Milton Dick (Speaker) Share this | Link to this | Hansard source

I have received a letter from the honourable member for Mayo proposing that a definite matter of public importance be submitted to the House for discussion, namely:

The need for the Government to urgently address gaps in research, diagnosis, funding and services associated with women's health.

I call upon those honourable members who approve of the proposed discussion to rise in their places.

More than the number of members required by the standing orders having risen in their places—

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

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

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

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

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

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

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

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

Ged Kearney (Cooper, Australian Labor Party, Assistant Minister for Health and Aged Care) Share this | Link to this | Hansard source

I'd like to thank the member for Mayo for introducing this incredibly important issue today in the MPI. It is an honour to speak with you all about the inequities in women's health. I worked in the health system myself for a long time. Funnily enough, I've been a woman for a lot longer. As a former nurse and, now, as the assistant minister charged with women's health I'm honoured that, every day, women share their deeply personal and often painful stories with me. I thank the Minister for Health and Aged Care, who is here with me today, for working so closely with me and initiating a lot of the policies that we have so far.

The reality is that life-altering inequities persist for women in our health system, as outlined by the member for Mayo. These, of course, are exacerbated if you live in rural or regional locations, if you are from the LGBTIQA+ communities or if you are a migrant woman. I've made it my mission to address these systemic challenges, and I want to take a moment today to reflect on how far we've come in just two short years of government.

Finding solidarity across social media, women are showing up in droves to tell their stories, using the hashtag #MedicalMisogyny. Too many women know how this story goes: having pelvic pain so debilitating it's impossible to go to work or school; being told paracetamol will do the trick or just use a hot water bottle; being sent away with no guidance on the unbearable night sweats, mood swings and often flