions which have been made.

Those of us who, like me, are supporting this legislation are simply seeking to rectify a very poor decision taken by the parliament in 1996 when it passed the Therapeutic Goods Amendment Bill 1996. Even then, it was just a political fix, a means of buying off Senator Harradine in exchange for his support for other government legislation. Let us be very clear about it. That was the purpose of the amendment in 1996: to satisfy a political need of the government at the time.

This bill will have the effect of normalising the evaluation of RU486 for use in Australia, by giving to the Therapeutic Goods Administration the responsibility to evaluate the quality, efficacy and safety of the drug and ultimately to approve or not approve the use of the treatment in Australia—as the TGA does with all other drugs—and removing the responsibility for approval from the minister. I will come to the minister’s contribution a little later.

This is not a difficult concept. It is not a debate about the issue of abortion, much as the opponents of this bill are trying to make it so—and just as the Minister for Health and Ageing tried to do a moment ago. Of course, they and others have geed up interest groups to prosecute that debate as if it were about that issue. With respect to those who hold this view, it is misguided and it ought to be rejected.

Let me say also that I accept absolutely that the views that I am expressing will not necessarily be shared by all of my constituents, some of whom have communicated their views to me, and on occasions those views have differed from mine. I have enjoyed that process of communication. The views expressed to me have been sincere, considered and generally well argued. However, there could be no argument, in my view, which could justify the Minister for Health and Ageing, or any other minister for that matter, having the responsibility for giving approval for the use of or making judgments about the efficacy, safety and quality of any medication, let alone RU486, which may be used for medical procedures that are otherwise legal in this country.

I am particularly concerned that those who oppose this legislation may share the view that patients, in concert with their doctors, are unable to make informed and appropriate judgments about the procedures that they may contemplate using. Of course, this is particularly important in relation to RU486 because of its potential to be used as an alternative to surgical terminations. As others have said, terminations are legal in Australia.

Despite what the minister said in his contribution, and as much as we abhor and are concerned about the issue of abortion, there is no evidence from overseas experience that there will be any increase in terminations as a result of the introduction of this drug. All that this legislation will do is change the procedure for the approval of RU486. If an application is made and approval is given for its use, it will provide a treatment option for patients and their doctors. This is potentially of great importance to Australian women, particularly those who live in rural and remote areas whose treatment options are currently very limited.

I am strongly of the view that we should be able to recognise and trust the ability of doctors and patients to make judgments, including about risk factors, treatment and medication. If this treatment were being contemplated for use in a remote location, then clearly there would need to be consideration given to supervision, including the proximity of hospital and other emergency services. I know many medical practitioners who practise in remote communities. They clearly understand the limitations of access to these types of services—they deal with them every day.

I know that in my electorate there will be many who will see the potential availability of RU486 as an option which, with proper supervision and monitoring, will provide an alternative to a surgical procedure which would require them to travel a long way from home. Fundamentally this is what this debate is about: the potential availability of a new treatment not just as a means of achieving terminations but for other medical conditions such as brain tumours or serious endocrine conditions and certain types of breast cancers and ovarian cancers. We know that RU486 has already been authorised under the TGA’s Special Access Scheme to treat some of these conditions.

Much has been said about the appropriateness of the TGA to make an assessment of RU486, because of the moral implications of the use of the drug. In the contribution from the minister we heard words to that effect. This is simply a furphy, and it is being used as a rationale to mount an argument against terminations and to deny women a choice—in consultation with their doctors—of treatment options.

I reject also the sensationalist and extremist positions that have been adopted by some of those who oppose this piece of legislation. Some of the comments of those who should know better have been wrong and misleading and have been designed to intimidate and frighten—for example, statements from the minister for health that refer to ‘an epidemic of abortions’ and ‘backyard miscarriages’ and ‘pop and forget pills’ or his consistent claim, which he repeated this afternoon, about there being ‘up to 100,000 abortions per year’, when he knows that this claim is patently false. Then, of course, there was his asinine statement in the Daily Telegraph on 10 February:

If the vote goes to strip me of this particular responsibility I think there are many commentators who will say this is effectively a vote of no confidence in the capacity of the Health Minister to make a rational decision, which is not a position a politician likes to be in.

The minister should step down from his high horse. This is not a debate about him, as much as he might like it to be, although his various statements are evidence enough of why this parliament should remove from the minister the responsibility for making determinations on RU486 or any other drug.

I am amazed that others have sought to admonish those who have attacked the minister for his position on the issue of RU486. Let it be very clear that the minister is big enough, as you have seen this afternoon, and ugly enough—as we all know—to look after himself. The fact that these ministerial supporters have been waving the Abbott banner simply provides further evidence of why the TGA and not the minister should be responsible for the evaluation and approval of RU486 and all other drugs. I wonder what these flag wavers would say if a very pro-choice person was the minister. You can imagine what would be going on if there were an application for the approval by the minister of RU486. You can imagine the political pressure that would be put on such a minister by these flag wavers who currently support the minister’s position.

I want to pick up on a point made by the minister. This debate, as well as not being about abortion, is not about faith or the worthiness of those who will vote for or will not vote for this legislation. In particular, despite what some have sought to portray, this bill and those advocating it are not attacking the Catholic Church or any other church. That view is mischievous and just plain wrong. Let me make it clear that in debating this legislation today the parliament is making an informed, conscious and responsible decision about how it believes this drug should be dealt with. It is right and proper for the parliament to take this decision. That is why we are elected to this place.

The minister, much as he may argue to the contrary, is not accountable when it comes to making decisions about RU486. The minister is a single person exercising sole discretion. He is not accountable to the parliament for the decisions he makes on RU486, and his decisions are not reviewable by the parliament. In terms of the amendments that have been put, I would counsel those wanting to support this legislation to oppose both amendments.

In closing, I want to make mention of the contributions of others on both sides of the debate. I particularly want to thank the member for Moore and the member for Lalor for the way they articulated the logic and merits of the case for supporting the legislation.

Before I sit down, I want to make one other observation. The minister, when he made his contribution, talked about the question of faith. He referred to religious people, people who ‘take their faith seriously’. Let me make it very clear to the minister that there are people on this side of the debate who have a contrary view to the minister about this particular subject who are also religious and who also take their faith seriously. I take it as an absolute insult, as someone who practises as a Catholic, to be told by the minister that somehow or another I am less of a person than he is because I am adopting the position that I am adopting.

Let me say whilst I am on it that I read the comments by Cardinal Pell where he referred to the sectarian anti-Catholic attacks by parliamentarians. I understand he may be concerned about the contribution made by a particular senator in the other place and the wearing of a T-shirt, which I think was way out of order. But let me make it very clear to him and any other persons who are observing this debate that this is not a sectarian debate. This is not about religion. This is not about whether or not I have a strong sense of faith or strong religious convictions. This is about the procedures for the approval of a drug to be used in Australia—nothing more and nothing less. I commend the legislation to all people in this parliament.

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

I rise this afternoon to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. The bill seeks to remove the responsibility that is now in the hands of the health minister of the day, whoever that might be, to allow RU486 as a drug to be used for medical terminations. I respect the views of everyone speaking on this bill. It is terribly important, because we have all been given the opportunity for a conscience vote on this bill. A conscience vote takes, I would hope, the party politics out of the decision. So we are really all on our own, as it were, when it comes to deciding how we should vote with regard to this bill. In many ways that is very good for democracy.

I have had comments from members of my electorate. When people have particular positions, many say, ‘This is very good for democracy.’ It enables us all to go back to our electorates and seek a wide range of views. Many views on this subject have come unsolicited, which I have certainly appreciated. It allows you to make sure you keep in touch with the views of your constituency in relation to this conscience vote. I take the views of my constituents very seriously. A large number of people have contacted my office, both from within my electorate and—possibly more so—from outside my electorate. I respect all of those views. The views that have come to me from my electorate have been for and against. There is not a universal yes or no. So then it comes to me to use my judgment as to how I should vote on this subject.

This is not a debate about abortion. Some have said it is a debate about abortion. This parliament does not have the power to deal with the issue of abortion. Those laws are with the state and territory governments around Australia. They are not laws of the Commonwealth. That is why it is not an issue about abortion. Whilst the drug that is the subject of this bill would, if allowed to be available in Australia, bring about a termination, the bill is not per se about abortion. Nor do we in this place have any power with regard to the laws governing abortion. As I said earlier, they are the laws of the state and territory governments, not the Commonwealth.

This bill, if it is passed, will allow the Therapeutic Goods Administration to consider the safety and efficacy of RU486. A lot of people have used the word ‘bureaucrats’ when they talk about the members of the Therapeutic Goods Administration. I want to use some time this afternoon to read into the Hansard who these people are. The people who make up the membership of the Therapeutic Goods Administration are in fact appointments of the Minister for Health and Ageing. They make up the Australian Drug Evaluation Committee. It is a requirement of the law that the minister appoint core members to that committee. The regulation says:

• three must be eminent medical practitioners with at least two specialists in clinical medicine; and
• one must be a pharmacologist, or hold a degree in science, specialising in pharmaceutical science.

The associate members must include:

• at least one pharmaceutical chemist with recent manufacturing experience in therapeutic goods; and
• at least one toxicologist; and
• a medical practitioner in general practice.

They are hardly bureaucrats.

I have great respect for the people who are on the Australian Drug Evaluation Committee. They are eminent people in their fields. The chairman is Professor Martin Tattersall of the Department of Cancer Medicine, University of Sydney. Other core members are Professor Nicholas Glasgow of the Australian Primary Health Care Research Institute of the Australian National University; Dr Alyson Kakakios, Head of Department, Department of Immunology and Infectious Diseases, the Children’s Hospital at Westmead in New South Wales; Dr Geoffrey Herkes, Senior Staff Specialist in Neurology, Royal North Shore Hospital, and Senior Clinical Lecturer in Medicine, University of Sydney, New South Wales; Associate Professor Anne Mijch, an infectious diseases physician at the Alfred Hospital, a consultant physician at the Melbourne Sexual Health Centre and Royal Women’s Hospital and a senior lecturer in the department of medicine at Monash University in Victoria; Associate Professor Duncan Topliss, who is the director of the department of endocrinology and diabetes at the Alfred Hospital in Victoria, and Chairman of the Adverse Drug Reactions Advisory Committee of the ADEC; and Professor Julia Potter, who is a pathologist in the Canberra Hospital in the ACT. The associate members of the Therapeutic Goods Administration are also very eminent people—doctors and professors.

I have read the names of those people into the Hansard because some members have been referring to them as ‘bureaucrats’. They are highly qualified and well-educated people who are all appointed to that committee by the minister to consider and evaluate drugs that come forward as to whether they should be made available in Australia.

I am not competent to judge the safety or the efficacy of any drug that we have available in Australia today. I am not competent to judge whether Ventolin is a safe drug. I am not competent to judge whether Nurofen should be under a certain classification that is available in Australia today—or antibiotics or other drugs that will improve the quality of life and be responsible for improving the health of Australians. I am not competent to do that. But, in this case, I do trust the minister’s appointments to—the core members of—the evaluation committee of the Therapeutic Goods Administration.

As I have done some research on this subject, I have also discovered that RU486 has been available in many countries overseas—in some of them, for more than 20 years—such as the United Kingdom, the United States of America and countries in Europe. Contrary to some of the media reports, I understand that it is available in China and Israel; that is the advice that I have.

I also understand that RU486 has purposes other than as an abortifacient. RU486 can be made available through a special access arrangement for some life-threatening diseases. It does have an effect for some people who suffer from inoperable meningiomas, Cushing’s syndrome, breast and prostate cancer, glaucoma, depression or uterine fibroids. It also has shown some promise in the treatment of HIV-AIDS, dementia and progesterone dependent uterine and ovarian cancer. As I understand it, if RU486 were available—rather than being available only through special access arrangements, as it is at the moment—it could certainly improve the life of many people who suffer those very serious life-threatening and debilitating diseases. But, as I have said, it is only available now through a special access agreement, which often takes time, which means that it is often too late to be able to provide that relief or support to those who suffer some of those forms of cancer or inoperable and life-threatening diseases. I certainly have faith in those who comprise the TGA and that they are competent to make the decision as to whether RU486 is safe to be used, under what terms it should be used and its efficacy.

I know that two amendments will be put before this place before the final vote is taken; they are the Laming and Kelly amendments. I have decided to support one of those amendments, in that it would allow the TGA to consider the safety and efficacy of RU486 and then make a recommendation to the minister. As I understand that amendment at this stage, that would allow the drug to be evaluated by the Therapeutic Goods Administration. If the minister of the day then disagreed, he or she would have to lay before the parliament their reasons for disagreeing with the evaluation of the Therapeutic Goods Administration. It would then become a disallowable instrument in this place. At that juncture, if the parliament disagreed with the minister, the drug would be made available—but that is only if the Therapeutic Goods Administration had made that recommendation and the conditions under which it could be prescribed for use in Australia. If those amendments do not get up, I believe that, on balance at the end of the day, I will give my support to this bill before the parliament.

In conclusion, this is a very difficult debate. As I said earlier, it is not about abortion; it is about which body is most competent to deal with the evaluation of this drug. I think I have outlined in my address that I have faith in the professionalism and the expertise of the core members of the Therapeutic Goods Administration to make that evaluation in the first place. I believe that, if the proposed amendments get up, the sovereignty of this parliament would be given the opportunity to consider any decision that the minister would disagree with, if the Therapeutic Goods Administration had made a recommendation for the availability of RU486.

Kelly Hoare (Charlton, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to support the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 in its unamended form. In doing so, I congratulate the co-sponsors of the bill, Senators Claire Moore, Lyn Allison, Judith Troeth and Fiona Nash. I also congratulate the member for Moore, Mal Washer, for introducing the bill into the House yesterday.

This is a debate about process. It is a debate about whether any application for the drug RU486 to be imported into and registered within Australia should be considered by the TGA or whether we should continue to allow for ministerial responsibility for approval. Currently, the drug RU486 can be imported into Australia only for research and clinical use with the permission of both the TGA and the Minister for Health and Ageing, who is required to notify the parliament of his or her decision. This restriction has imposed an effective ban on the drug. There are many contentious drugs and drug uses for which the government allows and indeed promotes the use of the TGA as the appropriate agent for oversight. The TGA is, after all, charged with risk management connected to pharmaceuticals.

There are a number of drugs that are used in Australia as abortifacients, as well as others that have abortifacient effects, which the TGA has registered and now monitors. Indeed, the TGA currently lists around 55 drugs or categories of drugs that either cause or are suspected to have caused or may be expected to cause an increased incidence of human foetal malformations or irreversible damage or have a high risk of causing permanent damage to the foetus. These include the antimalarial Quinine, several vaccinations, numerous antiepileptics and the mental illness treatment lithium salts.

It is also important to remember that not only is RU486 designed or capable of inducing abortion; its antiprogesterone action may allow it to improve and save the lives of seriously ill Australians. RU486 is indicated as therapy in a variety of serious and, in some cases, life-threatening medical conditions. As the member for Maranoa just indicated, these include inoperable meningiomas, Cushing’s syndrome, breast and prostate cancer, glaucoma, depression, endometriosis and uterine fibroids. In addition, the drug has shown promise in the treatment of HIV-AIDS, dementia and progesterone dependent uterine and ovarian cancer.

We are all entitled to our beliefs and opinions, but medical decisions should be made on the basis of rigorous and up-to-date medical advice. Who better to evaluate the medical evidence than the Therapeutic Goods Administration? A recent research note by the federal Parliamentary Library service says that the current debate over RU486 is essentially over questions of risk management and that management of the risks associated with medicines is an explicit function of the TGA. The government should step back and let the TGA do its job. The TGA is regarded by the government as being qualified to manage the risks associated with any therapeutic good that is used, or is proposed for use, in Australia.  From this, one could reasonably assume that it is also qualified to manage the risks associated with abortifacients such as RU486.

RU486, like every other pharmaceutical, should be dealt with by independent medical experts at the TGA who can be relied on to make decisions about safety in an unbiased and knowledgeable way. Such decisions should not be made on the basis of the personal beliefs of a minister for health or of a parliamentary secretary for health. I agree with the coordinator of Children by Choice, Cait Calcutt, when she stated:

Women have waited nearly a decade for politicians to decide that politics has no place in medicine and that the TGA, not the clearly-biased Health Minister, should decide whether RU 486 is safe and effective. It’s unfair to ask them to wait any longer.

In 1996 this parliament made a decision based on the facts and information before it that the approval process for the drug RU486 be removed from the TGA and be placed solely in the hands of a single politician—the minister for health. If I had been here at that time, I would not have voted for this change. Indeed, if approval for RU486 had remained in the hands of the medical experts, it is quite likely that at that time it might not have been approved. There had not been the research or the experience which would have allowed the approval.

However, as research continues and trials are conducted, many new drugs have their safety and efficacy investigated, tested and proven. This has led to many countries around the world and the World Health Organisation approving RU486 to be used as an abortifacient, widening the choice for women who, for whatever reason and in whatever circumstances, require an abortion. In July 2005 the World Health Organisation placed RU486 on its list of essential medicines and described abortion by either surgical or medical means as ‘one of the safest medical procedures’. Women in over 30 countries including the UK, the United States, much of western Europe, Russia, China, Israel, New Zealand, Turkey and Tunisia have access to this drug, but not Australian women.

The so-called Harradine amendments to the Therapeutic Goods Act in 1996, supported by the parliament, have effectively banned the drug in this country for the last 10 years even though, with the research work going on around the world to ascertain its safety and with the WHO listing, the safety and efficacy of RU486 has obviously been confirmed. At that time there was much political sensitivity surrounding abortion in this country. However, now abortion is legal in all Australian states and territories. If abortion is legal, don’t regional, rural and urban Australian women deserve the right to choose the most effective option for themselves—a decision which should be made between a woman and her doctor?

Although this is supposed to be a debate about process, it has also developed as a debate about abortion and the safety of RU486, so I will now turn my remarks to that. The evidence clearly and overwhelmingly shows that RU486 is safe and effective. Indeed, many Australian, international and world health bodies support the availability of RU486 to all women. These organisations include the World Health Organisation, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Public Health Association of Australia, the AMA, the American Association for the Advancement of Science, the US Federal Drug Administration and the Rural Doctors of Australia, just to name a few.

Although some members are concerned about the political sensitivity of the issue of abortion in their electorates, a recent survey conducted in January this year by Newspoll and commissioned by the Australian Reproductive Health Alliance showed that 68 per cent of Australians are in favour of RU486 being made available to qualified medical practitioners in order to terminate a pregnancy. Some in this debate, including the member for Lindsay in moving her amendments to this bill, have emphasised that as elected representatives we have a responsibility to make these decisions on behalf of our constituents. We do have a responsibility to represent our constituents here, and that is what we all do with dedication, passion and commitment and to the best of our ability. But we do not have a right to make these decisions without the medical expertise and without personally knowing what leads a particular woman to choose to have an abortion. As the member for Moore stated, he does not have the expertise to make these decisions, and he is a qualified, experienced and very good doctor. The current minister for health is not, nor could we anticipate that future ministers would be.

We have heard in this debate personal stories. I have received correspondence and phone calls from women relating their own personal experiences. As parliamentarians, we have no right to decide what is best for women who require an abortion. That is a matter between them, their families and their doctors. It is the woman’s choice. We also do not have the right to deny them and their doctor access to the most effective and safe means. We do have the responsibility to ensure that when there is an application to import RU486 for use as an abortifacient there is the most rigorous investigation by the medical experts within the Therapeutic Goods Administration.

Before I conclude, I want to turn to the amendments proposed by the members for Lindsay and Bowman and to encourage members who, in good conscience, were considering supporting this bill because of all the reasons related in this debate to do so—and I include in that the member for Maranoa, who has just spoken. If either amendment is passed by the House of Representatives, the choice for Australian women will effectively remain where it is today. Both amendments allow for further and continuous parliamentary debate on the issue of abortion, because they both indicate a further level of approval by the parliament. This is a debate we had over 30 years ago, which was settled with states allowing women to have an abortion if they so choose. Also, there has been no application for approval of RU486 because of these procedures. The procedures proposed would be too lengthy, costly and uncertain for manufacturers to go through, thus still denying Australian women this choice.

Further, it has been advised that, if the amendments proposed by the member for Lindsay were to succeed, they will negative the second reading of the bill. She understands this and has since laid out her intention. Also, if members are considering either of the amendments, they need to be aware that if the Kelly amendments are carried, it will be the end of the bill and the Laming amendments will not proceed. So I encourage all members considering supporting this bill to do so, because, if they are considering supporting the amendments for a so-called compromise, this bill will fail.

In conclusion, I reiterate that I am pro choice—that is, I respect and agree with a woman’s right to choose an abortion in consultation with her doctor. That is her decision and hers alone. It is not a matter for any politician of any political persuasion or faith—or, indeed, of no faith. Australian women currently have the right to choose an abortion but not the method. They should have that right and will have that right only if the TGA has the responsibility for proving or not proving the safety and efficacy of the use of RU486 as an abortifacient. I reject the amendments and support the bill.

Tony Smith (Casey, Liberal Party) Share this | Link to this | Hansard source

The Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 bill has stirred significant debate in our community. Can I say at the outset that I respect all the views that have been put to me by constituents within the federal electorate of Casey. This is a bill about which few people have neutral feelings. I have received many phone calls, emails and letters from people strongly supporting the bill and from people strongly opposing it. I have read them all, and I thank each and every one of those people for taking the time to express their view to me.

This, of course, is a debate where each of us is called upon to deliberate and vote according to our conscience. This is not something to be weighed against electoral considerations—not something to be the subject of lobbying by members or senators in this place. It is simply something for each of us, on our own. In any conscience debate and vote, it is inevitable that every single one of us in this House and every single senator in the other place will disappoint some people and please others. But it is incumbent on us to weigh the issues involved, review the facts and evidence and make our best individual judgment. I have weighed the issues and considered a number of matters in detail.

Firstly, I have weighed the view expressed by many people that the passage of the bill will lead to a greater number of abortions in our country. The legal regime relating to abortion is governed by state and territory law and is longstanding. If RU486 were to be approved some time in the future, it would not extend those laws in any way. At issue is not whether someone has a termination but, rather, how they have one and, given that, I do not believe the provision of RU486 at some point in the future would lead to a greater number of terminations in this country. In this, we must examine international experience, as previous speakers throughout this debate have done, and we can see that there has not been an increase in the rates of termination in those nations that have had access to RU486.

Concern regarding the number of abortions is justified, but I do not believe fewer abortions will be achieved by seeking to restrict another option, or by endeavouring to reverse or restrict the current legal regimes in our states and territories. The current legal basis for abortion is about as old as I am. Even if one or two states or territories in the future were to restrict or change their position, there would still be six or seven other jurisdictions in Australia, as well as nearby nations such as New Zealand, where terminations would be performed. Instead, the path to fewer terminations in our country is to be found with continued attitudinal change in our community through education. Given the settled and longstanding nature of the law, the issue at hand in this debate is whether a second option is available within the existing framework. The issue then is the judgment on the health and safety of such an option. To this end, there have been many strong arguments put that RU486 is dangerous and unsafe. The fact that the drug has been in existence and widely available in the United States for nearly six years, as well as in much of Europe for a longer period, and our close neighbour, New Zealand, is compelling. I do not believe it would still be available in those countries if there were any doubt that it was dangerous. The US Congress has not overturned the United States Food and Drug Administration’s approval of the drug in September 2000, over five years ago.

Secondly, and most importantly for Australians, as many of my colleagues in the House and the Senate have pointed out throughout the debate, the safety issues would be determined by the Therapeutic Goods Administration which, as previous speakers have pointed out, comprises medical experts with the sole aim of assessing the safety and effectiveness of drugs. It is best able to determine the merits of the safety of RU486. Further, any provision of RU486 would be by way of medical supervision by doctors in Australia, who are amongst the very best in the world. I do not believe for a minute that Australian doctors want to do anything other than administer all drugs with the utmost care and supervision.

In recent days there has also been a great deal of discussion with respect to the need to maintain parliamentary oversight on policy matters such as this. I believe our parliamentary oversight is strong and enduring by virtue of this parliament and this debate. Parliamentary oversight exists for every agency. Parliament can delegate authority, modify a delegated authority or remove a delegated authority at any time, should it wish. The Therapeutic Goods Act 1989 itself can be amended or altered by this House and this parliament at any time. There is no act of the federal parliament which cannot be altered or amended, subject to the Constitution of Australia. For all of these reasons, I will support this bill. The member for Bowman has proposed an additional mechanism for parliamentary oversight which I will consider supporting. However, in the event that his amendment does not succeed, I will still support the bill, as I have publicly stated and for all the reasons I have outlined.

Can I say, as the Prime Minister and other ministers and speakers in this debate have rightly said, the passage of the bill is in no way a reflection on our Minister for Health and Ageing,  Mr Abbott, whom I regard as a friend, a fine health minister, and someone who through dint of timing is in a difficult position that either of the past two health ministers could equally have faced. I do believe he has been unfairly attacked on the basis of his personal position and his religion, which I find very regrettable.

I conclude where I began by thanking those who contacted me, including the many people whose counsel, friendship and understanding I value, who I know do not share my view on this bill—people with whom I agree on many other important issues in the building of a better Australia.

Kirsten Livermore (Capricornia, Australian Labor Party, Shadow Parliamentary Secretary for Education) Share this | Link to this | Hansard source

I rise in this House to support the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I also want to make it clear that I do not support the amendment that has been moved and the amendment that has been foreshadowed in the debate so far. I know it has been said dozens of times in this debate already, but the simple fact of the matter is that this debate is not about the rights and wrongs of abortion. What we are being asked to decide tomorrow is the appropriate means by which this particular drug, RU486, is assessed for possible clinical use in Australia. The question is: should the decision to allow the use of RU486 in Australia be made by the Minister for Health and Ageing or should it be made, as it is for every other pharmaceutical product, by the Therapeutic Goods Administration?

In framing the debate in those terms, I know after listening to many of the previous speeches that I am not being terribly original. I am also not trying to be somehow disingenuous. I am not trying to put some kind of spin on the issue in order to avoid the sensitive topic of abortion. I have no reason to do that anyway. I have nothing to hide as far as my view on abortion is concerned. Indeed, I am on the public record in two of my local newspapers going back to the start of this debate in December as being an advocate of a woman’s right to choose an abortion if, after weighing up her circumstances, that is what she believes is right for her. If this did happen to be a debate about abortion, then my constituents already know where I stand.

However, as I said, this is not what we are being asked to vote on tomorrow. Instead, we are being asked to consider and ultimately to overturn the present arrangements dating back to 1996 which classify RU486—and, I note, only RU486—as restricted goods that, according to the Therapeutic Goods Act, cannot be evaluated, registered, listed or imported without the written approval of the Minister for Health and Ageing. Since it came into force, this scheme has acted as an effective ban on the importation and use of RU486 in Australia. Without ever having to provide reasons or explain his or her reasons to the Australian public, each of the successive health ministers has rejected any attempts to add RU486 to the 50,000 or so pharmaceuticals that are approved for use in this country.

The present health minister, Tony Abbott, has complained during the public debate over RU486 that people have unfairly concluded that he is blocking the use of the drug because of his Catholic faith. Of course, no-one should ever be criticised for their religious beliefs, but there is no getting away from the fact that, in the absence of a transparent process for making these decisions, people will jump to all sorts of conclusions about any minister’s motivations and personal biases when trying to understand his or her actions. This bill before the House today seeks to guarantee that future deliberations about RU486 will instead be transparent, unbiased and based on the best available scientific evidence. I believe that the best way to do that is to give the power to the Therapeutic Goods Administration so that it can subject applications relating to RU486 to the same rigorous evaluation that it applies to every other drug.

That brings me to another important point about this debate. Just as it is not about the availability of abortion, it is also not about allowing open slather for anyone who wants to administer RU486. Contrary to what many in the community seem to believe, this amendment, if it succeeds, will not in itself allow for the introduction of RU486 in this country. Rather, it will give the Therapeutic Goods Administration the authority to evaluate applications for the importation and use of the drug within Australia. Many of the emails and letters that I have received from constituents and others with an interest in this debate have referred to serious health risks associated with the use of RU486. On the other hand, submissions to the Senate Community Affairs Legislation Committee inquiry refer to its use in 35 countries around the world and the drug’s endorsement by respected bodies such as the World Health Organisation, the Australian Medical Association and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as evidence of its safety.

By voting for this bill today I am not accepting or dismissing any of those assertions. I am just not qualified to make that judgment. But the members of the Therapeutic Goods Administration are, and we trust them to exercise their professional judgment on our behalf in assessing the benefits and risks of every other drug that comes onto the market in Australia. The pharmaceutical scientists and medical practitioners who are given that responsibility have the expertise and experience to properly interpret the research and trials of RU486 and decide whether it should be made available for use in Australia and under what conditions.

So by voting for this bill I am not passing judgment on RU486. Rather, I am passing judgment on the lack of proper administrative process represented by the current system. Let the TGA submit the drug to its usual processes and make a decision on its safety. If the drug passes that test, then it does not, as some people have argued, give the green light to mass abortion. In fact, statistics from other countries where RU486 has been permitted show that there is very little effect on the overall number of abortions performed in the periods before and after the introduction of the drug. Rather, if RU486 becomes available then it simply becomes another option for a woman to consider with her doctor when she exercises her right to have an abortion—a procedure that is legal when performed under prescribed conditions in every state and territory of Australia.

In all the discussions here about who should be making decisions, it is appropriate for us to debate whether the TGA or the Minister for Health and Ageing should decide on the availability of RU486. One decision that I believe should be completely off-limits for any of us to restrict or pre-empt in any way is a woman’s decision when faced with an unwanted pregnancy. Each woman in those circumstances should be free to act in accordance with the law and with appropriate medical advice and to decide what is best for her.

That is why I have a problem with the amendment moved by the member for Lindsay and the amendment foreshadowed by the member for Bowman. Those amendments, which make parliament the ultimate arbiter on RU486, would still leave us with the same flawed position we have now. The health minister does not have the qualifications or expertise to make a clinical judgment about the use of RU486, and neither do we as members of parliament. So, under either one of these schemes, when faced with the decision about whether RU486 should be available MPs would be back to relying on our own values and beliefs about abortion.

I have no doubt that values and beliefs play a big part in the decisions women make about whether to have an abortion, but they should not be the values and beliefs of any of us here. Our responsibility, when it comes to RU486, is to put in place and oversee a process that thoroughly tests the drug’s effects so that when women exercise their free will in accordance with their values and beliefs they know that they can do so safely. As parliamentarians we should not impose our moral views on women, and we should not allow those views to stand in the way of a woman’s ability to make her own decisions about something as personal as abortion.

If we do not pass the bill and allow an application for RU486 to be assessed on its scientific and medical merits, then we are making it harder for many women to have that freedom of choice. I am talking particularly about the situation of women in rural and even regional areas of this country. As a member representing a regional and rural electorate, I agreed with the Minister for Workforce Participation, Sharman Stone, when she raised the problem last year of women in her electorate having limited access to surgical abortion. The same situation applies in Queensland, where there are only three clinics outside the south-east corner. There is one in Townsville, one in Cairns and one in Rockhampton in my electorate. That means that the option of surgical abortion is difficult or even impossible for thousands of women living in rural and remote Queensland, far away from those services.

The other factor that impacts on the choices available to rural and regional women is the cost of surgical abortion in our parts of Queensland. In Brisbane and the south-east corner, the cost of an abortion is between $210 and $300. For a woman attending the clinic in Rockhampton, however, the rate is $450. Of course, that does not take into account the costs of travel and accommodation for those women who live far from Rockhampton or the other regional centres where this service can be accessed.

So, while the option of having an abortion is a legally available choice for women in my electorate, the reality often is that it is not a choice that they are able to exercise, for those practical reasons. A health professional in my region has told me of her concern that these practical barriers to accessing surgical abortion can lead women to take desperate and unsafe steps to procure an abortion, with great risks to their health. Each woman should be allowed to make her own decision and be guided by her own conscience and beliefs and her individual circumstances. If RU486 can be proved to the satisfaction of the TGA to be a safe alternative for a woman wanting to give effect to that decision, then it should be available to her.

Before I conclude my remarks, I would also like to acknowledge, as I have noticed many speakers have in this debate, the many people who have called my office or sent emails and letters letting me know their views and the way that they would like me to vote. Most of them do not agree with my position, but they have in the main put their case courteously and respectfully. I tried in each case to reply in a way that respected their right to have a strong view while being honest about how I would ultimately vote. I know that the way that I intend to vote on this bill does not have universal support in my electorate. Some people may be disappointed or even angry about the position I have taken. As I have said all along, I am voting for this bill because it promotes good governance and proper process and also because I respect the right and the ability of women to make their own decisions. Let the TGA decide on the safety of RU486 and let women decide what choices they make for their bodies and their futures.

Michael Keenan (Stirling, Liberal Party) Share this | Link to this | Hansard source

I also rise tonight to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I have given a lot of consideration to the matters contained within this bill. I have also discussed them extensively with both my constituents and my colleagues. Many people whom I respect have come to see me about this bill. I have received more correspondence and phone calls about this issue than any other since I entered parliament in 2004. I thank all of those people, particularly my constituents in Stirling, who took the time to contact me about their views and for making the effort to do so. There is no doubt that emotions on this issue run high, although it is fair to say that I have been contacted by far more constituents who oppose this private member’s bill than who support it. Of course, I would never make the mistake of assuming that that necessarily reflects the majority of my electorate. But, at the end of the day, after all the correspondence and phone calls, I am called upon to vote on this issue according to my own conscience, and I will be supporting this bill and the amendment to it moved by the member for Bowman.

I do so with some reservations, but on balance I believe the Therapeutic Goods Administration is the most appropriate body to make the decision about the safety of RU486 and that the parliament and not the individual minister should retain the ultimate power whether this drug or any particular drug should be made available. There are several reasons I take this position. This is a very complex argument and it has been conducted on many different levels: pro- and anti-abortion, the safety of RU486 and the effect that it can have on women’s health, issues of process and issues of the proper place of this parliament in relation to the bureaucracy. I will try and touch on them all, although I am mindful that many members rightly wish to speak on this bill, and I will try and be as concise as possible.

Many members in this debate have stated that it has nothing to do with abortion. I cannot fully accept that, and I think we will see a lot of people make a decision on this bill based on how they feel about abortion. But we need to remember that the Commonwealth government does not regulate abortion. As members know, it is regulated by the states, and every single state allows abortions to be performed under certain circumstances. Considering that this is the case, the issue is whether as a parliament we should force people to have a surgical abortion as opposed to a chemical abortion. I do not believe that is a reasonable position for us to take. If abortion as regulated by the states is legal, then we should not deny the people the option of having one in a way that they, in association with their medical practitioner, deem to be the safest for them. I have noted the views of members about the safety or otherwise of the RU486 drug. I understand that many members believe that this drug can damage the health of women. I note that many members have also dismissed these concerns and declared the drug to be safe. Correspondence to my office has similarly expressed strong views about the safety or the danger presented by RU486. I do not feel that I am in a position to adjudicate between these differing points of view. I am not a doctor or a medical scientist, and I do not see how we as parliamentarians without this specific expertise can decide whether this drug, when properly administered, is safe.

That is why we have experts on the government payroll to advise us on these matters. The TGA is better placed than parliament to advise on RU486’s safety. As parliamentarians, we often call upon the various arms of the government to advise us on matters on which we have no particular expertise. It is appropriate that as a parliament we can delegate responsibility to agencies to advise us on these decisions or, in certain circumstances, delegate the power to make these decisions based on the available evidence. If the TGA were to deem this drug unsafe, then that to me would be the end of this issue.

My personal morality sees me very uncomfortable with the number of abortions that are performed in Australia. There is no question that this represents a terrible tragedy. But I accept that I personally will never need to face the choices that a woman faces with an unwanted or unsafe pregnancy. I do not feel it appropriate for me to marshal the power of the state to impose my personal morality on my fellow Australians. I passionately believe that we must give individual Australians as much control over their own lives as we can. I do not seek to be a parliamentarian who increases the role of government, and I certainly do not seek to make decisions for people that are best left to their own personal morality. So, although I feel distinctly uncomfortable with abortion, I do not seek to impose my views on others. Individuals are best left to make these decisions on a private basis.

This brings me to the issue of the proper role of parliament in this debate. I have listened very closely to colleagues who have argued that parliament must remain supreme over unelected officials, in this case the TGA. I agree that it is vitally important that parliament, which is directly accountable to the Australian people, maintain its position as the supreme decision-making body in Australia. I therefore see a lot of merit in the amendment that has been circulated by the member for Bowman allowing parliament to disallow approvals that have been made by the TGA. I take his point that RU486 may not be the only drug which it would be appropriate for this parliament to deliberate upon. With medical science evolving at such a rapid rate, it is very possible that occasionally new drugs will bring new ethical dilemmas, and it is the parliament that is the most appropriate body to settle the policy settings appropriate for these new drugs or not. Every member of parliament is forced to account, and needs to account, for the decisions that they make to the people within their own electorates.

That is why it is the parliament and not the executive or an individual minister that should rightly control and debate the ethical parameters for the use of controversial drugs. The issues raised by the rapid advances in medical science are only going to get more complicated, and we need the collective wisdom of the parliament—speaking as individuals and not as members of specific parties—to adequately resolve them.

There is no question in my mind that the parliament, today, yesterday and probably tomorrow, is displaying all that is great about Australian democracy, and I have listened carefully to the vast majority of the contributions that have been made in this debate. Notwithstanding that, there have been points made both in this chamber and outside the House in the lead-up to this debate that I personally find grossly offensive. Senator Nettle’s ill-advised T-shirt has been roundly condemned, and I hope that she will listen to this advice from her peers on the offensiveness of wearing a T-shirt that shows contempt for large numbers of Catholic Australians. I have also been pretty surprised by suggestions that the Minister for Health and Ageing, because of his faith, is an inappropriate choice for that particular ministry. That really is the most outrageous bigotry, and I am surprised that in 2006 anyone would express such a view.

My choice to support this bill is in no way a reflection of the current minister’s abilities or views. Mr Abbott has been a first-class health minister who has advanced the interests of my constituents in Stirling and of the Australian public in general. This debate is not about a particular minister but about what is an acceptable process for RU486 to be evaluated. The present process was the result of a compromise between Senator Harradine and the government in relation to other issues. What emerged, in my view, was not good public policy and could result in this policy arbitrarily changing based on the differing views of successive health ministers. I believe that the proper process is for the TGA to advise on the safety and the efficacy of RU486 and for the parliament to be the final arbiter of the ethical and moral framework for the use of this particular drug within the community.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

At the onset of my contribution to the debate on RU486 and the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, I need to state very strongly that this debate is not about abortion. The legality or illegality of abortion is determined by the states and territories. I find it very concerning that a number of issues have infiltrated this debate and a lot of false and misleading information has been put on the record. The issue we are debating here in this House today is whether the drug RU486 should be made available to Australian women. Currently, the Therapeutic Goods Amendment Act 1996 delegates the responsibility for decisions in relation to the evaluation, registration and listing of RU486 to the minister for health. This has effectively banned the use of RU486 in Australia without a proper process and without the scientific rigour and scrutiny of the Therapeutic Goods Administration—scrutiny to which all other drugs are subject.

I find that quite concerning. As has been said by many other speakers in this House, this came about because of the Harradine amendment, which was passed on the voices. This was done largely to placate Senator Harradine. I, like the member for Stirling, believe that this was very bad public policy. This should not be the reason for a parliament deciding one way or another. It should not be decided to cater to one particular senator or one particular member just to get other legislation through the parliament. Good public policy is evaluating the information before the parliament, developing policies and putting in place a proper process. I think bad decisions are made by parliaments and politicians if we base those decisions purely and simply on our personal, moral and religious beliefs and values. I believe, when we are looking at whether or not a drug like RU486 should be available to women in Australia, it should be based on scientific and medical factors.

Paragraph 1.72 of the Senate Community Affairs Legislation Committee report lists the groups that have formally expressed their support for RU486, and it is a very impressive group: the World Health Organisation, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Australian Medical Association, the Rural Doctors Association, the Public Health Association of Australia, the UK Royal College of Obstetricians and Gynaecologists, the American Medical Association, the American Association for the Advancement of Science, the US Federal Drug Administration and the Federation of International Gynaecology and Obstetrics—all experts, all bodies, that know about drugs and health and that have scientific information and medical knowledge. I am very, very impressed by that list of organisations that actually support the use of RU486.

That brings me to the question of who is best to decide whether or not a drug should or should not be supplied or available in Australia. When I consider that, I come to the decision that the Therapeutic Goods Administration should be that body. It is appointed by the Minister for Health and Ageing, and the people that sit on the TGA are highly qualified and eminent scientific and medical professionals—people that have made decisions about many new drugs and many new drugs that are dangerous if they are misused.

It has been said during this debate and in some correspondence that I have received that RU486 is a dangerous drug. I say that many drugs are dangerous if they are not used under supervision and if an adverse reaction is had to them. Many drugs that are utilised during chemotherapy can be very dangerous to the patients undertaking the treatment. One of the most common things that happens when a person undertakes chemotherapy is that their white blood cell count drops, and this makes them very vulnerable to infection. Drugs such as warfarin, a life-saving drug, can also be fatal. It is so important to monitor the use of these drugs. What I am putting forward to the House is that any drug can be dangerous if it is misused.

The information I have read about RU486 puts it into a much safer category than many drugs that are available now. But I am only a layperson and I am not qualified to make the decision. I believe the decision should be made by the TGA. If the drug is approved, if the TGA says that drug should be available in Australia, it will be up to the woman’s doctor, in consultation with the woman, to decide whether or not it is appropriate to prescribe that drug. It will not be a drug that is available over the counter. It will not be a drug that a person can take willy-nilly. It is a drug that will be prescribed by a doctor and administered with the doctor monitoring the reaction to the drug.

On the other hand, we have a situation where the Minister for Health and Ageing is making the decision as to whether or not the drug is safe. The current minister has a Bachelor of Economics degree and a law degree. He is a very qualified man. But he does not have the scientific and medical qualifications and knowledge to make a decision about whether or not RU486 is appropriate to be sold in Australia. The decision should be based on medical and scientific grounds, not personal beliefs. As I have already said, I believe the TGA has that ability.

The minister has argued in past debates that decisions cannot be left in the hands of politicians. I refer to the republic debate in the late 1990s when the minister argued very strongly that you cannot trust politicians to make a decision about the head of state. It is not a matter of trust. I do not believe that politicians are qualified to make a decision about whether or not a drug is safe on medical and scientific grounds.

It has also been argued in the amendments that parliament should make the decision. Once again, I would argue very strongly that I do not have the qualifications or the knowledge needed to make that decision. I know I have paraphrased the amendments that are before the parliament, but basically this is a decision that should be in the hands of the experts. I will be supporting the bill and opposing the amendments. I believe the TGA is the body that should determine which drugs should or should not be available in Australia. It is not appropriate to delegate that responsibility to a minister in this parliament. Ministers change and ministers have different beliefs. At the moment, the minister does not support the supply of RU486, but the next minister may. It is not an issue that should be determined on that basis. Rather, it should rest with the experts, and the experts are the TGA.

Alby Schultz (Hume, Liberal Party) Share this | Link to this | Hansard source

I stand here as a human being whose body is not biologically structured to understand problems associated with pregnancy or indeed abortion. I am not going to talk about abortion because this debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 is not about abortion. I am, however, going to take the opportunity to pick up the point that has been made repeatedly by members on both sides of the House today about ‘qualified persons’. It would appear from comments in this debate that some members of the House have a view that people in the medical profession are the best placed and most responsible people in the community to make drugs such as RU486 available on prescription. Whilst this is generally so, there have been countless occasions on which drugs have been prescribed without follow-up investigation of the long-term negative health effects and, in some cases, death of individual recipients of drugs under prescription. My family has been down that path. My 13-year-old grandson had all of his internal organs destroyed because of the overprescription of drugs that were supposed to help them. Public accountability for these outcomes in most cases is nonexistent and in many cases covered up. So much for the accountability of people who are qualified to make decisions on drugs such as RU486.

In 1994, RU486 was imported into Australia through the backdoor. Abortion drugs, as I understand it, have always been prohibited imports unless exempted by the Department of Health and Ageing. In fact, in 1988 the federal government gave a commitment that it would not allow such an exemption without the Minister for Health and Ageing’s involvement. The point is that the drug RU486 was approved by a nameless, unaccountable bureaucrat without the specific knowledge of or approval by the minister of the day, and a minister of the Crown would have been made publicly accountable for any serious health outcomes or indeed the death of any person from side effects following the use of the drug. Is it any wonder, then, that the drug mifepristone, commonly referred to as RU486, has never been registered for use in Australia?

In 1996 the government passed an amendment to the Therapeutic Goods Act which made the Minister for Health and Ageing responsible for decisions in relation to the importation, trial, registration and listing of RU486 and, indeed, other abortifacients, rather than the Therapeutic Goods Administration, commonly referred to as the TGA, which is the statutory body usually responsible for the approval of medicines in Australia. This was on the grounds that these drugs amounted to a special category of drug requiring an additional layer of public scrutiny. I thought that was a very responsible attitude by the government.

A majority of correspondents and callers to my office and to me personally are opposed to the use of RU486 in Australia or wish the decision regarding its use to remain with the minister. RU486 has been in use in the United Kingdom since 1991 and in the United States since 2000. France was one of the first countries to approve the drug in 1988, and it is also used in New Zealand. In America the deaths of four women from septicaemia within a two-year period after each had used mifepristone have prompted the US government to convene a group of experts to examine the cases. A further woman has also died in Canada, two in the United Kingdom and one in Sweden. My reason for raising this is it is a question of health outcomes from the use of drugs such as RU486. According to the American College of Obstetricians and Gynaecologists, complete abortion will occur in 96 to 97 per cent of cases where both mifepristone and misoprostol are used, and for those for which the drug does not work a surgical abortion is still required. It has been estimated that between five and eight per cent of treated women will require urgent post-abortion care, including in some cases dilation and curettage, fluid resuscitation and/or blood transfusion. The United States FDA’s patient information sheet on mifepristone states that women who use the drug can expect to experience bleeding for an average of nine to 16 days and that bleeding may last for up to 30 days. In French trials one woman bled for 69 days.

The physical elements of a medical abortion are the same as miscarriage: heavy bleeding, including the expulsion of blood clots and tissue, pain and nausea. These physical signs are the same signs associated with septicaemia and have been dangerously overlooked in some cases. In other parts of the world, medical abortion is administered under close supervision due to the risks involved and, according to Australia’s Chief Medical Officer, this would make it unsuitable for use by women in rural and regional areas where limited access to obstetric facilities exists. He also concluded that making mifepristone available as a prescription medicine without appropriate frameworks to ensure its safe use would increase the risks to women undergoing termination.

Decisions about RU486, due to the nature of the drug, cannot be made by the TGA. The TGA cannot ensure that the drug is administered in safe circumstances to women who are fully informed, that proper supervision is provided and that the drug is not going to end up on the black market being sold to desperate young women. I believe decisions about the use of RU486 need to be made by the minister in consultation with his or her cabinet colleagues and, in the final analysis, certainly need to be made by the parliament itself. There needs to be accountability. It would appear from past experiences and history that the only people who appear to be accountable for decisions that they make in this country are members of parliaments and the parliaments themselves and, more specifically, ministers, who have a statutory obligation to be responsible for their roles as ministers of the Crown.

Having said that, I will take this opportunity to talk about the concerns I have as an individual about the health, particularly the mental health, of people who are subjected to the after-effects of a drug that many people in countries across the world are concerned about. In an article published in the current issue of News Weekly of 18 February 2006, Charles Francis AM, RFD, QC has this to say:

When Roussel Uclaf first announced production of the abortifacient RU-486 (Mifeprex) in France, it was hailed by the media as a “Holy Grail”. Despite its many problems, abortion-providers appear still to regard it as a great benefit and argue that politicians have no right to deprive women of it.

He goes on to say:

No reputable pharmaceutical company in America wanted to have anything to do with the production or marketing of Mifeprex. It was left to the Population Council Inc (a powerful pro-abortion group) to obtain the rights from Roussel Uclaf to market the drug through a new shell company, Danco Laboratories Inc.

Danco was incorporated in 1995 —not in the US, but in the Cayman Islands. It does not market any other pharmaceuticals. The shareholders were not interested in setting up a company which would produce a range of medications beneficial to mankind. In some of the proceedings against Danco, the inference is they were simply in it for the “quick buck”.

He further says:

When the original application for approval was made to the US Food and Drug Administration ... it was accompanied by two French tests and one US test only, none of which met FDA’s standards.

The FDA appears to have been reluctant to approve RU-486; but after intense pressure from the Clinton Administration, the drug was approved in September 2000, subject to a number of restrictions.

He goes on to also say:

Despite its high-sounding name, Danco—

the company I referred to—

was unable to manufacture RU-486 itself, nor could it find anyone in the US prepared to do so.

Eventually Danco settled for a Chinese company located near Shanghai, a company cited by the FDA for producing tainted drugs.

This is another reason I have for opposing this drug being out of the control of this parliament. Inevitably, the deaths of young women as a result of problems led to litigation associated with five women in North America. He says:

A prominent Californian products liability law firm is acting for the relatives of Holly Patterson, Chanelle Bryant and Hua Thuy Tran (referred to as “the decedents”).

The complainants’ briefs in these cases make poignant, informative and frightening reading. No intelligent person reading these briefs would want RU-486 available in Australia as an abortifacient.

The essence of the main allegations against Danco and the Population Council is that they marketed the drug with full knowledge of “unacceptable risks of serious injury or death”. By the time the drug was provided to the decedents, it was already associated with such risks.

I want to put those comments on the record and to make a final point in this House in the brief time available to me. The issue that I personally believe is paramount to the introduction of drugs in this country is that the people who are approving and/or administering the drugs have to be made accountable for any outcomes from that drug which cause significant health problems—or indeed create a long-term situation which ultimately results in severe disability or death in some instances—to the person that the drug is being prescribed for.

Whilst I am not going to support the bill in this House, I am going to support the Kelly amendment—as it is commonly referred to—to the bill. The amendment not only allows the Minister for Health and Ageing continue making the decision but allows the parliament itself to either disapprove or not disapprove the minister’s decision. Failing that amendment getting up, the amendment that makes the approval, monitoring and accountability of RU486 a decision of the parliament would be the next alternative that I would support.

I thank you, Mr Deputy Speaker, for the opportunity to make a contribution to this very important debate tonight. Whilst I respect the individual contributions made today by my fellow parliamentarians from both sides of the House, it is a conscience vote. That is the vote that I will be making when the privilege of a conscience vote is extended to me. Whilst I understand that there are many people throughout Australia—and indeed in the electorate of Hume—who may have different views from me and many people who are diametrically, socially and religiously opposed to abortion, this is not an issue of abortion. I believe it is an issue of public health safety and that is the reason I made the contribution that I made in this House here tonight.

Duncan Kerr (Denison, Australian Labor Party) Share this | Link to this | Hansard source

The fundamental issue that is before the House tonight is whether it is appropriate to retain the ministerial or parliamentary level of approval for the availability of a particular drug, RU486, and, in relation to the proposed amendments, for some other classifications of therapeutic products. By way of background to my contribution to the debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, I think it is appropriate to set out the framework in which assessments of drugs proposed for availability on the market in Australia occur. Drugs can be submitted for assessment by an independent scientific body. They are then put through a process which involves looking at the research background, the testing and the therapeutic effects of those drugs and, ultimately, decisions are made about whether they be made available and the limits to their availability and the purposes for which they can be utilised.

Of course, some drugs are made available on a limited prescription basis and others as non-prescription items. But, essentially, with all such products—other than one particular drug, RU486—we have consigned the decision about whether or not risk and safety are acceptable to an arms-length, independent, scientifically based process.

When we come to consider the arguments that have been addressed, particularly by the immediately preceding speaker, the member for Hume, who constructed an argument based around safety, it is a difficult argument for me to accept because we must realise that almost every therapeutic product that is on the market carries the potentiality of significant adverse health effects. For most drugs that we receive on prescription, if we look at the product disclosure information, it reveals that, under certain circumstances, those products carry with them risk. In some instances, they may create higher risks of heart conditions for people with particular backgrounds. But almost every product will have some disclosure and many indeed are prescribed after proper consultation with doctors on the basis that, whilst the risk exists, it is counterbalanced by the benefit to the patient.

I have gone through a very tragic personal instance where my father’s partner, who survived my father, was prescribed warfarin, which is a drug for blood thinning. One of the sadder side effects is that it gives rise to the potentiality for bleeding. During one evening she suffered a massive internal bleed, died and was discovered the next morning. This did not involve RU486. Warfarin is regularly prescribed by physicians. They obviously have to take into account the side-effects. On balance, for many people warfarin prolongs their life, makes them capable of activity of which they would not otherwise be capable. Some of the drugs available are put through these tests and assessed as having serious potential side effects, but they are properly available on the basis that the risk assessment is to be between the patient and the doctor, knowing the potential benefits to be achieved. Those risks were very much to the fore of my mind when that tragedy happened in my family.

So I put aside those arguments about safety. The people who make decisions about safety are the same people who routinely make decisions with all the drug products that are available on the market. Any issue of that product goes with proper discussions between the user and her medical practitioner and with full disclosure of the nature of the risks to the person—the woman in this instance, if it were RU486.

We have to also consider that in this instance it is not the case that we are comparing a risk-free process that might be available for abortion with that of RU486. Surgical procedures, which are available lawfully in teaching hospitals and institutions in Australia, carry with them some degree of risk. Every significant surgical operation which has anaesthesia associated with it—and many procedures of that nature do have anaesthesia associated with them—carries quite identifiable risks, including risks of death. So people who undertake these particular procedures do not do so lightly; they already confront degrees of risk that they must choose to accept. They make decisions which must be terribly confronting, but we are not comparing one framework where there is no risk with another where there is significant risk; we are dealing with relative risk, which needs to be properly assessed, medically assessed and disclosed and understood by people after discussion with their physicians.

The second argument turns on the nature of the procedure. The starting point is that we enter this debate accepting that, within Australia, abortion is a legally available procedure under various legal rulings, pursuant to the Menhennit rulings of courts, principally in circumstances where assessments are made that a woman’s life or her mental ease would be damaged were that procedure not to be carried out. We are not dealing with a situation where the acceptance into the market of this particular product would for the first time make available a procedure otherwise unavailable. We are simply addressing one particular way in which that objective can be achieved.

The next point I would address is some of the arguments that have been advanced to persuade me and my colleagues, notwithstanding those two starting points—that, ordinarily, drugs are assessed for safety by an independent arms-length non-political process and, secondly, that the outcome that is sought to be achieved is lawful. The first objection is put on the basis that a majority of the Australian population disapproves of terminations and that we should resist anything that would increase the number of terminations so procured. I think it must be at least doubtful that an additional choice as to the means available for abortion actually would increase the number of procedures. I do not know that there is any evidential basis for that—in my mind it seems an improbable argument—but even if it were a factually sustainable one I do not see a basis for accepting a majoritarian argument.

We each represent different electorates and views will differ enormously within those electorates. I suspect that the majoritarian outcome would support the view that I am putting to the House that this drug should be available. Certainly that is the balance of submissions I have received from within my own electorate, although not of those I have received generally from across Australia which have run in a majority in the other direction. The submissions from my electors have very strongly run in favour of the view that I am now proposing. I think a mechanical application of a majoritarian point of view is something that no parliamentarian can accept as conditioning the way in which they would make a determination in relation to these matters. If there is a majority in favour of the drug being available but no proper basis upon which we could so decide, we should reject it. On the other hand, if there is the opposite, a majority against the drug but no scientific, ethical or procedural reason to make that determination, it seems to me that we are back into an area which properly should be described as one of proper, rational law-making. How are we going to make proper, rational laws in a community where we might properly say that we come from a common obligation to respect the laws of our nation and to respect the values and aspirations of our fellow citizens but where so many of us have quite different views on some very fundamental matters?

I have tried to live a moral life without religious belief. I do so on the basis of an acceptance that, in that process, one has to strive hard to make certain that an underlying morality can be found in some coherent, sensible way—a secular way. Much of my thinking is conditioned around the work of John Rawls. His book A Theory of Justice identifies a number of circumstances in which the state is justified in interfering with the interests of the individual. I also, however, quite properly respect those in my community who hold Christian beliefs, Islamic beliefs or a variety of different views which are conditioned from a very different starting point.

At the end of the day in a democracy we have to resolve these issues not merely through the exercise of conscience but also through the exercise of intellect—and conscience and intellect come together. In that situation, that larger framework regarding the choices to be made in relation to this matter, I suppose I come down to this question: whose choice is to govern the final outcome? Is it to be the decision of a minister of the Crown about the availability of a medical product which, absent this particular piece of legislation, would be determined on its scientific, medical rights without political interference, or should it be the choice of an individual woman on the advice and with the informed opinion of her medical practitioner to assist her in making that decision?

I accept that people of goodwill have put a proposition that we should accept, as a highest order proposition, the sanctity of life. I do, but this parliament has to address matters around a framework where we accept that in some circumstances that sanctity has been reduced—

Debate interrupted; adjournment proposed and negatived.

I was speaking of the issue of sanctity of life. I certainly take the view, for example, that the death penalty is an abhorrent penalty and I have campaigned all my life against it. But we made, just the other day, a decision in this parliament, in the legislation dealing with the call-out of the military to assist the civil power, to authorise the military to shoot down civilian aircraft. I accepted—grudgingly and with great reservation—the legitimacy of that choice. It is a choice, however, that I would hate as a minister to have to address and to make. But essentially this parliament is willing in that area to say that, under very extreme circumstances, we will authorise our military forces to shoot down a plane that might be full of innocent passengers—our children, relatives, friends—in order that the greater good of the community be protected, lest that plane be seized and crashed into a large building, as happened on September 11.

We do accept under some circumstances that sanctity of life is not an absolute. We have a larger debate about when life begins. That is a debate which, were this debate about the availability of abortion, would have members of this House choosing positions which reflect their strong personal convictions in relation to those matters, their judgments of conscience, their judgments of understanding of human life and their judgments about when we ought to accord to the product of reproduction the status of protection of human life. But that is a debate, as I have indicated before, which is, in a sense, not material to this decision. We are accepting in this debate the availability of abortion.

I also want to indicate that many members have given considerable thought to what they wish to say in this debate. Some have revealed personal circumstances in which they have been involved, including Senator Minchin, Mr Laming and the Treasurer, Mr Costello. People have worn their hearts on their sleeves in this debate. But I doubt that any of us have a greater entitlement to a conclusion in relation to whether this particular product should be available or not on the basis of our particular individual experience. We cannot live the experience of others and most particularly I, as a man, cannot live the experience of a woman who might be placed in the circumstance of deciding whether or not to pursue and seek an abortion.

In the end, this parliament has to cut the Gordian knot. We have to make a decision about the bill that is now before us. Some proposals seek to keep that knot tied—in fact, to have us come back again to redebate the merits of having some external political supervision of a scientific and medical judgment after this debate. I see no wisdom in that whatsoever.

If there is a majority in the Senate and this House that the decision should be made objectively, that risks should be assessed in the same way as would occur with respect to any other therapeutic product or good, I see no wisdom in going through a process of having this debate and then reinserting into the legislation different mechanisms of imposing political control over a judgment that ought to be scientific.

We should not be the ultimate gatekeepers of choice in this debate. I have not worked out a better way than the acknowledgment of the right of a woman—properly advised by her competent medical practitioner regarding the relative risk of products, on information made known to that medical practitioner and the woman after proper assessment by an impartial scientific assessment—to make that choice. And I do not believe that any other member of this House knows of any better gatekeeper of that choice than the woman concerned. On that basis, I certainly do not wish to substitute my political judgment or to speak on behalf of others in relation to their political judgments to intervene in that ultimately important and, no doubt, always difficult choice.

Dave Tollner (Solomon, Country Liberal Party) Share this | Link to this | Hansard source

First, let me put on the record my thanks to the many people of the Northern Territory who contacted me on this issue. Their emails, faxes, phone calls, letters and words—both for and against—have been of great assistance to me in the consideration of the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I have thought long and hard on this matter, and at this point in time I must disagree with the proposal to remove ministerial authority and to include RU486 in the list of restricted goods and leave the evaluation of the use of medical abortifacients to the Therapeutic Goods Administration.

As all members in this place know, I am a proud Territorian. I am acutely aware of my responsibilities to represent the people of the Northern Territory and to act in their best interests. David Gawler is a highly respected surgeon from the Royal Darwin Hospital and he works extensively within the Indigenous communities. He has real concerns for the people of the Northern Territory in relation to this bill, as he expressed to me in writing and in conversation with my office. Mr Gawler and many other people who have contacted me are very concerned that RU486 has been widely promoted for use by women in remote areas. In fact, it has been claimed that gaps in abortion services in these areas will be overcome by this drug’s introduction.

There are a number of reasons why such a proposal is not only ill considered but dangerous. First of all, the manufacturer’s protocol for the ‘safe’ use of RU486 stipulates that a woman having this type of abortion must see a doctor on day 1, 3 and 14. In many areas of Northern Australia, serviced by itinerant doctors, this would not be possible. Continuous medical cover is rarely available in most parts of Northern Australia.

There are also clinical issues. RU486 has some quite serious and potentially fatal complications which have been well documented, even by the manufacturer, including severe haemorrhaging and toxic shock syndrome. Professor Andrew Child, director of obstetrics and gynaecological services for the south-western part of Sydney and former president of the College of Obstetricians and Gynaecologists, has advised that the drug’s introduction would increase the risk of adverse outcomes, especially for women in remote areas. Just imagine in a typical wet season, with flooded airstrips and poor weather, how long it would take to airlift a sick patient suffering a complication from the use of RU486 from her remote location to hospital.

There are also well-documented communication problems in the north, where many Aboriginal people do not speak English. Indigenous women, in particular, who have an inadequate understanding of their doctor’s advice, may not follow the manufacturer’s instructions, and this may lead to nonattendance at required medical appointments. This situation can result in serious complications and even death.

Moving away from my specific NT concerns and looking more broadly, it must be recognised that there are also the psychological consequences to consider. I am deeply concerned at the lack of research in this area. Relative to a surgical abortion, an abortion using RU486 may be ‘easier’ initially, but what of the psychological consequences of delivering a dead embryo at home, with the associated pain and bleeding—apparently speculative, but I think they are obvious with commonsense.

Many supporters of RU486 have suggested that the drug’s use involves merely technical considerations. But it involves killing an embryo—a scientific name for an unborn child. At seven weeks, the developing limbs can be seen, the head is quite large compared to the trunk, the fingers and toes are present and the arms bend at the elbows. The upper lip is complete, and the external ears form elevations on the side of the head. The embryo is perhaps an inch or two in length.

This is not merely a technical issue of safety or efficiency—of whether medical abortions are to be preferred to surgical abortion. Are we living in an abortion mentality, a culture which is indifferent to killing an embryo? If that were the case, we would not even be having this debate.

The most common ground for abortion—psychiatric—is rarely of such significance as to impel the abortion provider to refer the woman for ongoing treatment by either a psychiatrist or a clinical psychologist. The counselling provided by abortion providers is usually perfunctory and is generally directed towards encouraging a woman to proceed directly to an abortion—not to consider the alternatives or the consequences. Women are rarely told of the risks of abortion: breast cancer, subsequent pre-term birth, low birth weight and illness. And what of the psychological consequences of delivering a dead embryo at home? Perhaps this debate should be about the support on offer for women seeking an abortion instead. It has often been suggested that the reason most women have abortions is the lack of support, sometimes in circumstances of financial difficulty or lack of support by a partner or spouse.

While most Australians accept that abortion is ‘necessary’ in some cases, most have a deep uneasiness about abortion. I agree with the opinion that the TGA would no doubt treat RU486 like any other drug and assess it from a purely technical viewpoint, having regard to safety and efficiency. Yet what is at stake is far more than safety and efficiency.

Look at the morning-after pill. Postinor-2 is an emergency contraceptive and is sold in a pack. Postinor-2 was relisted from schedule 4 (prescription only) to schedule 3 (over the counter) on 1 January 2004. Prior to this Postinor-2 was only available via prescription, although it was not subsidised under the PBS. It became available in Australia in July 2002. According to the publication Australian Statistics on Medicines there were 35,258 scripts for Postinor-2 dispensed in 2002; this increased to 79,735 in 2003. More recent figures, from 2004 when it became an over-the-counter drug, are not available.

A good friend of my wife, who shall remain nameless in this debate, was given the morning-after pill by her well-meaning and loving mother—similar to the way in which many parents give their children condoms. With no medical supervision and after some sustained use, my wife’s friend became quite sick. Upon visiting her doctor, she was told that her illness was a result of her overuse of the morning-after pill. What is more, she was told that she would never be able to have children. This was absolutely devastating news for her. We have been assured in this place that RU486, should it be introduced into Australia, will only be available on doctor’s advice and through prescription. We were told the same thing about the morning-after pill, Postinor-2.

I find something quite odd about this whole debate. There is no application at the moment to have RU486 made available in Australia—there has not been in the past, and I am not aware of any suggestion that an application is about to be made. It goes without saying that here in Canberra there are many people skilled in the political arts. There are people of all political persuasions who are paid for their rat cunning, their conniving ways and their ability to get an outcome by stealth. I have absolutely no doubt in my mind that a couple of these faceless tacticians are at work here.

Whilst I believe that most parliamentarians are debating this issue on its merit, I have no doubt that there are some who see this as nothing but a great opportunity to undermine the current health minister. I have overheard it said in the corridors that this bill is being called the ‘Get Abbott Bill’. The view of these people is that the current minister is unfit for the job because of his strong spiritual conviction. Personally, I am disgusted at this narrow-minded view and the political skulduggery that goes with it. Women deserve to have their health and, more importantly, their value taken more seriously than that. For all of the reasons that I have stated, and many more, I cannot support this bill.

Sharon Grierson (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in support of the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 and to oppose outright the two amendments. I also acknowledge the good work that has been played in this debate in the House by the member for Moore and the member for Murray. Likewise, I thank Senators Moore, Allison, Troeth and Nash for the opportunity to debate this private member’s bill—and also, hopefully, to put an end to this divisive and emotive activity that inevitably attaches to any debate with an element that touches on the termination of life. It is always regrettable to me, having lived a fairly long life, that the same passion and earnest debate never seems to occur here when we are discussing the nurturing of life, certainly the lives of our children and young people.

Given the highly charged debate that has surrounded this private member’s bill since it was introduced in the Senate, it is important to clarify at the outset what this bill does and does not do. It is not a bill to import or approve the importation of the drug RU486. That decision can only be made by the TGA. It is not a bill to remove parliamentary scrutiny of any decision by the TGA about RU486. That scrutiny does not currently exist. It is not a bill to change the laws on abortion. Those laws are state matters. It is a bill to remove the power of the Minister for Health and Ageing to veto—alone, by him or herself and without consultation—any application to the TGA to evaluate RU486. The bill before the House, therefore, seeks to repeal ministerial approval for RU486 and to leave approval with the Therapeutic Goods Administration.

In my view, the TGA is the most appropriate body to assess RU486. We do trust the professionalism and expertise of the TGA to assess the safety and effectiveness of literally tens of thousands of other medicines, including highly addictive and potentially deadly drugs with serious side effects. This bill corrects an anomalous situation whereby all other drugs except RU486 are overseen by the TGA. I have to question why we have this anomaly. I think it has to be understood. There is a paternalism that exists in this parliament, and sometimes I do think that it is about controlling women, through methods of legislation in an area where perhaps men feel left out. The anomaly of course dates back to 1996, when this government took power. If you can imagine the negotiations with then Senator Harradine you will know that the gestation of this debate was in discussions about power and control. That is always unhealthy; it exists too much here and it absolutely has too much influence on the decisions we make.

Were this bill to be adopted, all submissions for the importation of RU486 would have to be approved not only by the TGA but also by the relevant ethics committees that would work on this issue. So there would be two layers of checking: the TGA and the relevant ethics committees. And if an application were made for registration of the drug for sale in Australia it would have to be considered by the Australian Drug Evaluation Committee, which is an expert advisory body appointed by the minister. This is a robust system of checks and balances that keeps politics out of the equation and ideology separate from sound decision making. That is what this bill would achieve.

Women who may then choose to use this drug would do so in consultation with their medical advisers. That is always best. I feel for men. They often feel they are outside this decision—and they are, because they can never understand or go through it. I also look at young people and I wonder how many young teenage boys would make a decision to become a sole parent, to give up their career, to give up their social life, to give up their education or their training. I can tell you: not many. Within 12 months of a child’s birth I think it is something like 70 per cent who are in the care of a mother alone. That is sad, but just remember that that is not an easy path to take.

Women will make that decision, which is rightfully a medical one, in conjunction with their doctors. They will not be turning up at the office of their member of parliament or their senator to talk to them about it—and nor should they ever contemplate or feel that they have any responsibility except to their personal life choices. Their reproductive health choices are theirs; they must be theirs. Life is not easy. Most people are just trying to have good relationships and a good life without doing any harm to anyone. Women deserve to make their reproductive health choices themselves without the interference of parliament.

I also cannot support either amendment put forward by government members. The Laming amendment is very similar to one that was moved in the Senate—and was lost, fortunately. Although it does have a different definition of restricted goods, and while there is no continuing role for the Minister for Health and Ageing under this amendment, a decision made by the TGA to register or list RU486—that is, any determination that RU486 is safe and effective—would become a disallowable instrument subject to potentially endless debate in the parliament. That would be emotional, divisive and unnecessary.

In the member for Bowman’s speech on this bill, he argued that there will not be lots of disallowance motions on RU486 before the parliament in the future ‘because there is only one RU486’. No. He got that wrong. In fact there are at least four manufacturers out there, and there could be more because the drug at present is off patent and each manufacturer would require separate TGA approval to market their product. So there would be a lot more debates. They would also require TGA approval for different uses or any variation of the uses. Let us put this to bed once and for all. If the Laming amendment does not inhibit manufacturers from applying to the TGA, as is currently the case, then it does mean the parliament would face those many debates in the future—before we even get to the fact that his amendment expands the list of restricted goods to include a whole unknown range of new drugs. We do not need it.

The Kelly amendment is aimed squarely at killing off this bill once and for all and replacing it with her very own bill. Approval or refusal would then become a disallowing instrument and could be debated and voted on in parliament like any other piece of legislation. We would end up again with potentially endless debates on RU486. It is not a solution. I have made public comment to this effect: for goodness sake, members of the coalition, stop trying to please each other or to please the powers that be—whether they be the health minister or the Prime Minister—and start thinking and catching up with what the Australian public want. Who better than the TGA to assess the safety of RU486? Certainly the current minister has no medical training or expertise to make this decision. It does not seem to me that controlling fertility is something that he is an expert in, either. You would have to think that, for women for over 30 years trying to control fertility, it is a serious business and it is certainly not easy.

In 1996, when the issue of access to RU486 was first debated in this parliament, senators and members expressed concerns because the long-term effects of using RU486 were unknown. That was 10 years ago and, while that argument may have had some basis a decade ago, this is no longer the case. Since then, more than 2½ million women have used RU486. The drug has been licensed for human use since 1988 and is now available in the US, Canada, the UK, many countries in Western Europe, Russia, China, Israel, Turkey and New Zealand. More importantly, the issues of safety and risks associated with this drug are very clearly issues for the TGA and medical experts and should have nothing to do with politicians. In European countries where it has been available for decades there has been no evidence of any increase in the number of abortions performed overall, but there has been an increase in the number of early abortions. As is well known, the safety of an abortion is directly related to how early in the pregnancy it is performed, so this drug may in fact offer a safer health option for some women. The use of RU486 to induce abortions is supported by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the AMA, the Family Planning Association, the Public Health Association of Australia, the Doctors Reform Society and many women’s groups throughout Australia.

The Minister for Health and Ageing and the Prime Minister have both at different times expressed the view that access is too important an issue to be left in the hands of so-called bureaucrats who are not elected by, and thus said not to be accountable to, the Australian people. Let us look at the level of accountability in the current system. Under the current arrangements, the minister is simply required to notify the parliament of a decision to approve an application for evaluation by the TGA—a process that has never occurred, so it is difficult to know what, if any, level of parliamentary scrutiny would be achieved. The minister has not been required to table decisions not to approve such applications, so the parliament is not necessarily informed or given an opportunity for any oversight of such a decision. The current regime is hardly conducive to open and transparent processes with high levels of accountability. They are not there anyway. Indeed, when comparing the current arrangements—where all power rests with the Minister for Health and Ageing—with those proposed in this bill, it is the TGA that offers a more open and transparent decision-making process. It is much more accountable to the parliament.

This bill is not leaving an important decision in the hands of faceless bureaucrats—what rubbish—as some have suggested. It puts the decision in the hands of medical experts in an institution known as the TGA that was specifically designed just to do this work. The TGA will decide whether this drug should be available. It will be women and their health practitioners who together will decide if it is suitable for them and whether they wish to use it. Given recent scandals where this government and its ministers have consistently refused to be accountable—like the AWB scandal and the complete misuse of the oil for food program, the children overboard affair, the regional rorts and the ironclad guarantees, to name just a few—I know in whose hands I would rather see decisions about RU486 placed. When it comes to accountability, the TGA is a far better option than the minister for health.

Issues relating to women’s fertility are not best left in the hands of politicians. These are matters for women and health professionals, not the Australian parliament. Even a cursory glance at this minister’s track record will attest to the dangers of subjecting issues about women’s fertility to the rough and tumble of politics. It is perhaps not well known that while this Minister for Health and Ageing was happy to grant an additional $300,000 in funding to three anti-abortion pregnancy counselling services last year—that is, services that not only advise women against abortion but flatly refuse to refer them to abortion services if asked to—this government provides no funding to pro-choice pregnancy counselling services. Yet we have heard people say over and again that there should be more education and support for women. According to Reproductive Choice Australia, a pro-choice advocacy group, there are only two dedicated pro-choice pregnancy counselling services in Australia and neither receives any Commonwealth funding. Yes, the government funds family planning services by a dwindling amount, but there is insufficient money for abortion counselling.

How does this minister justify his decision to fund anti-abortion organisations only, when 65 per cent of Australian men and women, according to the February 2006 Morgan poll, approve of the termination of unwanted pregnancies? Likewise, when IVF technology came under attack as this government tried to restrict Medicare subsidies, the minister’s office released unattributed and incorrect data to support the proposed restrictions. We see similar tactics being used this time around with RU486, with the minister consistently using the figure of 100,000 abortions per year, which he knows to be wrong, and his ongoing talk of a so-called epidemic of abortions simply inflames emotions and brings no credit to him. We do expect more from our Minister for Health and Ageing, who should be acting in the interests of the health of everyone, not just a few. I support this bill in its original form and oppose the Laming and Kelly amendments.

Joanna Gash (Gilmore, Liberal Party) Share this | Link to this | Hansard source

When I sat down to decide what I was going to say in the present debate surrounding the topic of RU486, it dawned on me that this was not going to be about the efficacy or otherwise of RU486; this was really going to be about two major issues—pro-life versus pro-choice and how far we are prepared to relinquish personal responsibility to the government.

I will deal with the latter first. We have always been a government that advocated a minimalist approach to government intervention in our everyday lives. Indeed, the debate about workplace relations legislation was all about giving employees a choice, expanding their options and letting them have a say in their own destinies.

We had an earlier debate about abortion, and the general consensus, whilst not universal, was about choice. In fact, the battle over abortion and a woman’s right to choose was fought and won 20 years ago. I am amazed that the question of abortion and a woman’s right to choose can still dominate headlines and community debate as much as it is at the moment. Yet today we are back here once again debating choice. This seems to be becoming a recurrent theme. I am somewhat perplexed that those that espouse choice the most are the greatest advocates of further government controls. I am very much concerned that governments the world over seem to be obsessed by total control but are afraid of being tagged as authoritarian, although some, I must admit, have given up that pretence a long time ago.

If we profess to be a minimalist government—that people should have a greater say in their lives, that they are responsible for their own actions, that they should have greater choice—why should this matter be treated differently? We want people to take responsibility for themselves and their own lives, yet time and time again governments just cannot help themselves and jump on the morality bandwagon, saying, ‘We know better.’ It seems to me that if an individual is prepared to live with the consequences of their own actions after having come to that decision, hopefully with the support of their family and their doctor, then it must remain their decision, not one decided by government or an individual politician.

However, I acknowledge there are many people who would like someone else to make a decision on their behalf, particularly if the matter is unpleasant. That is unfortunate. We need to bring this into perspective. Alcohol, tobacco, drugs, illicit sex and even obesity are things that impact on the greater community. It is right that the government, as the representatives of that community, have a say. The costs associated with dealing with the fallout from abuse of alcohol, tobacco, drugs and even food is great and costly. In that respect I think the government has a right to regulate these matters.

Unwanted pregnancy is a different matter. It does not matter whether the abortion is surgical or chemical, the same approach should apply. How much harm to the community will there be if a woman prefers a chemical intervention to a surgical one, remembering that it is legal to do so? The government needs to decide whether RU486 is inherently harmful to the individual, and, if so, whether this harm, as a result of wholesale use, will impact on the greater community. I have not seen any evidence that, under controlled clinical administration, it is as harmful as drug abuse, alcohol abuse, tobacco abuse and, for that matter, overindulgence in food. It seems on the evidence, given its widespread availability in other countries, there is sufficient experience to be able to determine that on the balance of probabilities it is relatively safe to use under medical supervision.

If that is the case, this debate comes down to a question of morality: pro-life or pro-choice. I have made myself clear in earlier debates as to where I stand. As far as I am concerned, a woman’s body is her own. If there is no detriment to her health as a result of a chemical intervention, then the choice should be given to her in the full knowledge of the consequences of her actions. Whether these consequences be physiological or spiritual depends on the path she chooses to follow.

This debate is somewhat personal to me. I emphasise once again that I am not pro-abortion. My own daughter, because of her physiological make-up, is unable to tolerate anaesthesia, so a surgical abortion for her would not be an option. Surely someone in such a position deserves whatever medical options are available to her. A medical intervention, regardless of what it is, is an issue between the patient and their doctor. They should be allowed to make an informed decision in consultation with those who have expertise in that area—I speak of the TGA, who are the authorising agency for all other drugs within Australia. No bureaucrat and certainly no politician should be responsible for judging the worthiness or safety of a drug.

I do not want to go back to a time when backyard abortions were necessary because of the moral and ideological imperatives of the time. We have gone beyond that. RU486 is just another option to terminate a pregnancy, but neither should it be considered and used as a ‘morning after’ pill. The sanctity of life must be respected. It is abhorrent to me to resort to abortion as a contraceptive, but I know there are instances where it is necessary, and it is then we need to give women the choice of what is safest for them.

What we should be discussing is whether people are sufficiently informed to make that decision and what should be responsibly done to ensure that they are informed. If they are, and have made an informed decision, then frankly it is academic whether they use RU486 or a medical instrument as a conclusion. My view is that this drug should be made available, but that certain protocols need to be followed as a qualifying criteria for its use. It should not be made freely available and certainly not without the approval of a medical practitioner. The clinical protocols need to be satisfied and the medical practitioner should be satisfied that the harm to the woman is minimal.

I do have concerns with any philosophy that delivers absolute powers to any one individual, because that is not the nature of the democracy that we deserve and expect. Having said that, I wish to clarify my total support for Minister Abbott. He is an excellent minister. My decision to support the bill must in no way be construed as a lack of support for him. I take offence at my colleagues, particularly the comments by the member for Indi and the member for Solomon, who say that this bill is about a lack of confidence in the minister. To me that is an insulting and provocative statement that should never have entered this debate. This debate is not about pro-abortion; it is about experts, not politicians, deciding if a drug should be available.

It might be appropriate for me to mention that I agree with comments made about too many abortions, and it behoves me to ensure that in government we do establish more family planning clinics in the hope that we can reduce the incidence of abortion and perhaps encourage the alternative of adoption. There are many in my electorate who have gone down this path to try to adopt, with little success.

I do have a concern—that is, if we are to allow liberalised access to this drug then we must be satisfied that we are not opening ourselves to future harm litigation of thalidomide proportions. It matters not what the drug is being used for; the same guarantees should apply.

This is not a clinical or even a governance debate; it is a debate about religious morality and what beliefs we choose to subscribe to. If that is the case then it is a matter for the individual and not for the state. It is true we are elected to represent the people of Australia and our electorates. With an emotive issue such as this, there is no possibility of achieving a result that would allow all to be satisfied, particularly in Gilmore, by my decision. May I reassure the residents of Gilmore that this has been one of the most difficult decisions to make. Ultimately it is a vote of conscience. Governments must look after the physical welfare of individuals, and the spiritual welfare aspect is the domain of the individual. May I say that I am grateful to have been given the opportunity of voting on my conscience and that in this debate my conscience is clear.

Let me put this question in closing: how would men feel if it was made compulsory that they use contraceptives so no woman would have to have an abortion? It could make for an interesting debate. I too would like to thank all my colleagues from both sides of parliament for their contributions, be they for or against the bill. I fully understand their decision and how emotionally difficult it has been for us all. I also need to express my disgust at and disappointment with Senator Kerry Nettle’s choice of words on her T-shirt. They did nothing to lift the image of the debate; in fact, I found them greatly offensive. I support this bill and, in doing so, say to my critics who have accused me of being non-Christian because of my vote: nothing could be further from the truth. This decision will be a matter between me and my God. May I also ask my colleagues to look at the intent of the amendments to this bill. To my mind it is a tactic to distort the original bill and should not be supported.

Bernie Ripoll (Oxley, Australian Labor Party, Shadow Parliamentary Secretary for Industry, Infrastructure and Industrial Relations) Share this | Link to this | Hansard source

I rise today to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. In doing so, and in the brief time I have, I would like to make just three points. The first relates to this being a conscience vote, the second is about governance and the bill and the third is about the integrity of the conscience vote process itself. Contained within this framework is the reasoning by which I have made my decision on this legislation. I also want to make it clear from the outset that I believe that this debate is not about abortion but more clearly about the power over the process of a particular drug which happens to be an abortifacient.

No matter what anybody says about this debate, no-one should claim it is about abortion. We are not debating the legality or otherwise of abortion; nor are we debating the future or the morality of abortion itself. While I do accept the relationship between the approval at any level of the drug RU486 and the abortion question in broader terms, I do not accept that they are one and the same thing or part of this debate. Therefore I will be focusing on the matters at hand and what this bill attempts to change.

First, I go to the issue of a conscience vote. In my more than seven years as a member of the House of Representatives, this is only the second occasion on which I have had to vote on a bill as a matter of conscience. This at least demonstrates the seriousness by which this parliament upholds the right of members to a conscience vote on certain matters by agreement. This is a good thing that should be supported and respected and, I believe, forms an important part of our representative democratic system in consultation with the community. I take this very seriously indeed.

Therefore, as I prepare to cast my vote on the bill before the House, I would like to quote the words of Edmund Burke in his celebrated address to the electors of Bristol in 1774:

Your representative owes you, not his industry only, but his judgment; and he betrays, instead of serving you, if he sacrifices it to your opinion.

With those words in mind, today I back my own judgement and vote accordingly. Today, as the representative of the people of Oxley and as a member of a free democratic system of representative government, I vote according to what I believe to be in the best interests of the nation and of women. I support the amendment and the bill, which seeks to:

... remove the responsibility for approval of RU486 from the Minister—

for health—

and to provide responsibility for approval of RU486 to the Therapeutic Goods Administration.

I do so not only because I believe in the Labor Party national platform, which asserts ‘the rights of women to determine their own reproductive lives, particularly the right to choose appropriate fertility control and abortion,’ but also because I believe this bill is not about abortion. It is about the process in relation to the administration of a drug and it is about good governance.

This issue has received an enormous amount of media attention and public debate—let alone the volumes of correspondence from people all over Australia. Since debate on this issue began some months ago, I have received a great variety of correspondence from people all over the country expressing their views, and I appreciate their efforts, although I will say that receiving so many different views does little to help in the decision making processes of any member of parliament.

To make matters worse on an already divisive issue, government members have now moved a number of different amendments to the original bill, which will at best further complicate the issue at hand and potentially lead to confusion as to their effect. At worst, in the event that they are carried, they will make literally every application for the use of the drug RU486 a decision of parliament, so that we will need to go through this process again on each occasion.

In my view the decision is clear: either we approve the TGA authority to make the decision on use or we leave the legislation as it stands. There is no halfway house. We do not know what the decision of the TGA might be. All we know is that, if they assume the power of the minister, the TGA will need to follow due process and regulation to make their decision, unlike any minister when making a decision. It could well be that the TGA would not approve the lifting of the ban.

The question must be asked whether, if the Minister for Health and Ageing was advocating the introduction of this drug, this would be the same debate at all. The explanatory memorandum succinctly sums up the argument as I see it:

The TGA is specifically charged with identifying, assessing and evaluating the risks posed by therapeutic goods that come into Australia, applying any measures necessary for treating the risks posed, and monitoring and reviewing the risks over time.

The TGA is regarded by the government as being qualified to manage the risks associated with any therapeutic good that is used (or proposed for use) in Australia. It is therefore reasonable to assume that it is also qualified to manage the risks associated with medications such as RU486.

The minister for health has also argued that a vote for this bill is a vote to subcontract our duties to unelected officials or somehow a vote of no confidence in him. While he may be right on half that count, I believe the minister is wrong and is misrepresenting the facts.

The government’s willingness to divorce itself from responsibility and misrepresent the facts appears all too often—dare I mention the Australian Wheat Board, ‘children overboard’ or immigration matters? The government should not be allowed to cherry pick its responsibilities—between those matters it chooses and those it hands over to agencies, departments, delegates, authorities, expert panels, judiciaries and an endless list of other areas where the parliament sets regulations but hands over its authority—and then denigrate those who do not agree as somehow outsourcing our duties and responsibilities. The minister is simply wrong.

The Minister for Health and Ageing also spoke about freedom of choice for women, but he makes it clear that it is freedom of choice within the parameters of the values of the minister himself. There are also many other contradictory comments coming from the government over this issue, which I would like to draw to the attention of the House.

It is obvious from my comments that I will be supporting the passage of this bill, unamended, as it stands. In the little time that we have to speak on this, I want to comment on the principles adopted by the two major parties on the process in this debate. Firstly, I want to comment on the fact that the Labor Party respects the process of a conscience vote for the capacity it gives individual members of parliament to deal with matters deemed important enough to warrant such a process. I want to comment on the support for this principle there has been from my own party and I want to comment on the manner in which my own party has carried itself and respected the views of individuals on this matter. Secondly, I want to draw the attention of the House to the conduct of and deliberate confusion sown by some—and, I stress, only some—members of the government.

The government has argued for the retention of the powers of the health minister on this drug. But just days ago the Prime Minister did a backflip and also argued that the health minister cannot decide the fate of RU486—that the decision should be taken by all 17 members of the federal cabinet. The Prime Minister has inadvertently admitted that he personally does not trust the health minister to make decisions on this matter. At least on this point, I agree with the Prime Minister. Taking this to the obvious conclusion, though: if you cannot trust one minister, why should we trust the 17 others? Couch this argument against the words of the health minister himself in the republican debate, in which he said that politicians cannot be trusted. If any of us are to believe anything this minister or government says, we should believe the minister when he said not to trust him at all. They are his own words.

But this obviously should not be the exclusive basis on which any of us makes a decision on this matter. The fact that the minister does not have the expertise or objectivity to make such a judgment means that it should be carried out instead by a properly appointed expert authority regulated by the parliament. This is not so-called outsourcing of responsibility but proper process and sensible judgment.

Many arguments will be made in this place about this issue. I cannot say I agree with all of them, or even with their logic, but I will respect them. And I would respect them even more in the knowledge that members’ decisions came about with no undue influence or pressure brought to bear by other members of this House or by ministers themselves to affect the outcome of a conscience vote. I find that absolutely repugnant. What this whole debate proves and this process demonstrates, if nothing else, is that the Howard government cannot be trusted. I commend this bill to the House.

Michael Ferguson (Bass, Liberal Party) Share this | Link to this | Hansard source

I rise tonight to address the bill before us now, the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I want to say from the outset that, if this bill is put to a vote in its present form, I will not be supporting it; I will vote against it. In coming to this position I have searched my own conscience, considered the facts of the matter and taken in all of the many emails, letters and phone calls I have received from people in my electorate and even beyond. I have also engaged the views of my parliamentary colleagues because I feel that their experiences and subject knowledge are worth knowing.

Drugs which cause an end to pregnancy, like RU486, belong to a special category of drugs known as ‘restricted goods’ under the Therapeutic Goods Act 1989. Presently, restricted goods must have the approval of the Minister for Health and Ageing in order to be evaluated, registered, listed or imported. The restricted goods provisions were incorporated into the act in 1996 as a result of amendments to the Therapeutic Goods Act by former Senator Brian Harradine, a great man. Harradine and others successfully argued that these provisions were necessary because abortifacients are by their very nature a special category of drugs that warrant extra scrutiny.

Very importantly, it has to be pointed out that abortifacients are not therapeutic. In plain English: drugs which cause an abortion ought not to be confused with drugs which treat an illness. They are treated differently because they are different. There is no need to be highly educated to understand this; yet, with great respect, I observe that, of my colleagues who favour this bill, not one has been prepared to concede this point.

Some advocates of this bill allow their arguments to imply that the health minister is the sole arbiter of these restricted goods and that he is not qualified to test the medical effectiveness of abortifacients. I think that this is false and misleading, both to members and to the wider public. I remind the House tonight that this bill does not simply offer a choice between the TGA and the health minister as to which is best placed to approve a restricted good. The fact is that the present law already ensures that there is a role for both. That is appropriate.

If some are dissatisfied and feel that it is not good enough for the minister to have final discretion in approving or disapproving a TGA recommendation, they have the opportunity to address this by supporting an amendment. The amendment moved by the member for Lindsay ensures a continued and substantial role for both the TGA and the health minister and, in addition, a new, overarching role for the elected parliament, through disallowance.

I agree that the TGA ought to do its job and assess the safety, efficacy and quality of the medicine according to the best advice and clinical data that is available. I think we have consensus on that point. Its recommendation, in response to an application, should be considered by the government of the day through its minister for health, and the parliament ought to have the right to disallow a decision it does not agree with. This is appropriate; it is democratic, and it is responsible. To dismiss the TGA as a faceless bureaucracy is an insult to science and to the Public Service—agreed. Equally, though, to dismiss this on the grounds that politicians are not capable of representing the community is an insult to our representative democracy. We need to draw on the strengths of both the TGA and the elected parliament for drugs like this.

There is disagreement as to whether or not this bill is concerned with abortion in Australia. Again, with great respect, I think that is a monumental ruse—perhaps to lull members into a false sense of security in respect of the decision we are about to make. This is in part a technical issue, but it is not just technical. This is a social issue; it is a moral issue; it is, for some, a religious issue; it is a women’s issue and it is a men’s issue. Like it or not, we are all implicated in this. It goes to questions of life and death.

It may be possible in this magnificent chamber, isolated from our communities, to argue on technicalities only. However, none of us can escape the reality that Australians see this as a question at least partly about our attitudes to the value of human life. Facing this reality, we should not cast a vote which conveys to the community a relaxed attitude to abortion.

Let me ask members of the House this question: if this issue has nothing to do with abortion, then why do I have a conscience vote, and why do you? If I am wrong about all of this, then there is no explanation for the rash of foolish statements which have been uttered by members on both sides of this issue. I cite the comment by the member for Hughes with regard to the Muslim population. I cite Kim Beazley’s equally stupid response that ‘Danna Vale represents growing government extremism.’ He is full of hot air and bluster and has offered nothing of value to this debate, which I deeply regret. I cite a Greens senator who wore a deliberately offensive T-shirt and showed her party to be the moral wasteland that it is. There are plenty of others who will go unremarked.

However, I sincerely congratulate the majority of my colleagues for their speeches, which I have been watching and listening to closely. I do not agree with some of what I have heard but, at the same time, I have enough respect for them to at least think they are capable of considering the issues, representing their constituents and searching their own consciences. Further, I thank that same majority for extending to me the same courtesy.

I want to single out the member for Sydney, who gave a speech that I disagreed with in almost all respects, except for her stunning reflection that ‘all children deserve to be wanted and welcomed.’ I do not want to trouble the House with a long speech in favour of protecting the lives of the unborn, as I am sworn to do; however, I want to record my disappointment that some members have been unable to reconcile themselves to their own double standards. I have said it before and I will say it again tonight: it is a double standard for some people in the Australian parliament to have fought—in the name of the sanctity of life—to save the life of one young man who had been found guilty of drug trafficking, while at the same time engaging in a campaign for a drug which will allow the death penalty to be imposed on unborn babies.

I mean no offence but, in the spirit of free and fair debate, this has to be said and considered. I cannot accept that the sanctity of life is a concept that can be invoked on a selective basis. The value of a human life should not be measured by whether or not it is wanted. An assault against a pregnant woman that causes a miscarriage is seen by criminal law as assault against the woman and the wrongful death of the unborn child. Why is this? It is because the child is wanted. However, an unwanted child is afforded no such protection, simply because he or she is unwanted.

I want to say very carefully, deliberately and sincerely that I would not and will not ever pass judgment on a woman who has gone through an abortion—that is not my place—but I hope that no-one I love will ever be faced with the challenge of an unwanted or unsafe pregnancy and I do sincerely wish the same for all Australian women. I hope, however, that we as a nation can be mature enough to seriously challenge ourselves and to demand an answer from ourselves about the vast number of abortions that are performed in our wonderful country—and every year they amount to the population of the city of Launceston!

I do not pretend to have all the answers, but I ask my fellow Australians to have the courage to at least start to ask ourselves the questions. May I offer some suggestions? I think there is room for the ‘pro-lifers’ and the ‘pro-choicers’ to give some ground here. Even without reliving any debate on whether or not abortion should be legal or illegal, we have a duty to show good faith and to acknowledge that we will not fully agree on the sanctity of life and when life begins. Let us at least identify a subset of the abortion statistics that should be stopped: abortions that follow as the result of promiscuous sex lives; abortions that follow because of a lack of personal responsibility; abortions performed after 24 weeks, when any half decent neo-natal ward would be quite capable of sustaining life; abortions where a woman does not have the financial resources or the emotional ability to raise a child; abortions where the boyfriend does not want to take responsibility for the child he helped to conceive.

I think there is a major role for men in this process. We, after all, should take responsibility for our actions. Equally, men should not be excluded from decisions that affect the life of a child they helped to conceive. If they want to enjoy sex with their lover, then they should also support the person they wooed and really demonstrate their professed love by showing commitment through the challenging times. Life is not always easy, but that is life. We can do all of this without even challenging the broad principle that abortion is available in Australia. But, like every law, we can talk about boundaries, if we can be reasonable with each other in the interests of the dignity of human life. But, for now, as the health minister has said, extending the means of abortion will certainly not reduce the number of abortions.

Academically, the bill as it stands has some merit, in that medical experts are needed to take a lead role in the assessment of drugs. But to totally take elected government out of the assessment process is certainly an overcorrection of the 1996 amendment. For the reasons that I have already given with regard to the nature of these drugs, we do need to have consideration for a whole lot more than just safety and efficacy. The social consequences cry out for consideration.

I am sorry to disappoint anybody listening to or reading this contribution, but I did not particularly want to speak on this bill tonight. If I were to be honest, I would say that I have approached this issue fairly reluctantly. I do not even look forward to exercising my vote tomorrow. That is not to say that I am unsure. I am who I am, and I have never shirked from saying what I believe. As I said in my first speech, Aussies are sick and tired of politicians who cannot say what they mean and cannot mean what they say. I ran for election to the federal parliament so that I could represent the proud and spirited community of Northern Tasmania. I did not run for election hoping deep down that this issue would arise and that I could have a chance to fight it. However, the people of Bass have entrusted this role to me, to represent them, to fight for them, to be a leader and, importantly, to be a person who can use wise judgment. As reluctantly as I approach this, I know it is my duty and the duty of my colleagues.

I also know that I would be neglecting this duty if I were to flick off my responsibility to an organisation like the TGA on difficult ethical issues like this one. And I can say that I have spoken to colleagues on both sides of this chamber who have openly said to me that they cannot support an amendment which maintains parliamentary oversight, because they do not wish to be troubled with this issue ever again. That is why we are here: to tackle the tough decisions, to show courage and judgment and to remain close and accountable to our communities, whatever the cost. Australians deserve no less.

In closing I want to again thank all of those who have contacted me to share with me their views, whether we have ended up agreeing or not. It is important to me to stay close to my community, to listen to all who want to be heard and to at least try to help all those I can. I owe it to my constituents, having looked at all of the arguments, to make a decision based on conscience, not rhetoric, emotion or political agenda. God help us and forgive us if we get it wrong. I thank the House.

Steve Gibbons (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, which is designed to shift the approval process for importation of RU486 from the Commonwealth minister for health to the Therapeutic Goods Administration. I take this opportunity to thank the many hundreds of people on both sides of this debate who contacted my office through various means to calmly and in an articulate way outline their views on this important matter before us tonight. I believe the TGA is the appropriate authority to assess and evaluate all of the risk posed by therapeutic goods and drugs and for implementing appropriate strategies designed to minimise any risk involved in the use of this particular substance. I therefore will be supporting this bill and strenuously opposing the amendments.

It was inevitable that this debate would be focused around the issue of termination of pregnancy. Like all Australians, I find the number of terminations performed in Australia—reported by informed and accurate sources to be in the order of around 70,000 per year—unacceptable and simply astounding in this day and age. There has been speculation that this figure is much higher, mainly by those who choose to deliberately distort the issue to attempt to dishonestly manipulate the outcome of this debate. Whatever the true figure is, it is much too high. I can only imagine the frightening and tragic circumstances women who are forced to contemplate having a pregnancy terminated must find themselves in. But until we are successfully implementing appropriate measures like better education on family planning and appropriate counselling services, especially in rural and regional Australia, I suspect there will be no reduction in these appalling figures.

It is interesting to note that the Senate committee inquiring into this particular issue could find no evidence to suggest that there would be an increase in the number of terminations if the administration of RU486 were to be placed with the Therapeutic Goods Administration. We have for some time allowed the TGA to preside over a wide range of drugs and therapeutic goods and services that require extreme caution in administration, and I have every confidence in that organisation’s jurisdiction over RU486.

We are fortunate to have in this country one of the best health systems in the world. Our public and private hospitals—although often experiencing difficulties—are the envy of other countries throughout the world, although it is still very difficult for people from remote areas to access appropriate health care. We have a first-class system of checks and balances regarding the approval of various drugs and medications. RU486 will be administered under the tightest possible scrutiny involving a range of agencies with highly qualified health professionals. I have every confidence in our GPs and medical professionals to make appropriate decisions in the use of this drug, based on individual cases and taking into account ethical as well as medical factors.

I know that many people will be disappointed with my decision to support this bill, and I sincerely regret that, but I certainly make no apologies for it. While this bill is predominately about who or what person or organisation administers this drug, I cannot in all conscience, as a male member of this House, use my vote to restrict, limit or deny women access to an appropriate treatment or drug for any given set of circumstances. I have always believed that the matter of a termination of pregnancy should strictly be between a woman, those close to her and her doctor.

This bill is much more than just the issue previously mentioned; it goes to the important matter of who or what organisation is best suited to administer RU486. I am convinced that the Therapeutic Goods Administration is indeed the appropriate body to administer this drug rather than the minister for health. I have come to that view regardless of who is minister for health or who is likely to become minister for health in the future.

This debate, like all debates where a conscience vote is required, has aroused strong feelings from the Australian people on both sides of the argument. Indeed, politics can generate great passion and can bring out emotions more often seen in the outer at a football grand final. Often this very forum of federal parliament can itself look and sound more like a gladiatorial coliseum than a dignified chamber where the nation’s wellbeing is being debated. That is the nature of this chamber, and I, along with other MPs, have contributed, rightly or wrongly, to that situation. It has often been called a hothouse. This is just one of the reasons that I believe—and, I believe, that the majority of my colleagues believe—that this political forum is not where we should be debating the availability of the drug RU486. It should be a matter for thoughtful debate and for consideration of matters of science and medicine by qualified health professionals.

When politicians become embroiled in issues such as this, we are inundated with a vast range of extreme, colourful and sometimes frighteningly rude messages from around the nation. Some of it I would have to classify as hate mail. I make no complaint about this. It is simply part of the process of attempting to influence the outcome of a given situation. The age of instant electronic communications puts legislators right at the coalface whenever a contentious issue is raised anywhere in Australia. And because of the email address system MPs have no way of knowing if it is genuinely from someone from his or her area or part of an orchestrated national barrage.

I have received—no doubt along with all MPs—hundreds of emails, faxes and phone calls from people from all over Australia, most containing powerful arguments from both sides of this debate. Many I found to be disgusting and abusive right through to patronising and arrogant—again, from both sides of this debate. Having no way of knowing that one particular email—which was from Dr David Stratton in my electorate—was actually from one of my constituents and that it was a genuine, if not patronising, attempt to lobby on an important issue, I made a serious mistake in giving an unnecessarily brutal response. Once I became aware that he was a resident of my electorate and it was a genuine attempt to communicate his views, I contacted him by telephone. After a short conversation, I realised that I had been wrong in my interpretation of his comments and stated that I sincerely regretted responding in the manner in which I had. He said that he would prefer an apology. I then provided a verbal apology—and, again, I unreservedly apologise to Dr David Stratton. Ironically, he and I agree on the RU486 issue.

Since I announced my support for this particular bill, my office has been a focal point for a lot of this bludgeoning communication. We try to reply to as much of it as we can. Sometimes our judgment can be skewed by both the volume of this material and its hectoring nature, with its creative use of short, sharp slang. I believe that the sometimes extreme screeching nature of the communication now washing over MPs and staff from coast to coast is clear evidence of the need to take the RU486 decision out of the political arena. Loud is not the same as right; in politics, however, it is sometimes hard to tell the difference. For the reasons I have just mentioned, I will be supporting this bill and vigorously opposing the amendments.

Alex Somlyay (Fairfax, Liberal Party) Share this | Link to this | Hansard source

This bill is a matter of conscience. It is to be considered by every member of this House according to their background, their religion and their personal beliefs. It is sponsored in this House by the member for Moore, my very good friend Dr Mal Washer. Dr Washer is a reputable medical practitioner of many years standing. Dr Washer has a reputation in this House that is unblemished. No fair-minded person could question his ethics or motivation. That view has been supported also by a member of the other side, the member for Cowan.

The member for Moore has also made it clear that Tony Abbott, as the Minister for Health and Ageing, has no bearing on his reasons for supporting this bill. On the contrary; the member for Moore made it clear that, in his view, Tony Abbott is the best health minister he has seen in this parliament. I have been in this parliament longer than the member for Moore and I am inclined to agree with his comments. This bill, whatever its outcome, should not be seen as any vote of no confidence in Tony Abbott.

At this stage of the debate, I need not go over the technicalities involved in the TGA and its role in the approval of therapeutic substances; the ‘restricted goods’ comments that other members have made complete the record. That issue is on the record many times over.

I have to say that I do not agree with those in this debate who have attacked the integrity of those good people who work in the TGA. TGA personnel do an exceptional job in carrying out their duties and obligations, as laid down in the act. They are skilled professionals who are recognised worldwide as world class. They have my total confidence. Any criticism of their motivation or questioning of their professionalism is grossly unfair. TGA employees are also members of the voting public. I have no doubt that there would be TGA employees who would support this bill and there would be those who would oppose it. To blame the TGA and paint them as ‘faceless’ men and women is hysterical nonsense. They are fallible human beings, as we are all fallible human beings.

Like all other MPs, I have been subjected to an avalanche of emails and other communication. I doubt that there is an argument for or against RU486 that I have not heard or read. I have sought other people’s views. I have canvassed the opinions of many groups, including medical groups, church groups, members of my own family and friends. I have found that opinions are divided on this issue, even within medical groups, even within church groups and even within families. I have spoken to Catholics who oppose RU486. I have spoken to Catholics who oppose abortion, except in exceptional circumstances, such as when the life of the mother is at risk. There are people who have contacted me as Catholics and who claim to be Catholics who support RU486 as an alternative to surgical abortion. I have been contacted by women who have had abortions and many years later are suffering from the psychological guilt that lives with them. Some have pleaded with me not to support this bill; some have pleaded with me to support this bill.

All members are under pressure from different views in this debate. I have carefully considered every argument and every representation made to me. I will mention some of these arguments and counterarguments. One is that the availability of RU486 will increase the number of abortions. The counterargument to that is that, when a woman chooses RU486, the decision to have an abortion has been made already. Another argument is that, if the ban on RU486 is in place, why don’t we ban the production and importation of instruments used in surgical abortions? RU486 is not a therapeutic substance such as other drugs but a drug designed to kill the foetus, to take a human life—but so are surgical instruments.

There are those who argue that this bill is not about abortion. Let us not kid ourselves: this bill is about abortion. The fact is that abortion is legal in all states of Australia. Whatever the outcome of this bill, abortion will still be legal in Australia—whether or not we pass this bill.

My dilemma is this: my heart tells me one thing and my head tells me another. I am a Catholic because I was born a Catholic. My heart tells me abortion is wrong, and I have always declared myself openly to be pro life. However, I have always respected the right of anyone to believe differently from what I do, and I have never tried to force my views upon anyone else. I am not going to start now. My head tells me that RU486 is not inconsistent with the laws of the land, as enacted by the states under democratic process. My head tells me a decision made by a woman and a legally qualified and registered medical practitioner is their choice and right by law.

My heart tells me that I love this parliament and I would never act in a way to diminish its authority over the executive or the administration. As I said before, the TGA, like each one of us, is not infallible. The member for Lowe drew our attention to the TGA and the Pan Pharmaceuticals crisis of recent years and, in turn, the Auditor-General’s criticisms.

I understand and respect the views expressed by colleagues on both sides of this debate. I understand the pressure felt by colleagues who hold marginal seats by a mere handful of votes, but when the bells ring we will all have to be counted on this issue. The fact is that the community is divided, and it is impossible to vote in such a way as to please everybody. Each member has to vote according to his or her conscience. I ask the people of my electorate of Fairfax to understand this process and believe that I respect the views they have expressed to me. I ask them to understand and respect the decision I take.

I agree with the Treasurer’s comments earlier today that this bill does not diminish the sovereignty or the supremacy of the parliament over the executive or the administration. It is within the power of the parliament to repeal this legislation at any time. If the TGA acts in a way outside of its charter, under the act it will be held accountable. For instance, the Audit Act makes the Auditor-General an independent officer of the parliament. The Auditor-General does the work of the parliament to ensure accountability of the bureaucracy and agencies to the parliament. The fact is that we as politicians do not have the skills to perform those performance audits. We rely on the Auditor-General to do our work for us. Likewise, we do not have the medical or scientific skills to assess the safety and efficacy of RU486—but the TGA has. There are many checks and balances in the system to safeguard the public, and parliamentary scrutiny through the audit process, the parliamentary committee process and the Senate estimates process are but a few.

My public opposition to abortion is well known, but the debate on the legality of abortion was concluded 30 years ago. Abortion is legal today and will be legal next week irrespective of the outcome of the vote on this bill. Like other members of this House, the Department of Health and Ageing advises that there are 91,000 abortions carried out in Australia each year. That is far too many. But, after listening to all sides of this argument, I am inclined to support the bill because I believe the checks and balances are in place to ensure that the safety of women will be paramount in the TGA’s considerations without diminishing the sovereignty or the supremacy of the parliament. I will listen carefully to the remainder of the debate before I finally decide how I will vote. The ethical and moral questions still remain unresolved. The parliament is the appropriate place for the moral and ethical questions to be debated and determined. Is there a moral or ethical issue in this matter? Are we asking the TGA to make moral or ethical decisions? I said that my head tells me one thing but my heart tells me another. That is the dilemma that I will have to resolve before I vote on this bill tomorrow.

Chris Hayes (Werriwa, Australian Labor Party) Share this | Link to this | Hansard source

I know there are many and varied views about the issue of abortion, and it would be unrealistic to think these views can be easily quarantined from the considerations in the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 before us today. From the outset, I should indicate that my personal view and strongly held belief is that life begins at conception. Whether growing up in a Catholic family or being the product of a Catholic education has influenced my view in this regard I am not sure, but I know I hold so deeply to that view that for me not to admit it would amount to gross dishonesty on my part. I accept that among my colleagues and the public there are many who hold equally strong views, but views which are opposed to mine. I respect all these views but, as I believe that life begins at conception and I cannot be persuaded otherwise, I concede that there is no prospect of reconciling these contrary views when it comes to such a critical issue of moral belief.

I recognise that the bill before the House is not about the illegality of abortion. I am aware that some have already raised the issues associated with the criminal codes that apply in the various states and territories. I believe there is little point being pedantic on the legal position of abortion. There is broad acceptance that abortion is both legal and indeed readily accessible throughout Australia. It would be wrong to say that this bill is just about changing the approval process of a particular class of drug. This bill is about parliament relinquishing its responsibility to consider all matters associated with the approval of an abortifacient, including ethical and moral issues—that is, relinquishing the responsibility in favour of the TGA, which in general is an unelected administrative board which is partly funded by the pharmaceutical industry. The truth is that this debate is about abortion and, in particular, the type and extent of access women have to terminations. We would not be having this debate if that were not the case.

The reason why RU486 is a restricted drug and subject to section 23AA of the Therapeutic Goods Act is that its primary intended use is as an abortifacient. As such, for any drug of this type, there are always going to be issues in addition to the scientific and technical evaluations to be considered in any approval process. Abortion will always involve questions as to when life begins; therefore, there will always be issues of a moral, ethical and philosophical nature to be considered. This is why the Therapeutic Goods Amendment Bill was passed in its current form in 1996. It provided legislative support to ensure that drugs such as RU486 were not imported into Australia without the express approval of the minister for health, being a person directly responsible to this parliament. At the time, Senator Harradine aptly summarised the position when he said:

People on both sides of the abortion debate agree that the importation, trials, registration and marketing of such agents ... should not be left in the hands of bureaucrats and science technologists. There should be ministerial responsibility ...

The legislation established direct ministerial responsibility as a mechanism to ensure that an issue such as the importation of an abortifacient is subject to thorough consideration, not simply a technical evaluation of the effectiveness of the drug to induce a termination but also consideration of the broader range of social policy and ethical issues.

I do not believe anything has materially changed since the passage of the 1996 amendment that would warrant the removal of ministerial or parliamentary responsibility in the approval of a drug of this type. If passed, this bill would make the abortifacient drug RU486 subject to the ordinary approval processes of the Therapeutic Goods Administration under section 25 of the Therapeutic Goods Act. The act provides that, before any pharmaceutical drug can be marketed in Australia, it must first be evaluated and approved by the TGA against the criteria of quality, safety and effectiveness. The passage of this bill would in effect remove RU486 from the class of restricted goods which currently serves to prevent the evaluation, registration or sale of the drug without the approval of the minister. If the debate were simply about the technical evaluation of a drug and a consequential approval process, clearly the TGA would be the appropriate organisation to undertake this role. The technical and scientific competence of the TGA is not in question.

RU486 is not a medicine or a therapeutic drug because its intended use is not primarily for therapeutic purposes. The proposed purpose of RU486 is to chemically induce terminations. Clearly, we are not debating whether this drug should be made available for a therapeutic application. We know that mifepristone has already been used in Australia to treat brain tumours and the drug was obtained under the Special Access Scheme. This is a debate about whether or not the availability of RU486 for non-therapeutic use for abortions should appropriately remain with the minister, a person responsible to this parliament.

It is not possible to hide from the fact that there are significant ethical and moral issues associated with this class of drug. But leaving that to one side for the moment, there is also a real and genuine concern as to the longer term effects on women, both physically and mentally, as a consequence of medicated abortions. The Commonwealth’s Chief Medical Officer has already expressed the view that, as a procedure, medicated abortions carry a significant higher risk of later adverse effects. That being the case, it adds to the argument that any assessment of a drug of this type should not be left to a single faceted and technical approval system and must be subject to the most rigorous of evaluations, including the consideration of relevant social policy.

Some have argued that RU486 is simply a chemical way of doing what can already be achieved surgically, and that this medical means of termination provides women with a choice that will make abortion easier for them and more readily available. In all honesty, I must admit that, for me, ‘more’ and ‘easier’ does not necessarily mean better. It is inescapable that a drug of this type will always involve ethical considerations, as it raises issues beyond purely health issues. Therefore, I believe that as a parliament we would be abrogating our responsibilities to relegate this consideration to the TGA.

I would like to conclude by agreeing with the views of Senator Neal, expressed in the 1996 debate when she said:

These issues need to be addressed by the Executive of this government and addressed with absolute and direct accountability and absolute and complete transparency.

I oppose the bill.

Petro Georgiou (Kooyong, Liberal Party) Share this | Link to this | Hansard source

I welcome the opportunity to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I note that there are time constraints and that we have been asked to keep our comments brief, so I will do so. As the debate has made clear, this bill does engage people’s deeply-held feelings and beliefs and it has always been clear that abortion is a very difficult and very sensitive issue. Personally, I believe that the current law regarding abortion is appropriate, but the fact is that this is not a bill to amend the law relating to abortion. This is not a bill that automatically allows the use of RU486 in Australia. To date, the Therapeutic Goods Administration has not evaluated RU486. This is a bill about who will determine whether a drug will be made available: a minister or a body of experts.

I have to say that the introduction of this bill does not represent a lack of confidence in the minister. I hold Minister Abbott and his handling of the health portfolio in very high regard, although it is no secret that we have disagreed on some issues in the past. It is equally no secret that I believe that Minister Abbott is the best friend Medicare has ever had.

My position on this bill is quite straightforward. My position is that decisions on the efficacy and safety of drugs should be in the hands of experts. Neither a minister nor the parliament should determine on a case-by-case basis whether a drug should be made available in Australia. I believe that this would be both impractical and inappropriate.

We have a regime in Australia where the Therapeutic Goods Administration is responsible for determining whether qualified health practitioners should have access to particular drugs for lawful purposes. The Therapeutic Goods Administration has the mandate to ensure the quality, safety, efficacy and timely availability of therapeutic goods. The Therapeutic Goods Administration has a high reputation and that reputation is well earned.

Decisions of the Therapeutic Goods Administration about the availability of drugs are subject to a whole series of accountability processes, not least that their decisions can be appealed on their merits to the Administrative Appeals Tribunal. The established process of review of administrative processes ensures that the TGA is accountable for their decisions. I believe that the decision whether RU486 may be prescribed for Australian women should be made by the process of evaluation and review applicable to all other drugs and I will be voting accordingly.

In conclusion, I wish to say that a number of members of the Kooyong community have made their views on this issue known to me and I thank them for their counsel. I commend the bill to the House and I advise that I will be voting against the amendments.

Bob Katter (Kennedy, Independent) Share this | Link to this | Hansard source

In rising to speak to the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 the first observation that I want to make is that there is an endeavour being made here to introduce some oversighting by this parliament into the issue of this particular drug and, arguably, similar drugs.

The Therapeutic Goods Administration and the people backing this bill are saying: ‘Trust me. Trust the Therapeutic Goods Administration.’ The Therapeutic Goods Administration told us that thalidomide was quite safe. And, frankly, it was people in this place—and the media, it must be said—who contributed very greatly to exposing what was a horrific mistake by the TGA and one that they were not rectifying. It seems there is a belief in this place, as I have said many times in the context of free trade, that this place is some sort of a spectator’s club and that government is a spectator sport—that we do not actually participate or take any responsibility for decisions; we just come here and look at it all going past and let someone else do the hard yakka.

Our socialist friends—inappropriately, on my right—would be very interested in, and are obviously very ignorant of, the fact that under the free trade agreement the TGA and the PBS are now oversighted by a joint committee which comprises 50 per cent Americans and 50 per cent Australians. I doubt whether there would be a single intelligent person or a single thinking person in this place who would doubt for one moment that that committee is going to be dominated by the Americans. And those Americans will, of course, be from the drug lobby in the United States. So what we have here is the TGA being oversighted by—a nice phrase; I would replace it with ‘emasculated by’—an oversighting committee consisting of 50 per cent Americans, who will be representing the big drug corporations of the United States. If you read the free trade agreement you will realise that, yes, it is about quarantine and, yes, it is about the motor vehicle industry but it is also, mainly and principally, about destroying and emasculating the pharmaceutical benefits arrangements in Australia.

Those who vote for this bill will be putting their futures in the hands of the United States drug corporations. When the disasters occur, we will know who to sheet the blame to. It is an extreme reflection on the people on this side of the House that they have sat here and criticised the free trade agreement and yet they have not seen the implications of their own stupidity in what they are doing today. All that the amendments are asking for is some oversighting by people who are paid salary packages of $120,000 or $130,000 a year. Surely there is some responsibility on you to do some sort of oversighting of a highly questionable drug that is on the market at the present moment.

There is not a single person in this House who for one moment questions that this bill is about abortion. Of course it is about abortion. Absolutely it is about abortion. There is some argument about whether this drug should be taken earlier, or later, creating more horrific circumstances. The current estimations are that there are about 100,000 abortions taking place. There are only 126,000 births taking place. Soon we will be killing more unborn children than the number we will be having. I will return to that.

Why is this occurring? Let us simply look at the figures. Average earnings are $52,000 a year. Taxation, with GST and indirect and state taxes added to it, is pretty close to 40 per cent, but I will use a figure of 36 per cent, which is a bit low. That works out to $18,700. What if you are a family that wants to have three kids? The economic and physical constraints are such that it is very hard for a mother to work if she has three kids. The option is that the mother does not work and the husband receives an average income of $52,000.

Where will that leave this family that decides to have three kids and have a mother for their kids? They will get $52,000 less $18,700, which is $33,000. That is divided up amongst five people. The Courier-Mail, the biggest newspaper in Queensland, recently estimated that it cost $250,000 to raise a child. It is fair that that be divided by five. That leaves a family with a full-time mother and three children on $9,600 per person. If you have both mother and father working, it works out to $16,200 per person. But if you are a DINK—two people living together with no children—you will have a disposable income of $33,000 per person. The argument really is: do you want an income of $9,500 per person, an income of $16,000 per person or an income of $33,000 per person? Is it any wonder that we have 100,000 abortions a year? What a disgraceful statistic.

I am going to do one of those things that I very rarely do and read part of my speech. There are some things that I want to say, and I want to say them properly, so we have written them down.

This legislation has come from the Leader of the Democrats, who propelled her arguments by announcing to the world that she had had an abortion. I doubt whether there is a single person in this parliament who would find abortion—the killing of a human being before it is born—a desirable event. This lady herself, I hope, would not. To publicise such an event in the national media, most would agree, was distasteful to say the least.

The second lady leading the introduction of this legislation—and this involves all the people who are going to vote for this; this is the flag under which they are travelling—is a member of the Greens, Ms Nettle. She showed off on the national media a T-shirt that had on it a flagrant logo that can only be described as sectarian bigotry and a profound attack on the religious beliefs of members in this place. That is a disease that I thought we as Australians had stamped out in this country a considerable time ago.

That is the flag under which those supporting this bill are marching. I hope that they are proud of themselves. They will be remembered at the polls, because there is a crossover effect here. Those people who are strongly against abortion feel strongly enough to change their votes. That should be fair warning to the people in this place.

I saw the great abortion debate. As you would probably recall, Mr Deputy Speaker, I was heavily involved when Bjelke-Petersen attempted to make abortion illegal in the state of Queensland. As a result of that, I think that his vote lifted 6½ per cent when the election was held three or four months after that cataclysmic event in Queensland.

I want to mention a very courageous act by Keith Wright. He may have been disparaged after some of the events that later occurred, but that is a story for another day. He crossed the floor and voted by himself for Bjelke-Petersen’s bill—the only ALP person who did.

If you want to get down to religion, have a look at the roots of the ALP. They are deeply seated in the Irish Catholic people in this country. I do not know if I have an Irishman in my forebears, so I am not speaking as one of them, but anyone who knows their history knows that if ever the founders of this great party have been spat upon it has been in the debate that has occurred here today. Again and again, speakers made subtle but definite attacks upon the religious beliefs of people in this House—a thing that I have seldom witnessed in my 32 years as a member of parliament. They will pay a price for it. By the way, at the time of Keith Wright’s action the leader of the ALP was Mr Casey, who was a practising Catholic. He was thrown out on his head three months later after having voted against his principles. Mr Wright was put in as Leader of the Opposition.

So, if you want to know where the votes are going to be travelling, that is the way they are going to be travelling, because people respect people who have moral beliefs and who are prepared to act to their detriment. Seventy-two per cent of the people trenchantly opposed what we were doing in Queensland, but people respected the principles of the Premier, who had moral beliefs and was prepared to suffer at the polls as a result of those beliefs—as it turned out, he did not.

This Greens lady has attacked people for their religious beliefs. We will provide for her a short history lesson. To quote Winston Churchill: when Adolf Hitler invaded Russia, Churchill gleefully averred, ‘Those who will not learn from history shall be doomed to repeat it.’ And Hitler met exactly the same fate as Charles XII and Napoleon had prior. Mr Churchill was well aware of the fate of those two gentlemen.

We Australians 250 years ago had a spiritual belief system. A lot of the speakers for this bill do not seem to have any spiritual belief system whatsoever. But we Australians 250 years ago had a spiritual belief system that involved totems—you could not eat possum; I could not eat pigeon et cetera. Preservation of the food supply was at the heart of this particular spiritual belief—no species would be hunted to extinction. I think everyone here would say, ‘Good idea.’ Secondly, they had a belief system that resulted in zero population growth—bad idea: real bad idea.

Over the waves came people from a country with the highest of birth rates. They came here to a country which was empty, with the population of Canberra, only 300,000 people, scattered over a continent of 20 million square kilometres. Maybe the reason for the white fellas coming here was living room. Lebensraum was Hitler’s reason in Mein Kampf for invading Russia; Russia’s reason for taking Siberia and half of Mongolia, and the Americans’ reason for colonising and seizing the West.

History speaks loud of the magnetism of relatively empty land, whether it is the relatively and qualitatively benign taking of a Siberia or an Australia or the brutality of a Hitler type invasion. Empty land, land without people—there is a price to be paid for that policy and those belief systems. And we should learn, because 250 years ago we Australians suffered greatly; we were almost annihilated by people from across the waves. We were overwhelmed by them. Ask the first Australians whether an empty land or zero population growth is a good idea.

Sadly, Australia does not have zero population growth; we are well below zero population growth. When 20 Australians die they are only going to be replaced by 17 Australians. There are those who say that we have immigration. Yes, we might have migrants here, but they are not the race of people who are here now. They are not the 20 million of us who are here now—who I most certainly consider to be Australians, a separate race of people with our own belief systems, our own culture, our own pride in who we are and, I would like to think, our own dignity as well.

The ABS population figures for Australia in 2100 show that the projection for Australians, the race of people who are here now, is only 16 million. Australia’s present population is 20 million. One-third of those people in 2100 will be over 65. People over 65 are currently about 13 per cent of the population. Someone will have to pay to look after those people.

Professor Blandy of Melbourne University wrote a landmark article in the Weekend Australian in December 1994. I thought these figures were outrageous; I could not believe them. I went down to the library and the demographer in the library said: ‘Of course they are. When 20 Australians die they are replaced by 17 people. How many generations of your family died in the last 100 years?’ I went through it and I said, ‘Five generations died in the last 100 years.’ He said, ‘Five generations: 20 people are replaced by 17 and then 17 are replaced by 14 and then 14 are replaced by 12 and  then 12 are replaced by 10—you will end up with Professor Blandy’s figure of seven million people.’

That is where all these people who are voting for this bill today are leading this country. They do not like people. They constantly talk about how people have wrecked this and how people have done terrible things to this and how we have tortured the original inhabitants and wrecked the ecology and everything. They do not like people at all. They do not want to have any people. Well, I do. I like people—I really do. I think kids are wonderful. It is a great sadness to me that we could be a country with little or no children. Returning to Professor Blandy, he wrote:

As this large baby boomer group of women ages, they will stop having babies and that task will fall on a smaller number of women, born when fertility rates were lower. Under the plausible assumption of continuing low fertility, and if net migration were set at zero indefinitely, Australia’s population would peak at 19 million in the 2020s and shrink quite rapidly. In fact, it would shrink quite rapidly to perhaps five or six million by the year 2100. If net migration were set at 70,000—

it is about 110,000 at the present moment, but it has averaged less than 70,000 over the last seven or eight years, if my memory serves me correctly—

Australia’s population would reach 26 million in 2050 before shrinking to maybe 13 or 14 million by 2100.

Professor Blandy could be wrong. The ABS could be wrong. All these figures could be rubbish and stupid. Or some miracle is going to occur, some flash of lightning in the sky is going to occur, and it is all going to be different. No, it is not. And people will curse the people who were in here and made these decisions. Professor Blandy continued:

Would an ageing Australia with a shrinking number of people in it be secure in the face of an East Asia, burgeoning economically and in population? Would a rational and fair system of world government allow an empty Australia to become less populous than it already is?

Of course, the answer to that is no. I will quote from a book by an American—an adviser to a number of presidents of the United States—called The Death of the West:

In 2000 there were 494 million Europeans aged between 15 and 65. By 2050 there will be only 365 million. But the over 65s, now 107 million, will soar to 172 million. In 50 years the ratio that is now 5:1 will fall to 2:1. Taxation will have to be increased by some 30 or 40 per cent on the 40 per cent that it already is—

which, of course, we know is impossible. The other alternative is that people in their old age will not be looked after at all. This will be a very old country.

Senator Nettle may sneer at religious beliefs, but the greatest scientist of all time, Louis Pasteur, when asked what was his ambition in life, said, ‘To obtain the simple Christian faith of a Breton fisherwoman.’ The other great scientist of all history, Albert Einstein, when asked the same question, said, ‘To study so that I can understand God and his laws of nature better.’ These people would quail before the great intellectual precociousness of a Senator Nettle or the Leader of the Democrats in the Senate and their supporters in this place.

Mikhail Gorbachev, the man who took away the terror of nuclear holocaust—under which my generation lived for most of our lives—gave the quote of the century, according to Time magazine and most certainly according to me. The first thing Mr Gorbachev said when he became the leader of Russia was, ‘The important thing is that when we go on our knees of a night to pray we all pray to the same God.’

Slavery was removed by William Wilberforce and his great mentor John Newman, writer of Amazing Grace. Their driving motivation was their Christian belief. To Senator Nettle and her followers in this place: all religions have in their belief system survival—that is, survival of the clan and survival of the tribe. She will remove that survival from us. (Time expired)

Roger Price (Chifley, Australian Labor Party) Share this | Link to this | Hansard source

Mr Deputy Speaker, I rise under indulgence to inquire as to what is happening with the lights in the House. I thought we were going to have a full debate and a conscience vote in full light.

Bruce Scott (Maranoa, National Party) Share this | Link to this | Hansard source

I cannot tell you, but I think there has been some power failure and I think they are now returning to full power as you speak. Perhaps it is the power of the Chief Opposition Whip that is bringing the lights back on!

Greg Hunt (Flinders, Liberal Party, Parliamentary Secretary to the Minister for the Environment and Heritage) Share this | Link to this | Hansard source

In rising to address the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, I want to begin in my electorate of Flinders, in the towns of Somerville and Somers, in Mt Martha, in the towns of Rosebud, Rye and Dromana and in all of those areas such as Kooweerup, Cowes and Lang Lang, from which people have contacted me. There has been a wide debate in my electorate. It is a debate which has been characterised by a difference of views, but a respectful difference of views. I thank all of those constituents who have contacted me, with both information and their views, and their views have to a person been heartfelt and sincere. I know by definition that it is impossible for any member of this House to satisfy all constituents, so I acknowledge that the decision that I take and announce tonight must by definition disappoint some constituents. But I say that I make it having listened carefully to all of their views, having respected their views, but having ultimate responsibility to my own conscience and my own judgment. For that I take full responsibility.

At its absolute core, the debate on this bill is about allowing the potential extension of methods of termination from surgical termination to a combination of surgical and medical termination if the Therapeutic Goods Administration were to authorise the use of the abortifacient RU486. In addressing that question and in expressing my support for the proposition that medical termination should be made available in Australia subject to the approval of the Therapeutic Goods Administration, I come to this on the basis of having assessed four issues: firstly, the nature of the debate; secondly, the nature of assessment of health and safety; thirdly, the philosophical questions which are implicit in this debate; and, fourthly, the question of parliamentary sovereignty.

Let me turn to the first of those issues, the nature of this debate. Within Australia today I believe this has been a well-conducted debate. Around the world the question of abortion, or of any extension to the available methods of termination, in many situations has not been characterised by the civility which has generally been shown in Australia during the course of the last few months. For all of the disagreement and for all of the contest, we must recognise that we as a society have handled what is one of the most difficult issues with an extraordinary amount of good grace, good faith and good conduct.

Having said that, I wish to take argument with two points that have been raised about the rights and nature of the process of debate. The first is the idea that has been presented that men have no place in the consideration of this issue. I disagree. This and all other ethical and moral questions within our society are fundamentally the province of the parliament. I reject the notion that this debate is no place for men in the same way that I reject the notion that there is no place for women in consideration of the question of male suicide. I reject the notion that in consideration of a certain question there could be no place for people because they are atheists or Catholics. In the entrance to the Victorian parliament there is a mosaic, and that mosaic quotes from Proverbs 11:14. It reads:

Where no counsel is, the people fall: but in the multitude of counsellors there is safety.

That principle I believe has been applied and should be applied. Every person, irrespective of race, creed, party or gender has a right to participate in this and every other debate within the parliament. The second issue on which I wish to dispute some of the points raised about conduct in this debate is that this is in some way a vote of no confidence in the Minister for Health and Ageing, Tony Abbott. I reject that view entirely. My decision, and I believe the decisions of colleagues on both sides of the chamber, would have been no different no matter who was the minister or when the debate was had. I express my absolute belief in the capacity and the integrity of Minister Abbott. My respect for him simply could not be higher.

This brings me to the substantive issues in the debate, the first of which is the question of safety and efficacy. The Therapeutic Goods Administration is charged with monitoring and reviewing risks associated with the possible importation and licensing of any drug. The standing and status of this organisation has been called into question by some. That is regrettable. It is an expert body comprised of highly reputable, highly respected and highly experienced professionals. There has been general agreement within the debate in this House that the Therapeutic Goods Administration’s capacity to assess the pure health and safety issues is largely unquestioned. They have a right, a capacity and they have the responsibility under law to be the national custodians for establishing the health and safety of not just this but any other drug. The health and safety assessment should be carried out by the properly authorised and constituted expert body. That body is the Therapeutic Goods Administration.

But that is not the end of the debate, because that brings us to the philosophical or moral question in relation to the abortifacient RU486. Here I differ from many of my colleagues on either side of the House who assert that this debate is not a moral debate; that it is simply a question about process. I reject that notion, because to change the current laws, which allow termination under circumstances generally agreed in jurisdictions around Australia, is a key question which has been implicitly at issue in some of this debate. I would say that most people have decided that the general proposition that the laws should not be changed is an acceptable position. For myself, for reasons of safety and choice, I support the current laws in relation to the access and choice questions between a woman and her doctor.

But this leads to the second philosophical question, which is implicit and direct and at the heart of this bill and this debate about access to RU486: even if it is found to be safe by the Therapeutic Goods Administration, should parliament authorise, in terms of the morality and ethics of the issue, an extension of the methods for achieving a termination to include medical termination? That is the essence of this debate. If the Therapeutic Goods Administration finds that the use of RU486 is acceptable, should the parliament authorise the extension of the methods available for termination to include RU486 as a means of achieving a medical termination, which is in essence an alternative to the surgical termination? That decision is implicit in this debate. If this bill, which I support, is passed and if we say yes now, then there is a preliminary green light, on ethical grounds, to the extension of the right to a medical or chemical termination if the Therapeutic Goods Administration approves the drug.

I support that approval. I support that ethical position. I do that for three reasons. Firstly, because it provides an option of privacy, so that a woman, if she chooses to seek a termination, need not necessarily do so in a hospital environment, which is a public environment. There are many reasons why a woman may choose to seek privacy. I do not wish to impose myself between a woman and her right to choose privacy if she decides that she needs a termination. There are many ways in which the procurement of a termination in a public hospital may compromise a woman’s privacy, but that is a matter for each to choose. If medical termination through the use of the drug RU486 is allowed, that option is open.

The second reason why I support in principle the extension of the general termination methods to include medical termination is that there are many women who are concerned about the possibility of surgical damage. I am not in a position to judge whether that is founded or not founded, but I am in a position to say that that is their right to choose such methods if the Therapeutic Goods Administration believes that it is a safe method.

The third reason why I support the potential extension of termination to include medical or chemical termination is that there are many women who may be at significant risk if they undergo anaesthesia. That is another reason why this may well, depending on the circumstances, be a safer option, but again subject to the Therapeutic Goods Administration’s views.

In that situation my view on the philosophy is that the choice of method should be a matter for a woman, her family and her doctor, subject of course to the views of the most competent body in Australia that that is a safe method and a safe process appropriate for Australia. I say this, however, with the firm and absolute belief that we do have a duty to do whatever we possibly can to decrease the number of terminations in Australia, but not to do that by restricting access either to the general right or to a particular method but by decreasing the number of unwanted pregnancies.

I note that in my own electorate of Flinders an organisation called Core of Life run by two former midwives has been engaged in teenage sex education and information. The result of that has been that the Mornington Peninsula has seen a decrease in teen pregnancy of 50 per cent. That is the surest way to decrease the number of terminations. This project, I am pleased to say, with the support of the former Minister for Family and Community Services, Senator Kay Patterson, was funded to the extent of $600,000 to take the program around Victoria and hopefully around Australia. I submit to the House that the Core of Life organisation and the decrease in teen pregnancy resulting from it is precisely the kind of example we need of what should happen around Australia on a more extended and broader basis as a means of decreasing the number of terminations.

The final question is whether, if you agree to the extension of a method in principle, parliament is relinquishing sovereignty by passing this bill. Parliament is the sovereign law-making body under our Constitution. I respect that role, and it is a great honour to be part of that process. But I respectfully reject and disagree with the argument presented by some, and I acknowledge the Prime Minister’s position here, that the bill in some way disenfranchises parliament. I respectfully submit that that is wrong for two reasons. First, the decision we take today and this week is not a decision once and for all. If the bill passes, it will represent the second change of law and the third position of parliament on this issue in a decade. We will not bind future parliaments with our decision today, but we are engaged right now in an absolute exercise of parliamentary sovereignty.

This brings me to my second reason for rejecting the idea that the passage of this bill would in some way diminish parliamentary sovereignty. The parliament at this moment is in the process of making a choice about whether it believes the drug is ethical if the Therapeutic Goods Administration subsequently finds it is safe. It may make that decision in one of three ways. Firstly, it may decide now, this moment, this week, and in so doing pre-authorise the extension of the drug, if the Therapeutic Goods Administration finds that it is a safe method. Secondly, the parliament may make its decision after the assessment of the Therapeutic Goods Administration is available. In other words, the parliament may make its decision available afterwards. Thirdly—and this is the current option—it may delegate the decision to the minister. With the greatest respect to the minister, I disagree with that. Because of the very public nature and concerns of this debate, the decision should not rest with any one individual.

This brings me to my conclusion. Should we predetermine the ethical question before—and I believe that is not the best option—or after the TGA has authorised an extension of medical termination? Either way I support the extension of the notion of medical termination on principle. But ultimately I believe that the best time for the parliament to assess the ethics is after, rather than before, the Therapeutic Goods Administration has made a final determination. For that reason, I support the Laming amendment. However, if the Laming amendment is not successful, I will have no hesitation in supporting the bill in its unamended form. Ultimately, I support the principles in this bill. I support the notion of extension of medical termination in addition to surgical termination. I will support this bill through the Laming amendment or, if that is unsuccessful, through supporting the bill in its unamended form.

Ms Catherine King (Ballarat, Australian Labor Party, Shadow Parliamentary Secretary for Treasury) Share this | Link to this | Hansard source

I want to start my contribution to this debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 by thanking the people in my district who have taken the time to contact me about the issue. On both sides of the debate, views are deeply and passionately held, and that has been evidenced in the emails, calls and letters that I have received—as well as in a personal representation in Parliament House today from a constituent who is here in the gallery.

At the end of the day I cannot speak for all of you. I have one vote and only one conscience which I can exercise in this parliament—my own. The question that the bill asks is quite specific: should the drug RU486 be approved for entry into Australia by the TGA or should it remain a special case and only be approved by the Minister for Health and Ageing? By extension, the question is: should RU486 be treated differently from any other drug? This debate, therefore, should have been a very narrow one about whether RU486 is so dangerous it should be treated in an exceptional way. But the debate has developed into a debate about the morality of abortion.

The opponents of this bill have put forward two main arguments. The first centres around the safety of the drug and its impact on women’s health. The second says that abortion is morally wrong and that women should not have access to it at all. On the first argument, regarding the safety of the drug, it is specifically this issue that the TGA has been set up to determine. No drug or surgical procedure is without risks. The evidence presented to the Senate inquiry on this bill outlined extensively the risks associated with this drug. There would appear to be significant difference in the interpretation of that evidence, but on my reading the risks of this drug when used under proper supervision appear minimal when compared with those of other drugs. But again I would assert that it should not be me who makes that decision; it should be the qualified professionals at the TGA who make this final assessment.

The AMA, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and the Rural Doctors Association all endorse the use of RU486 for medical termination of pregnancy. I do not in saying this wish to diminish the fact that there have been deaths from this drug. In some cases, the causal factor of these deaths is still somewhat uncertain. In others there are clear indicators that the drug should never have been prescribed. In the 15 years that this drug has been in use in other countries we have learnt a great deal about the safety of RU486 and the circumstances in which it can be prescribed.

People opposing this bill have said that even one death is too many. Of course this is true, but there is no medical or surgical procedure without such a risk. Even drugs in common use such as headache tablets containing paracetamol contain risks and have even had a substantial number of deaths attributed to them. It is for exactly this reason that we should be charging the TGA with the responsibility to assess and monitor the use of RU486 in Australia—that is what the TGA does.

I do not, as some opponents of this bill have argued, want this drug to be made freely available, and it will not be. There should be no less regulation with this drug than there is with surgical abortion, but it is best left to those qualified to assess the safety of the drug and to professionals to issue and supervise recommendations for its correct use. If those opposed to the use of this drug and its possible side effects are serious about their objections to the safety of RU486, they should make sure that evidence is available to the TGA and its Australian Drug Evaluation Committee for assessment.

To date, the TGA has overseen the evaluation of over 50,000 drugs and therapies in Australia. It has access to counterpart bodies throughout the world, including the FDA, and access to the most up-to-date information on the use of therapeutic goods worldwide. It is in the best possible position to assess the available evidence on this drug, and we should let it do its job.

I note that some opponents of the bill have sought to argue that this drug does not have therapeutic value so it is not like any other drug and that, as it has social and ethical dimensions, it should not go to the TGA for assessment. However, we need to be very clear that ‘therapeutic good’ is specifically defined in the TG Act, and the term is not necessarily used in the same way that we use it in common speech. The TGA assesses many drugs that have social and ethical implications—for example, Viagra, birth control pills and medications involved in IVF.

The second main argument from opponents of this bill is about abortion. It is unfortunate that the debate has become one about the morality of abortion, as it has given many in the community the misleading impression that this parliament has the power to amend laws affecting the legality or otherwise of abortion. We do not. State and territory parliaments are where that power rests. The only powers we have in this place are to make it more difficult for women who decide to have a termination. We can make it more expensive; we can make it more difficult to access; we can limit the methods available; or we can place conditions on access.

Opponents of this bill would be happy, I suspect, if we did some, if not all, of those things. But I say to those people: our own history shows us that the only thing that this does is drive women to seek unsafe, unregulated abortions, and that would be a very dangerous thing to do indeed. Illegal abortions performed prior to 1971 were second in the five main causes of maternal death for Australian women. In 1965, in Australia, there were 45 maternal deaths due to abortion. Restricting access to surgical or medical abortions will not protect women’s health; in fact, the opposite is true.

Given that the debate has, as I said, become a proxy debate about the morality of abortion, there are a number of things that I would like to say. Some of the proponents of the anti-abortion debate describe members such as me as ‘pro-abortion’. There is no such thing. Their notion that I think abortions are terrific and that I go around advocating more of them is absolute nonsense. I desperately want to see fewer abortions in Australia. I hate the fact that women and their partners are faced with this terrible choice. For many, it is the most difficult decision they have ever faced and will ever have to face.

As a pro-choice woman, I am just that. We should not be encouraging people to have abortions, nor should we be seeking to make decisions for women who are uncertain about what to do. We should be making sure that they have access to supportive environments, adequate information and services through which to make their choice. I respect women enough to know that they have the ability to decide for themselves what is best for them. They are, after all, fully capable of moral choices. It is and should be their decision.

But if we are genuine about giving women choices then we have to be prepared to provide the support that would make it possible for them to continue with the pregnancy if that is what they want to do—support like providing paid maternity leave and flexible, affordable and accessible child care; ensuring there are workplaces that respect the needs of working parents; eradicating poverty and taking financial pressure off low- and middle-income families; keeping teenage mothers engaged in education; and supporting sole parents, rather than hounding them into the work force by reducing their pensions. If we are genuine about reducing the number of abortions, we should be funding better family-planning and counselling services, better sex education and contraceptive choices.

I think one of the unfortunate aspects of the debate is Tony Abbott’s proposition that it is a debate between people of religious faiths versus the rest of us. Frankly, as someone educated in Catholic primary and secondary schools, I found Kerry Nettle’s T-shirt both unnecessary and unhelpful. It was offensive at worst and juvenile at best. But, more than that, I find the notion that somehow those of us supporting the bill have less belief or faith than those opposing it deeply offensive.

It is from my Catholic upbringing that I get my deep sense of social justice. I would not have become a member of parliament without it. I am Catholic. I know there is an official Catholic view about RU486 and against abortion, but I do not think that all Catholics share this view, just as I do not think they all share the official Catholic view on contraception. Even where Catholics do support the official position against abortion, I am not convinced that they universally believe that public policy decisions should be dictated by our religious beliefs. If this puts me at odds with the church, I suspect it will not be the first or last time.

Finally, one of the other statements made by the opponents of this bill is that we will see increases in the abortion rate if RU486 is allowed into the country. But there is absolutely no credible evidence to say that this is the case. There has been no associated increase in abortions in the countries where RU486 is allowed. Women do not take these decisions lightly, and I just do not believe that, by making RU486 available, more women will suddenly choose to terminate their pregnancies.

Life is complex. We do not control our fertility all of the time. As flawed human beings, we make mistakes. We fall pregnant when we do not want to or are without the support to look after a child. We can try desperately to have a child and not be able to. We can lose a child through miscarriage or after they are born. All of these things and more can happen to us.

On matters such as this, in the end, I can only follow the dictates of my own conscience. This may put me at odds with some people in my own electorate. I ask that they respect my decision, just as I respect their right to hold an alternate view. A decision such as this is not taken lightly, and it is taken in full awareness of the awful responsibility placed on those of us in this place. I will be voting in favour of this bill, unamended.

Steven Ciobo (Moncrieff, Liberal Party) Share this | Link to this | Hansard source

Introspection must surely be one of mankind’s greatest strengths. The ability to contemplate vexing issues such as the one that lies before the House today, to question personal approaches and to deliberate on the shape and structure of our society are all, surely, most aided by careful introspection. For me, the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 is similar to the conscience vote on stem cell research. It is deeply challenging and requires a well-considered philosophical approach that incorporates rather than balances the moral, ethical and technical aspects of debate.

This debate, and the issues embraced by it, labour me. In contemplating the merits and demerits of the issues, I have progressed slowly, not necessarily by choice but as a consequence of my promise as a representative to be considered, deliberate and informed—echoes of Edmund Burke, I would hope. In this debate, I am uncertain whether I am envious or critical of those who have professed to having established their viewpoint rapidly or of those who entered into the debate with their decision having already been made. For many it would appear that this debate is only about abortion, but it is not. This debate is much more complex.

Simplification of the issues into black and white is a betrayal of the role we all hold as parliamentarians. Simplification may make it easy to be recognised as being pro-life or pro-choice, and it may make it easy to portray yourself or others as being right or wrong, but simplification does not equal distillation. I cannot pretend to understand the reasoning of those who view this debate in black-and-white terms. I cannot pretend to understand the approach of those who stipulate their complete opposition to abortion or, indeed, those who preach an unfettered right for a woman to choose. In my humble view, an elemental examination of this debate must be multifaceted. It must consider whether the minister for health, in the Therapeutic Goods Act 1989, or perhaps the parliament, is an appropriate check and balance on the introduction of abortifacients. Consideration must also be given to the efficacy and the safety of RU486 and its associated prostaglandin, the circumstances of its availability and use and the issue of other medical support, as well as the view of the community toward the issue of RU486.

Proponents of this bill, in essence, have stipulated that the act should be amended such that restricted goods under the act no longer require the approval of the minister for health in order to be evaluated, registered, listed or imported. Restricted goods are defined in the act as medicines intended for use as abortifacients in women. All other drugs are evaluated and regulated by the TGA.

Proponents argue that the minister for health—and, effectively, through him or her, the parliament—is not the appropriate person—or organisation—to determine whether an abortifacient should be allowed to be evaluated and regulated by the TGA. In advocating this position, it is apparent that proponents are of the view that the only consideration should be the safety and efficacy of RU486. Even if the TGA is viewed as being a delegated authority, the same proposition holds true. This is an argument I do not support.

Abortifacients such as RU486 raise more issues than simply the issues of safety and efficacy. There is a moral dimension also. The mere fact this debate is occurring is evidence of this. I appreciate that those who believe in a woman’s unfettered right to choose, unclouded by moral considerations, would promulgate the view that these considerations are the only considerations. I, however, do not. For many years in Australia it has been the case that a woman is able to obtain an abortion in particular circumstances. These circumstances are generally met when a woman’s mental or physical health is threatened. The administration of this threshold is determined and settled by the various state governments across Australia. This bill does not alter this threshold, and this is a threshold that I personally support.

There exists a threshold, however, because abortion is a contentious issue in society. I was grateful for the Southern Cross Bioethics Institute’s report Give women choice: Australia speaks on abortion. This methodically sound survey sought to capture a snapshot of Australian attitudes to abortion in December 2004. Interestingly, but not surprisingly, the survey found, inter alia:

Fewer than one in four thinks abortion is morally justified outside extreme cases involving disability or a danger to the mother’s health, and only 15 per cent believe abortion is morally acceptable when the foetus is healthy and there is no abnormal risk to the mother.

To my mind, this finding and others in the report highlight what I suspect all in this parliament know. The Australian people view the issue of abortion as serious and one which requires fundamental consideration. I cannot think of any body more appropriate than the parliament, which represents the will of the Australian people, to consider the issue of abortion and all associated issues.

I recognise also that I have myself stated that the debate before the House is not a debate about abortion per se. I am not seeking to make this the case. However, it is not possible to separate RU486 from the issue of abortion. RU486 is an abortifacient. Consideration of its use, control and evaluation automatically includes consideration of thresholds for abortion. RU486 has implications for the very circumstances in which an abortion takes place. As such, it rightly should be considered by the parliament, which is the organ that exercises the will of the Australian people.

Currently the operation of the act serves to require the minister for health to provide written approval before an abortifacient can be evaluated, registered, listed or imported. To my mind this is a deficient process. Certainly there must be a role for the parliament. However, this role should occur following a recommendation of the TGA. In this respect, I am supportive of the amendment to be introduced by the member for Bowman in this bill’s third reading should it be reached. Similarly, I am also supportive of the member for Lindsay’s amendment as an improvement on the current process. An amendment making the decision of the TGA on restricted goods a disallowable instrument by the parliament appropriately provides the check-balance between the safety and efficacy considerations undertaken by the TGA whilst also ensuring the parliament has oversight of a drug which directly relates to an issue Australians feel very strongly about.

In the absence of amendment, this bill would provide for an outcome which places a decision well within the appropriate consideration of the parliament solely into the hands of the TGA. The effect of this bill is to pretend that there is no moral element to a decision on RU486 and that safety and efficacy are all there is to be considered. I stress that in acknowledging a moral element to this debate I am not seeking to impose my will on anyone. Rather, it is an argument that there is a moral consideration. Irrespective of whether you support or oppose RU486 on moral grounds, it exists. As such, the parliament should rightly adjudicate. In the absence of a successful amendment along the lines of those I have mentioned, I will be voting against this bill. Although the current process is clearly flawed, it is superior to one in which we pretend that there is no tough moral element to be considered. Why is this debate polarising the nation if this is not the case?

The rapid development of science means all of us will be increasingly exposed to moral and ethical ambivalence. As parliamentarians, we must steady ourselves for growing numbers of tough decisions on difficult issues. Surely these issues must be determined by us, representatives of the people, and not by unaccountable bureaucrats who have no mandate to exercise such judgment.

Finally, I have listened to much of this debate in both the House and the Senate chambers; read hundreds of letters, emails and messages from constituents and others; read various articles and media commentaries; and been both inspired and disgusted. It has been with sadness that I have observed indefensible distortions of fact and unreasoned claims in this debate, on both sides. As someone with personal faith, I have been disappointed in the conduct of some who have claimed their position as absolute, with a certainty that I distrust. Similarly, the trivialisation of the moral side to this debate I believe to be out of step with the views of three in four Australians who, although not all people of faith, do recognise the moral consideration to this debate. Therefore, recognising there is a moral element to this debate, the parliament must remain the ultimate adjudicator.

I thank all who have contacted me over this debate. In many respects your contributions have been well meaning, considered, sincere and of tremendous benefit. For those who may not agree with the approach that I have ultimately taken, I consider it to be a reflection of the great diversity of opinion on this issue that exists in the community. I trust you, too, might recognise the inherent strength our nation enjoys as a result of this democratic keystone.

Kim Wilkie (Swan, Australian Labor Party) Share this | Link to this | Hansard source

I would like to start my contribution to the debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 with a quote:

I have nothing against politicians, nothing against politics. But politicians and politics need to be in their right place and I think they are breaking the bounds somewhat and intruding into something that should be kept above politics.

Many members will be surprised to learn that this quote is from the Minister for Health and Ageing. But in the interests of accuracy it should be noted that this comment was made by him in the context of the debate on the republic in 1999, when he was arguing that politicians could not be trusted to choose a head of state. In my view, if the minister were consistent he would also be of that same view in the case of the current debate in this House on the processes to be used in the assessment of RU486. The debate on this bill is not about whether abortion should be allowed in Australia. That matter was settled a long time ago by the state and territory governments, who have jurisdiction regarding this procedure. Unfortunately there has been significant confusion and, I believe, deliberate obfuscation by some on this particular point.

Like all other members, I have received a huge number of emails, letters and phone calls regarding this bill. I thank all of those who have written to me from my own electorate and from other parts of Australia for letting me know their views. I have endeavoured to answer all correspondence on this matter. It is clear from some of the correspondence that there has been misinformation supplied by those who wish to turn the debate on this bill into a debate on abortion. Let us be 100 per cent clear about the intent of this bill. The bill before the House is about whether the Therapeutic Goods Administration, the TGA, should evaluate RU486 without the current requirement for approval to do so from the minister for health.

At present, as other members have noted, RU486 is listed in the restricted goods category, which means that, unlike all other drugs, it cannot be evaluated, registered, listed or imported without the written approval of the minister for health. In the case of all drugs other than those deemed restricted goods, the TGA is regarded by the government as the appropriate authority to determine whether or not a drug is safe for use in Australia. Specifically, the TGA identifies, assesses and evaluates the risks posed by drugs and, on the basis of its investigations, decides whether a drug should be approved for use. If a drug is approved, the TGA then monitors and reviews the risks over time. The approach required of the TGA means that decisions about whether drugs are allowed to be used in Australia are entirely based on scientific, clinical and medical evidence.

As I said before, under the Therapeutic Goods Act 1989, RU4686 is defined as a ‘restricted good’. Restricted goods cannot even be evaluated by the TGA without the written approval of the Minister for Health and Ageing. Since RU486 was classified as a restricted good in 1996, there has been an accumulation of information and evidence about the risks and benefits of RU486 when used as an abortifacient and also in its use for treating certain types of cancers and other conditions. While the current legislation allows the TGA, under its Special Access Scheme, to grant approval for RU486 to be imported, in practice this scheme is unworkable.

Let me inform the House about the plight of Canberra resident Ms Mary Lander, who has given me permission to outline her particular circumstances. Ms Lander discovered about 12 months ago that she had a brain tumour called a meningioma, which accounts for 15 per cent of all primary brain tumours and 12 per cent of all spinal cord tumours. Unfortunately, there would be dangers in operating to remove Ms Lander’s tumour, as it is on the brain stem and any such operation could result in significant damage. Accordingly, doctors are reluctant to operate.

On the basis of her own research, Ms Lander found out that RU486 could be used to stop the growth of a tumour. This is because, being a progesterone antagonist, RU486 binds with the progesterone receptors in the tumour and can therefore halt the growth of tumours and, in some cases, has been known to result in the regression of tumours. Ms Lander therefore applied to the TGA to import the drug seven months after first being diagnosed. Within weeks the TGA, under the Special Access Scheme, had issued a permit to her GP. Meanwhile, Ms Lander had found a supplier in France and planned to pay $2,500 for 200 tablets, which would have provided her with a six-month supply of this drug.

Before the drugs could be sent to Ms Lander, she needed her GP to sign off. But the doctor’s insurer advised the GP against supervising her treatment with RU486, because the drug had not been subject to the normal TGA evaluation processes. This is because, although the import permit had been granted, RU486 is still deemed ‘restricted’ and, therefore, without ministerial approval, the TGA could not evaluate it. Without such evaluation, the TGA could not provide the normal assurances about drug use on which doctors depend for their indemnity requirements. Unfortunately for Ms Lander, this means that she still cannot use the drug, because doctors—on the basis of insurance issues—have so far refused to prescribe it. Ms Lander’s situation is a tragedy. It is a direct result of RU486 being in the restricted goods category.

Indeed, in a report in yesterday’s Canberra Times, Ms Lander posed the following questions—and I ask all members to consider these questions when they come to vote on this bill:

How many people have suffered unnecessarily in the past nine years? How many have been left with defects and disabilities? How many have died because they simply do not know about the drug’s uses and/or how to obtain it? Why is it necessary for people to have to overcome such enormous hurdles and restrictions just to access RU486 for a serious medical condition? Why is it necessary for them to suffer and why is it necessary for them to die, when this medication could ease their suffering or even save their lives?

Ms Lander concluded that ‘clearly it is a consequence of abortion politics’. How can any of us allow the situation to continue whereby Ms Lander and others in similar circumstances are denied the treatment that may well save their lives?

According to documented medical evidence, RU486 benefits are not isolated to the treatment of meningioma. RU486 has been found to have beneficial effects in the treatment of uterine fibroids, endometriosis, cervical ripening, breast cancer, ovarian cancer and prostate cancer. The reason it has proven effective in the treatment of these conditions is that some of these cancers are hormone dependent and RU486 is known as a progesterone antagonist. Due to its antiglucocorticoid activity, RU486 may also be effective when used to treat depression, HIV-AIDS and dementia. Indeed, in terms of its effects on HIV-AIDS, RU486 has been demonstrated to blunt the infectivity of HIV. But, unless this bill is passed by this House, those alternative users are also being denied because of the fact that RU486 is deemed a restricted good and the TGA has not been able to assess it. It is worth noting that, in the respective speeches to the House in this debate, neither the Minister for Health and Ageing nor his parliamentary secretary referred once to the other documented benefits of RU486. In their positions, they should know better.

In my opinion, all drugs proposed for use in Australia should be assessed by the independent scientific, clinical and medical experts at the TGA and not be subject to the approval of one individual, the Minister for Health and Ageing. This would ensure that, if RU486 were to be approved for use in Australia by the TGA, it would have been thoroughly evaluated in terms of its potential risks and benefits and it would also be subject to ongoing rigorous monitoring and review. That is why I support this bill.

In terms of accountability, there has been a lot of baseless rhetoric about where accountability should lie concerning the approval process for this drug. Some, including the minister, have argued that we need to continue to have the Minister for Health and Ageing responsible for the process of initiating and approving the evaluation of RU486 because he is accountable to this parliament. As an aside, I am not sure that argument washes when you see the way the government ministers continue to refuse to be accountable to this parliament on a wide range of issues, most notably at present in the case of the AWB scandal. But, in any case, the TGA and the Australian Drug Evaluation Committee are accountable to the parliament through the minister. In fact, the members of the Australian Drug Evaluation Committee are appointed by the minister. Just as the Reserve Bank of Australia is accountable to the Treasurer through this parliament, the TGA and the Australian Drug Evaluation Committee are also responsible to the parliament—and there is nothing unusual or untoward about this. But the claims about the TGA not being accountable are fallacious.

Let me also comment on the two amendments that have been proposed. One has been moved by the member for Lindsay. Under this amendment, the Minister for Health and Ageing would still retain the power to approve or not approve the use or importation of RU486; but, once the minister had made the determination, the determination could become a disallowable instrument. This is flawed. A manufacturer or importer would still need to seek ministerial approval and then would be subject to the vagaries of this parliament for approval. Why would a manufacturer or importer run the risks associated with such a process, given the enormous costs associated with evaluation, which could run from hundreds of thousands to millions of dollars? In my view, the member for Lindsay’s amendment would continue the effective ban on the use of RU486.

An amendment has also been proposed by the member for Bowman, which would eliminate the role of the Minister for Health and Ageing in the approval process for RU486 but, like the amendment moved by the member for Lindsay, would make any determination to register or list RU486 for use a disallowable instrument, meaning that this parliament would decide whether the drug could be used. This amendment, too, would not guarantee that decisions about the use of RU486 in Australia were made only on the scientific and medical evidence available. Again, this amendment would continue the effective ban on the use of RU4686 in this country by requiring parliament to vote on it.

And that is the crux of this matter. Why should any politicians have any role in determining whether a drug should be evaluated and, if approved, used in Australia? I do not believe that is the role of any of us in this parliament. That is why I will support the bill as proposed by the member for Moore and seconded by the member for Lalor. May I say before closing that I would like to applaud the efforts of Senators Allison, Moore, Troeth and Nash and the members for Moore, Lalor and Murray in this debate. They have worked tirelessly to promote the bill to senators and members from the best of motives. We in this place should not be able to decide whether or not drugs should be approved for use in Australia. That is the rightful and appropriate role of the TGA.

I have heard many of the contributions to this debate from other members. Most of those contributions so far have been thoughtful, sensible and based on fact. It just goes to show how truly democratic this place is when we can get away from the whips. We do not often have conscience votes on matters in this House, and I know that this bill has presented difficulties for many in examining the issues in relation to RU486. However, on the basis of the facts presented in this debate, my vote will be to support this bill.

Barry Wakelin (Grey, Liberal Party) Share this | Link to this | Hansard source

Firstly, in speaking to the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, I thank all constituents and colleagues for their wonderful interest in and advice on this difficult issue. The gift of life is our greatest gift, and anything which intrudes on that is a sad event and creates for me, as I think it does in most Australians, a sense of personal distress. Personally, I find it impossible to separate abortion from that general description. It is said that we have 91,000 abortions per year in this country. I further find it impossible to make this a gender-specific issue—that is, a specifically female issue. I believe that my wife, my daughter, my grand-daughter and my sisters are of great interest to me and that I care for them as much as other people in this country care for their loved ones. Therefore, I find this narrow definition of gender quite difficult and impossible to accept.

I am advised that it has always been possible under current arrangements to apply for approval to market RU486 but that no such application has ever been lodged in Australia. We could debate for some considerable time whether potential sponsors are deterred because of the ministerial power or authority. That is not my role here tonight, but I just make the point that it has been possible and no-one has sought to make an application.

I would just like to describe the substantive clinical facts of RU486. Medical abortion using the RU486 misoprostal combination will lead to a successful abortion in between 92 and 98 per cent of cases. In the five to eight per cent of cases in which there has not been a successful abortion, the abortion will need to be completed surgically by a qualified physician. In some cases women will require urgent medical care for side effects such as internal bleeding and infection of the retained products of conception, and safe medical abortion like surgical abortion requires the availability of an appropriate level of backup medical care to address possible complications arising from the procedure. Wherever people sit in this debate, that seems to be generally agreed.

Coming from a rural, regional and remote part of Australia, the case has been put to me that RU486 offers some benefit to people living in remote areas in particular. I would just remind the House and those who have an interest in this issue—and I think that is very many Australians—that safe medical abortion, like surgical abortion, requires the availability of an appropriate level of backup medical care to address possible complications arising from the procedure. We all know that that very specialist support is quite limited in remote and regional Australia and therefore quite difficult to rely upon.

I cannot separate the ethical issue from the clinical issue. I cannot put the abortion issue over there, accepting the jurisdictional factors, and say that it is not part of this discussion. I cannot abdicate what I regard as my key responsibility as a member of parliament. To say that the minister—and members of parliament, for that matter, but particularly the minister—does not have access to accurate advice is an insult to this place, to our executive and to our system of government. The Minister for Health and Ageing has the Chief Medical Officer and a bureaucracy which is of a very significant dimension. So the minister can seek the best advice that this country can offer.

In concluding my comments—and I do not wish to repeat what many others have said—it is important that I just reiterate that the gift of life is our greatest gift, that parliamentary responsibility stops with me as an elected representative, that it is impossible for me to separate the ethical from the clinical and that there is a very clear ethical and moral dimension to this discussion. Therefore, I will be supporting the amendments to the bill and voting against the bill if necessary.

Gavan O'Connor (Corio, Australian Labor Party, Shadow Minister for Agriculture and Fisheries) Share this | Link to this | Hansard source

I rise to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 and, in doing so, wish to acknowledge the sincere and measured contributions of many members on both sides of the chamber who have preceded me in this debate. I wish to acknowledge, also, the many constituents who have expressed their views to me in this matter. While those expressed views have in the nature of things been conflicting ones, they have been honestly expressed and have been important in developing my position on this bill. I thank also members of my party in Corio for their input and wise counsel, as well as community and religious leaders who have taken time to discuss this matter with me.

I have not declared a public position on this legislation in the media, as I believe that it is right and proper as an elected representative to hear all views from those who have wanted to express them to me, including those of my colleagues, and to declare my intent on the floor of this House. This is the third conscience vote I have participated in since being elected to this parliament in 1993, and I welcome the opportunity on this occasion. While the process of decision making has been extremely difficult—and it has not got any easier over the time I have been in this parliament—my primary responsibility in this matter has been to my constituents and to this parliament and not to anybody else.

This matter is a sensitive one, and I regret the actions of some of my parliamentary colleagues who have attempted to cloak this debate in emotive and sometimes intemperate language and rhetoric. This has definitely not assisted the process of careful and rational consideration by others of this important matter to Australians. I, like many others in this parliament, have found this issue a most difficult one to consider, given the quite powerful and logical arguments that have been mounted on both sides of this debate. But I have given this bill my best shot—my close attention, thought and consideration—and, although the decision I have reached may not coincide with the views of some, it has been honestly reached, is balanced and, I believe, is in the interests of the community and this parliament.

In the 13 years that I have sat in this parliament, I have strongly advocated the primacy of the role of the parliament in ultimately deciding matters of great moment that arise from time to time in our society. Parliament here is the ultimate clearing house of views, positions and sentiments of the Australian people. I have watched the primacy of this place be constantly challenged by the executive and the bureaucracy and its authority eroded. Against this backdrop, it is important to distil the central issue at the heart of this private member’s bill, which is a proposed change in the evaluation and approval process relating to the pharmaceutical drug RU486, which may be and is used as an abortifacient.

In the course of this debate many members have articulated their own personal views on abortion, and that has been the substance of an important part of the correspondence and phone calls I have received from constituents and others in the Australian community. Given the nature of this debate and the conscience vote on this bill, it is entirely appropriate that members express their views on the abortion issue. The reality is, however, that in relation to the issue of abortion and pregnancy termination the legislative framework is determined by state governments. My views on abortion are known to my community: I oppose it. But, as a male who will never find himself in the same intimate and intense position as a woman in making the enormous decision on the future of a pregnancy, I have never arrogantly presumed to dictate my own personal view to a woman faced with that decision. Rather, as a former educator who has dealt with the situation with several families, I have approached the issue with all the sensitivity and compassion I could muster to ensure that the best and full range of counselling services and advice was made available to the individuals and their families in confronting their momentous decision. One’s personal views on the issue of abortion are obviously important to some members more than others, given the fact that the drug RU486 is an abortifacient.

But the real task I believe we face as legislators in considering this bill is to legislate a process of evaluation and approval which, on the one hand, is rigorous, has inherent scientific integrity and is capable of providing expert advice on safety and efficacy considerations and, on the other hand, provides a viable process for synthesising the ethical, moral and general community viewpoints to provide a societal overview of the matter. Therefore, I see a critical role for both the TGA and the parliament in the process. In describing a role for the TGA and the parliament in this process, I am mindful of the emotional debate generated by RU486, and I acknowledge the powerful arguments advanced by those who are supporting this bill.

But there are two matters I would like the House to weigh heavily in its deliberations and in developing its legislative, procedural and structural response. The first relates to the safe use of RU486. While the drug is in widespread use in some 30 countries, there is a mounting body of evidence that its use carries significantly higher health and mortality risks for some women. I note the recent actions of the American Food and Drug Administration in initiating an inquiry into safety aspects of the drug and similar moves in other countries to examine this matter more closely. It would be prudent, therefore, to ensure that the best available scientific and medical advice is available to decision makers, be they in the TGA, the executive or the parliament, on these important considerations. I see an important role for the TGA in providing this expert advice, notwithstanding the serious reservations I have about the culture that has grown up inside the TGA, which is commented on in various Audit Office reports and private consulting reports that are now a part of the public record. I refer here to its closeness to the powerful pharmaceutical companies operating within our health system.

The second matter I would like this House to weigh heavily in its deliberations is the inherently contentious nature of this and other restricted drugs under the act, the widely divergent and conflicting views sincerely held by many Australians on their use, and the societal and community impacts of their use. This necessitates, in my view, the input and oversight of the parliament in consideration of these matters.

As the clearing house for views and sentiments throughout this nation, it is appropriate that this parliament and its members figure prominently in the structures we establish to deliberate and consider this issue and others like it in the future. Imperfect as we all might be as individuals, we ought to put our faith in the collective wisdom inherent in genuine democratic processes and structures.

Regrettably the time allocated for individual members to debate this bill has been curtailed, as I would have appreciated additional time to explore the many issues and arguments that are important and inherent in this debate. I will not be supporting this particular bill, but will support the amendment proposed by the member for Lindsay, which I think most closely approximates my view on providing an appropriate role for the TGA, the minister and the parliament in these matters.

Should the amendment not find favour with the House, I will support the amendment proposed by the member for Bowman which provides for parliamentary oversight of these TGA processes. I do not favour these momentous issues being wholly considered within a bureaucratic process and structure such as the TGA’s or giving this minister sole responsibility and discretion in this matter. I would urge members to consider and support the amendments that insert them, as the elected representatives of this parliament, directly into the consideration of this matter and the processes and structures that will be established as a consequence of this debate.

I do acknowledge and appreciate that the views that I have expressed here tonight may not coincide with those of some members of my own party and indeed some members in the Geelong community, but I can assure all members of this House and my electors of Corio that I have laboured long and hard in my consideration of this matter. It has not been an easy matter for me nor, I think, for any other member of this House to consider, to deliberate on and to reach reasonable conclusions. I have been heartened by those in this debate who have been measured in the way that they have expressed their views. I brook no truck with those who have sought to extract political advantage and to impose their emotive and extreme views on others, either in the parliament or outside it.

I hope that through this great democratic process that we are engaged in here the best solution for all Australians will be reached, one where we can have a scientific and medical examination of this particular drug which is expert but which also inserts into the process the elected representatives of this parliament. I think that is very important to this debate.

Kerry Bartlett (Macquarie, Liberal Party) Share this | Link to this | Hansard source

This is an issue which has attracted keen public interest and one on which views on both sides are held strongly and argued passionately. The flood of correspondence to our electorate offices and the moving speeches in the Senate and in this House are evidence of this. I rise tonight to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, not because I have any new revelations or insights to share, but simply to place my own views on the public record. Members will be pleased that I intend to do so briefly. In short, I am opposed to this bill. Despite the arguments put by many here today, I do not accept that the ultimate authority for granting or denying approval for RU486 should be in the hands of the TGA rather than the parliament. Certainly their medical advice must be considered but the ultimate responsibility must remain with the nation’s parliament.

I have reached this conclusion for two reasons. Firstly, I do not believe that RU486 or indeed any other abortifacients are within the purview of the TGA. The role of the Therapeutic Goods Administration is to evaluate the effectiveness, quality and safety of therapeutic goods—that is, those drugs designed to prevent or heal illness. Pregnancy is not an illness and, clearly, the termination of a pregnancy is not a matter of curing an illness. The Therapeutic Goods Act does not cover abortion and nor should it. Abortifacients are not therapeutic goods. They are not designed to preserve life but rather to take life.

This leads to a broader and more substantive issue. This question is not just a medical one—it is far more. It carries profound ethical and social ramifications. To pretend that this debate is not about abortion itself, that it is just about process, is—with the greatest respect to my colleagues—simply not sustainable. This debate is, at its core, about allowing access to an abortifacient—to approve or not approve a drug which has the whole intention of terminating a pregnancy, which ends the life of an unborn child. The debate in the community indicates that this is how this issue is viewed. It is precisely because of these profound ethical and social implications that we are having this debate. And it is precisely for this reason that the decision should reside with the national parliament, with the elected representatives who are accountable to the Australian public, rather than with an unelected body, no matter how proficient or knowledgeable its members might be.

It has been argued in this debate and more broadly that, as abortion is legal in this country, the issue is only about process. Yet most would agree that there are far too many abortions in this country, and I share that view. It is tragic that some 90,000 to 100,000 unborn babies are aborted each year in this country. I acknowledge that in the vast majority of cases the decision is an agonisingly difficult one and I in no way cast judgment on parents grappling with this, whatever their decision. But as a community we cannot simply ignore this issue.

My concern is that, by handing over the approval of RU486 and other abortifacients to the TGA, we abrogate our responsibility as a parliament. It somehow allows us as elected representatives to further distance ourselves from the question of abortion and as a community to further desensitise ourselves to this tragic annual loss of young lives. My concern is that it unintentionally reinforces a message—perhaps only at the margins—that this terrible toll is somehow acceptable, that abortion is not a last resort, and that we need not to be looking more earnestly at other approaches.

For me the fundamental principle is the sanctity of human life. The more we ignore the taking of lives, no matter how young, the further we move from this principle. I have never sought to impose on others my views on this very difficult and complex matter. Yet, as this is a conscience vote, I must, like all others in this place, follow the dictates of my own conscience no matter how flawed it might be. For that reason, I am opposed to this bill and will vote accordingly.

Roger Price (Chifley, Australian Labor Party) Share this | Link to this | Hansard source

When I first heard that a private member’s bill from the Senate about RU486 was to be debated, it gave me a lot of concern. I had not thought much about the drug. I did not know a lot about it. I thought that I would have to do a lot of research and, more importantly, a lot of soul-searching. In the stem cell debate I was in a significant minority in the House when the vote was taken.

Whatever we want to say about the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, it is not a bill about abortion. Let me read from the explanatory memorandum:

A Bill for an Act to repeal Ministerial approval and to leave approval with the Therapeutic Goods Administration over access to RU486, and for related purposes.

That is the first sentence of the explanatory memorandum. The second sentence is this:

The purpose of this bill is to remove responsibility for approval for RU486 from the Minister for Health and Ageing and to provide responsibility for approval of RU486 to the Therapeutic Goods Administration.

With the greatest respect to those who have made a contribution in this place, it is not a referendum about abortion. It is not a bill about being for abortion or against abortion. I am happy to say where I stand on these things. I have always been opposed to abortion. But I am equally opposed to the idea that governments should dictate to women about their reproductive rights. However, I would support any measure that makes it easier for women who need to contemplate having an abortion to avoid having that abortion.

This is not a bill that calls into judgment the Catholicism of the Minister for Health and Ageing, Tony Abbott, just as it does not call into judgment my Catholicism, as flawed as it may be. This is a bill about a process—a process of administering a drug. For all that people have said about the Therapeutic Goods Administration in the adverse, let me say that it has approved up to 50,000 drugs so far. This will be another one. If there is an apprehension that this drug has adverse effects for any women taking the drug, it would be the responsibility of the Therapeutic Goods Administration to fully explore any adverse consequences and make appropriate recommendations or approvals based on that.

It is true that this drug is now available in many countries. I suppose you could say that there is a likelihood that the drug would be approved by the Therapeutic Goods Administration, but they still have processes and protocols to go through before making that assessment. I might also say that in that most Catholic of countries, France, this drug has been available for many years.

In his contribution the minister for health said that he was going to bring forth a cabinet proposal to provide further assistance for women who are contemplating abortions and make it easier for them not to have abortions. I welcome that. This is the right path to go down rather than trying to legislate.

I find it somewhat ironic that I have perhaps one of the poorest electorates in New South Wales demographically and yet I am sure that you will agree with me, Mr Deputy Speaker Causley, that one of the groups in our society that is most vilified—and vilified by a lot of people—is teenage unmarried mothers. It seems that no opportunity is missed to moralise, lecture and denigrate them. Yet in my electorate I have always been very proud of Plumpton High School, where there has been a special program that encourages young teenage mothers back into school. I in no way wish to denigrate the Catholic school system, but I am not aware of any program in a Catholic school that operates like Plumpton High School. The Anglican Church in Sydney, I am aware—and probably in the rest of New South Wales—is also developing quite a number of schools. Again, I am not aware of any such program.

If we are concerned about the number of abortions in our society, we should not vilify people who choose to have the child. In fact, we should make it easier for them. We should not ostracise them from society or make it even harder for them to succeed. We ought to have programs like the one at Plumpton High School. Having said that, I remind everyone that teenage single mothers are a very small percentage of single mothers.

The other thing I would say to the minister for health is to repeat something that the honourable member for Lowe has said. For a long time the honourable member for Lowe has exhibited, in his own unique way, a tenacious interest in knowing exactly how many abortions are performed each year in Australia. In that regard he has put a number of questions on the Notice Paper. Yet Minister Abbott declines to answer them. The unkindest interpretation of this is that Minister Abbott is happy to use the figure of 100,000 abortions a year, knowing that it is much less than that. Wouldn’t it be helpful to any debate in the parliament—here today, or tomorrow or next year—if members of the parliament and the public at large actually had the accurate figure of the number of abortions being performed in Australia?

I am surprised by the amendment moved by the honourable member for Lindsay. It actually took a little while for the full implications of that amendment to be understood—in an unprecedented way, I suppose. The Speaker was asked a question by the honourable member for McPherson and the honourable member for Mackellar, trying to understand the import of her amendment. Basically, the import of her amendment is that, if the amendment is carried, the whole bill is negated and it will require the introduction of a private member’s bill not yet on the Notice Paperalthough I understand a contingent notice is going to be lodged by the end of the night.

I say to the honourable member for Lindsay that it is perhaps better if one is more transparent in what one is trying to achieve. If, all along, your amendment required a private member’s bill, why not lodge it at the same time that you moved your second reading amendment? There is some suggestion, of course, that the member for Lindsay is acting at the behest of the Minister for Health and Ageing. I am in no way able to comment on whether that is right or wrong, but I do say to the member for Lindsay: be a bit more transparent in the future in the way you use the processes of the House. I should indicate that I will not be voting for that amendment.

The member for Bowman has also submitted an amendment. I must say that I am attracted to the idea of his amendment, particularly its justification that work is being done on drugs that will come on in the next decade or so, which will be very different from the drugs that we know today—in other words, they will not be specifically addressing a psychiatric, psychological or medical problem but will perhaps enhance intellect or wellbeing. We have not seen these drugs to date. I do accept that they probably do need a different type of approval. However, it is also true that legislation oftentimes lags these developments rather than precedes them. Whilst we are a little way from there, and whilst I am attracted to it, I think it is something that we will need to look to in the future rather than acting here in the present. And I do not like RU486 being lumped in with those particular drugs that he has in mind as being available. I will be voting against his amendment.

I want to indicate that I will be supporting this bill. I cannot say that I have had a great crisis of conscience or that I have agonised about it. I repeat: this bill is about a process. It is not a referendum. It is not a plebiscite about abortion. It is about a process. Nothing makes that clearer than the explanatory memorandum. This bill does not call into judgment Tony Abbott’s Catholicism, or anyone else’s Catholicism who is participating in this debate here today in the parliament, or has done so in the Senate, or any member of the public who is contemplating having a view.

I do not join in the surrogate debate on this bill, because it is not what I am being called to mind to bear my conscience about. It is about a process. I have no difficulty with voting on the process. I think it is appropriate that the same process that we have used to assess 50,000 other drugs should be the same process that is used to judge this drug.

I do not see this as an aspect of the sovereignty of the parliament being overruled or my rights as a member being overruled. Like other members in this debate I understand only too well that I will disappoint those who are opposed to my decision to support this bill. And for those who wanted me to support the bill, I probably poorly executed the case and caused them some angst. But, as members of parliament, we need to make decisions. We need to stand up and be accountable for those decisions. I do so. I support the bill and I oppose the amendments.

Paul Neville (Hinkler, National Party) Share this | Link to this | Hansard source

The Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 cuts to the core of issues that demand that we stop and reflect on our role as legislators and on the ramifications of passing the amendments. I am referring there to the amendments in the bill, not to the amendments moved by Miss Kelly and Mr Laming.

The bill revisits an issue we debated in 1996. At the time the amendment to the Therapeutic Goods Act placed abortifacient drugs in a special restricted category such that drugs within this category cannot be evaluated, registered, listed or imported without the written approval of the minister. As I said, it received bipartisan support. Why did we do that? The simple reason is that the role of the TGA is to approve drugs for the beneficial purposes of its citizens—that is, for medicinal purposes, for infection control, for pain relief, to counteract cancer and for many other things. I would have no problem, for example, with RU486 being put to the TGA for cancer treatment. After all, we have many drugs which are allowed on a restricted basis. But this bill sets out to repeal the amendments of 1996, which in effect will strip the minister of his power to approve the release of RU486 into Australia. In effect, it will simply allow another form of abortion.

Many speakers in this debate have argued that we are not talking about abortion or, indeed, RU486 and its subsequent use but rather about who should have the authority to approve it—the minister or the TGA. This is to tiptoe around the intent of the bill. All drugs approved by the TGA are for the enhancement of life. But RU486 is an abortifacient, a poison, a death-inducing instrument, that leads to the female body expelling the embryo. To pretend this debate is about something else is to be either lacking in courage or disingenuous. Using the drug for this purpose creates a new perspective that goes beyond the charter of the TGA and to the accountability of the government of the day. We should not flick pass this issue to bureaucrats when the implications go beyond matters medicinal and to the safety of women, to ethical considerations and, quite frankly, to the ultimate character of our nation.

Let me make it clear that I have no argument with the competence of officers of the TGA, nor with the efficacy of their work, but in matters of the future demography of our country they are not accountable; we are. We are elected representatives and legislative arbiters on behalf of the Australian people. The office of the Minister for Health and Ageing is an extension of that role. We as parliamentarians must understand that by amending this legislation we are placing a higher value on choice and convenience than on human life. We must not resile from our responsibilities when it comes to contentious social and ethical questions. We are accountable to the public and duty-bound to help build a better Australia. I am fundamentally opposed to the act of abortion, no matter how or when it occurs, and I cannot support any action or procedure that facilitates the termination of human life. While I acknowledge women’s rights, it is the life and rights of the unborn child that I believe need to be defended. Powerful though we as legislators might be, we cannot legislate a human being back to life. Therefore, I do not support this bill, though I would on the basis of what I have said support the Laming amendment.

This debate has been more about choice and convenience, a political debate, and it has had an ugly side to it: the denigration of members—and, of course, the minister for health himself—because of their faith. The inference is that we have accepted church direction. Even uglier is the offensive Nettle T-shirt ‘Mr Abbott, get your rosaries off my ovaries’. This was a giggling, offensive insult to most Christians in general, and Catholics in particular, and bordered on the sectarian. That this T-shirt was sponsored, promoted and sold by the YWCA is almost unbelievable. That this once proud organisation of Christian virtues dedicated to the healthy bodies and minds of young women could stoop to such a tacky level is unimaginable. They have recanted today, but strangely they still promote the pro-choice position. They have said, ‘Sorry, but we’re going to keep going.’

The debate on people’s faith is unjustified. We are conditioned somewhat by our family environment and our religious upbringing in the sense that it is part of our development of conscience. But do not insult me by saying that I have been dictated to by my church as to how I should vote. I had no trouble in reaching my decision on my own. It is equally regrettable that some have linked their argument to the emotive scare tactic against non-Christian religions. This does not enhance the pro-life case, and I will have no part of it.

The road to open, almost unfettered, abortion on demand has been all pervasive for some decades. First, it was only ever to be used in the case of the mother’s life being at risk. Then it was extended to the mental welfare of the mother, her psychological status, and then to the economic capacity of the family. If RU486 is approved, it will be extended to mere convenience. The methods that are being used in abortion, not just in RU486, are being refined all the time—if, indeed, ‘refined’ is the right word. After RU486, can we expect a move to lengthen the 28-week limit on late term abortions, which is the case in most states? The thought of partly birthing a foetus and then carrying out the suction removal of its brain while it is still alive—and I will not go into any more horrifying detail—fills me with unspeakable revulsion. It is evocative of the Dark Ages and we should have no part of it. You can add to this some international studies that point out that more female than male foetuses are aborted. This debate has been all about the role of women and the enhancement of women. Yet, isn’t that the ultimate denigration of womanhood?

I do not say these things to be insensitive. I do not say these things as a scare tactic. I do not say these things to be confrontationist. But it is undeniable that these forms of abortion are becoming part of a continuum. I ache for women and their families who have experienced abortion. I make no moral judgment of those who entered into such an arrangement in good faith. But as a legislator I have to vote according to my conscience and I believe that my electors, though some of them may differ from me, would expect me to do so.

It is a sad fact of life that there are nearly 100,000 abortions a year in this country. Surely future generations of Australians, regardless of their ethnic or religious derivation, will make a very harsh judgment of our generation. What a marvellous opportunity these potential 100,000 young Australians could be. What sportsmen, academics, tradesmen, educators and wonderful mothers have we lost? The issue before us tonight is one of fundamental importance. For every argument in support of amending the bill there is a counterpoint.

The unleashing of RU486 upon our society has serious implications not only at the moral level but also on the health front. The complexity of the issues related to this bill is evidenced by the number of submissions received by the Senate Community Affairs Legislation Committee inquiry into this bill. The committee received around 2,500 submissions and more than 2,000 letters from pro-choice and pro-life adherents. That level of engagement is supported by research commissioned by the Australian Federation of Right to Life Associations, which showed that more than 64 per cent of respondents from non-metropolitan Australia did not support abortion for non-medical reasons. Interestingly, almost 87 per cent of respondents also believed that abortion can harm a woman’s physical and mental health. As a regionally based elected representative, those figures go to the forefront of my mind.

I have listened carefully to the opinions of the medical fraternity. The US Food and Drug Administration is currently investigating five deaths between September 2003 and June last year attributed to sepsis in women who had RU486 treatments. Their deaths and the incidence of adverse events associated with the use of RU486 were detailed in a study conducted by American obstetricians Margaret Gary and Donna Harrison, which produced some very concerning results. The details of the five reported deaths are quite horrifying in themselves and I will not go into the gory details. The study showed that there were a further 64 life-threatening adverse events and 224 serious events, amongst them serious bacterial infection, bleeding, haemorrhaging and ruptured ectopic pregnancies. The report concluded that the drug posed ‘a significant risk of severe, life-threatening, or even lethal adverse events’ and that:

... the choice of mifepristone termination over surgical termination is based mainly on patient perceptions of safety, convenience, and privacy, but these perceptions do not accurately reflect the realities of the regimen.

Dr Gary also believed that the adverse reactions reported to the FDA were only a fraction of those that were actually occurring. Another distressing aspect of post-abortion health outcomes was highlighted in a recent New Zealand study which tracked 500 young women from birth until the age of 25. It found that 42 per cent of those women who had abortions suffered major depression at some stage, a third higher than those who continued with their pregnancies and double that of those who had never fallen pregnant.

Looking at this evidence, we should dismiss this point about convenience and focus on the dangers facing country women if they use this drug. Some argue that RU486 gives women in rural and remote areas more choice in their health care and is a matter of convenience. I fully appreciate that living and working in regional and remote Australia can prove difficult for doctors and patients alike. But the health risks linked to RU486 cruel any argument about choice or convenience. If a woman cannot access specialist medical services because of geographic isolation and takes RU486, what protection does she have if medical complications develop?

To emphasise my point, in Queensland we have 153 gynaecologists and obstetricians registered with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Of those 153, only three are practising west of the Great Dividing Range—two in Mount Isa and one in Roma. That is a very scary figure.

When you take all these things into account, it is another step on the slippery slope to more abortions. It is arguably injurious to women. It has divided our nation as no other subject has in the past. It cannot be argued that this is purely a case for the welfare of women. I cannot support nor will I support this bill. As I said before, I will be prepared to support the Laming amendment.

Kevin Rudd (Griffith, Australian Labor Party, Shadow Minister for Foreign Affairs and Trade and International Security) Share this | Link to this | Hansard source

We are asked in this debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 to vote according to our conscience, in which case we must first ask ourselves: what are those factors which shape our conscience—those factors which shape the moral compass we try to apply to our lives, however imperfectly we may in fact live those lives? What shapes my conscience on the matters before the House?

I have never made a secret of the fact that I am a person of faith and I would be lying if I said that for me faith did not shape deep questions of conscience. I do not believe, as a result, that people of faith have some sort of monopoly on conscience. They do not and I do not. Nor is faith the only guide to conscience. It must always be tempered by reason and, in the case of legislators, reason must be applied to a properly informed approach to public responsibility for the public good.

It is for these reasons that I have struggled with the questions alive in the legislation before the House. As a person of faith, I have conservative views on the sanctity of life. As a person of reason, I must recognise that I am being asked here to vote not on the legality of abortion but rather on its means. This legislation does not ask us to vote on the legality of abortion, because those powers lie within the exclusive purview of state and territory parliaments. These parliaments have determined these laws long ago and they have been subsequently reaffirmed through the courts. What is therefore at issue here is a debate about the means of abortion within the legal framework already determined by the states.

What questions of conscience arise for me within the narrow scope of this legislation? For me there are two. First, what is the relative impact on a woman’s life and what is the best means of assessing that impact and, second, when it comes to the life of the unborn, what is the relative impact on the abortion rate. On the first of these, the scientific literature suggests that both methods of abortion are of comparable safety in terms of the life of a woman. There is nothing on this score that would argue against the TGA rather than the minister having regulatory powers over its use within the legal framework already determined by the states. Furthermore, there is a strong reason for the TGA to have this power to monitor its continuing impact on a woman’s health and women’s health in general over time—it is the only competent professional body equipped to do so.

For me, the impact of this drug on the abortion rate is also of great importance. The international data measuring abortion rates indicates that countries which have introduced the drug have not experienced any increase in the abortion rate. In a small number of countries we have seen a small reduction in that rate subsequent to the introduction of the drug. In this context, I note carefully the submission of the Catholic Archdiocese of Sydney, which states:

At present, there is no substantial evidence that the availability of abortifacients increases, or decreases, a nation’s overall abortion rates.

If there was compelling international evidence that this drug significantly increased the abortion rate, my attitude to this legislation would in all probability be different. I believe the abortion rate in this country, of some 75,000 to 90,000 per year, is far too high. It is higher than that of a number of other OECD countries.

I am impressed by the fact that in the midst of this controversial debate—one conducted with great mutual respect in the main, although with a couple of now notorious break-outs—there has been agreement among many pro-choice and pro-life advocates that the abortion rate in Australia is too high. I have said to various proponents of the bill that for me this is a central consideration. I have also noted their commitment to work together in practical areas to bring the abortion rate down over time by concerted measures including better sex education; better general information on and availability of contraception; better family planning; better pregnancy support services for unplanned pregnancies; greater use of adoption; and, most critically, better and more affordable child care. This is a program of concerted action over time to which I propose to commit myself. I appreciate the fact that Senator Moore, for example, has committed to the same. For me, for the reasons I have outlined, the life of the unborn is of great importance. Within this framework and for the reasons I have stated, having tested these reasons with men and women of faith and of science, I have decided not to oppose this bill.

I said before that this debate has in the main been characterised by great respect for opposing views shaped by the exercise of individual and informed conscience. I have no intention of identifying those individual contributions that have strayed across the line. For me that serves no particular purpose. I have, however, noted some arguments that the church in general and individual Christians have no right to adopt a position based on faith. I take the reverse view. The church has every right to take a position on these and other great social, economic and political questions of our time, even when we may find those views personally or politically uncomfortable. That principle applies as much to this debate as it does to the industrial relations debate. Some attack the church for intolerance. What I find remarkable is the amount of intolerance I find expressed towards the church, as if faith is some sort of intellectual disorder. It is not, and nor is an ethical world view shaped by faith.

However members vote on this bill, let us all in this place work together to strengthen the family unit. Australian families today are under great pressure for many complex reasons. Families remain the essential building block of our society, our community and our country. This is often forgotten in this place. Let us hope that this debate at one level refocuses us on how this legislature and we as legislators can concretely rather than rhetorically protect, support and enhance Australian family life.

Bruce Billson (Dunkley, Liberal Party, Minister Assisting the Minister for Defence) Share this | Link to this | Hansard source

Let me begin by thanking the many people from both my electorate and way beyond who have made the effort to contact me with regard to their views and feelings about the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. As early as November last year I was responding to constituent interest in this subject by outlining my thinking. This accountability to my electors has enabled people to focus on my thinking and respond to or challenge the considerations that have shaped my view.

A few local people specifically responded to my replies and my views as published in local newspapers, but overwhelmingly the large numbers of letters, faxes and emails from both sides cited widely circulated and now familiar arguments. I may not agree with many of those who have written to express their opposition to the bill in its original form, but I respect their views and their right to express them.

Despite the intense emotion—and, in some cases, hysteria—surrounding this issue, it is vital that as elected representatives we remain focused on the question to be determined. This bill, in its original form, is very specific. It does not represent an ideological struggle between pro-life and pro-choice, nor is it about a question of one’s faith. Although, in reality, it was inevitable, it has not been helpful that the RU486 bill debate—which is essentially about the governing processes attached to the approval or disapproval of a class of drugs—has been used by some as a Trojan Horse to recontest broader questions concerning abortion law and the availability of termination services.

This is not about fighting a new war against abortion; this is about whether the law should be changed to remove the need for ministerial approval before the Therapeutic Goods Administration can carry out its statutory responsibilities to evaluate the safety and efficacy of a medicine before it can be registered for use in Australia. With supporting scientific evidence, the TGA may conclude that a medicine is safe for use and has the clinical characteristics that are claimed. Current law prohibits the evaluation of a category of medicines called ‘restricted goods’ unless the minister approves of the TGA doing its work. This bill seeks to remove this restriction.

The TGA is well resourced within the Australian government’s Department of Health and Ageing. Crucially, its regulatory framework centres on a scientifically supported risk management approach—a task that it has been given by this parliament. It is my firm view that the TGA is the best-equipped body in this country to make informed medical judgments as to the suitability and safety of medicines. Its Drug Evaluation Committee consists of eminent medical practitioners, including a pharmacologist, a toxicologist, a pharmaceutical chemist with recent manufacturing experience and a general practitioner. This is hardly ‘just a bunch of bureaucrats’, as some would like to have us believe. The TGA is also empowered to play an important ongoing role of vigilance once a drug is approved and made conditionally available to the public. This includes investigating reports of problems and the laboratory testing of products on the market to ensure ongoing compliance and safety.

Yes, RU486 is an abortifacient drug, but, no, this argument is not about the lawful availability of abortions in this country. The lawful basis for abortions has long been settled by state law and judicial precedence, with the test—which I support—being risk or danger to a woman’s mental or physical health.

Let me state for the record that I am strongly opposed to the use of pregnancy termination as a routine form of ‘after the event’ contraception for reckless personal behaviour. Personal responsibility on the part of men and women for their sexual conduct and for the consequences of their actions must always be emphasised and encouraged. Health Insurance Commission data about Medicare services suggests that the number of abortions in our country has declined over the past 10 years, despite steady population growth. I welcome this trend.

In my community of the greater Frankston-Mornington Peninsula region, known as Dunkley, there has been a dramatic reduction in teenage birth rates over the past two years, from 6.6 per cent to three per cent, as the result of a remarkable program called Core of Life. This education, awareness and support initiative, which was started by Peninsula Health midwives Debby Pattrick and Tracy Smith, has since gone national, thanks to an Australian government grant of $615,000.

Governments and communities must support these types of preventative initiatives that draw out clearly for young people the profound implications of pregnancy and the need for proper care and mature conduct when they become sexually active. Any intervention to lawfully terminate a pregnancy needs to be most carefully considered and only made available with appropriate physical and emotional support for the woman involved.

When I first learned of the push to overturn what is effectively a ban on RU486, I was puzzled by the media reports of calls for the drug to be made widely available in rural and remote areas, on the basis that the medical and emotional support required for a surgical abortion was not readily available. I found this to be an odd argument, as RU486 represents an alternative to current lawful surgical methods of abortion. If approved, having been found safe and efficacious by the TGA, it would be subjected to regulated availability. The method of termination in no way diminishes the legal constraints, including clinical risk management and the need for proper physical and emotional support for the woman involved in such an invasive medical intervention.

Nor do I believe that women who find themselves in the terrible position of having to resort to a lawful abortion should be forced to endure the added hardship and trauma of being obliged to go through a surgical procedure, when a potentially less painful and less traumatic alternative process exists. Do the opponents of RU486 in all good conscience believe that forcing women to endure a more traumatic surgical procedure acts as some kind of deterrent? These same people emphasise the enormity of a decision to terminate and point to the risk of long-term physical, emotional and spiritual harm.

Yes, it is a truly profound decision to proceed with an abortion—one in which thankfully I have not been involved. But to restrict the potential availability of a medicinal alternative just means that some of those women confronted with the need for a lawful abortion simply endure an even more traumatic experience. If at some time in the future a safe and acceptable medicinal alternative becomes conditionally available, accompanied by the appropriate physical and emotional support and follow-up, then I firmly believe that it should be put forward as an alternative therapy to invasive and traumatic abortions.

The last thing I want to do is to encourage any unnecessary terminations, and I would not be supporting the unamended bill if I believed that that would be the case. I personally have not seen any convincing evidence that suggests that the number of abortions in this country would increase as a result of the regulated availability of RU486. Given the above reasoning and the assessment of the arguments put and the information available to me, I plan to vote for the unamended bill before this House and reject the amendments that are also on the table.

Laurie Ferguson (Reid, Australian Labor Party, Shadow Minister for Consumer Affairs) Share this | Link to this | Hansard source

At this late stage, there is very little new that can be said. I essentially support the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 and oppose the two amendments. I believe that the TGA is the professional body that should make these decisions. It has managed to do so, with great faith from the Australian electorate and this parliament, in regard to 50,000 pharmaceuticals since 1989. And that is in a society where increasingly we must be concerned about the dominance of the pharmaceutical industry and corporate power in regard to the examination and testing of pharmaceuticals and the reliance, often, upon their supposed experiments and their statistics. Many of those pharmaceuticals display issues of toxicity and danger. We have had the confidence to put great faith in this body about a wide variety of other goods. Similarly, the Australian Drug Evaluation Committee is independent. Its personnel are appointed by the minister. So we have two bodies with a role in this. Quite frankly, quite crudely, I have more faith in their professionalism, knowledge and backgrounds than in an individual with a minimal scientific background.

That said, I want to deal with one aspect of this debate. As the representative of the most Islamic electorate in this country, I want to deal with the comments made by the member for Hughes. They might seem peripheral, they might seem esoteric, but they do cause me some concern. Even if one had the concerns of the member of parliament I have mentioned with regard to the growth of the Islamic population in this country, the reality is that Australia’s current migration intake is heavily accented towards skills and our contemporary refugee intake is from Africa, which means that the Islamic intake of population to this country is actually declining.

I noted figures from the Minister for Immigration and Multicultural Affairs this week which soundly repudiated the logic and lack of knowledge of the member for Hughes. In actual fact, of the top 10 intake countries last year, only one—Malaysia—was an Islamic country. I also expressed concerns about the member for Hughes’s contribution, because of her crude stereotypical approach to the Islamic community in this country. Quite frankly, the reality is that the number of children people have is based far more on economic realities, the conditions in the workplace and people’s socialisation processes than it is on a regard for religion. Who would have thought 30 years ago that Ireland and Italy, with very highly Catholic populations, would now have amongst the lowest birth rates in Europe? So we see there a clear indication that faith has a lot less to do with it than the reality of people’s economic circumstances.

The comments of the member for Hughes insinuate that amongst Muslims there is some level of attachment to religion which is totally unreal. A few minutes ago, the member for Hinkler—after deploring other people and ascribing his beliefs to his religion and to the fact that he was in some way instructed by the church—then had the effrontery to turn around and denounce people from the YWCA because they were pro-choice, an attitude which somehow implies that one cannot be a Christian unless one has the beliefs of the member for Hinkler. Quite frankly, we have seen in this debate the wide range of views of believers and non-believers with regard to this bill, put in a very personal fashion.

The comments of the member for Hughes give concern to people in the electorate that the birth rate of the Islamic population in this country is so great that we will be overwhelmed because of the abortion levels. The reality is that, as Muslims in this country go into their second and third generations, they will largely repeat the realities of the general population. I can see it myself because, as I said, I live in an electorate with a very high Muslim population. These people, in many senses, are just the Australian electorate but with a different religion. The vast majority of them have very little attachment to that religion. Quite frankly, many of them are as religious as I am—and that is not very religious. The comments of the member for Hughes were unhelpful, ill-informed and alarmist.

Turning to the broad issue again, I do believe that this is not an abortion debate. We are quite aware that tomorrow night when this bill is passed—and I think it will be by a fairly overwhelming majority—abortion law in this country, controlled by the states, will not be altered. We are essentially debating a means by which women in very difficult circumstances can accomplish this aim—under medical guidance, under medical supervision, with counselling et cetera. As the previous speaker on this side in the debate indicated, why would people go out there to make it more painful and more traumatic for women?

In conclusion, I strongly endorse the measure. The TGA is a respected organisation. It has personnel with experience. As a person who was one of the few that gave up science in the Higher School Certificate, I do not think I can comment about science and medicine, but I have seen a number of speakers in this debate who have wandered well beyond their knowledge in these fields. The TGA is a responsible body, and that is where the decision should be made.

Debate (on motion by Mr Baldwin) adjourned.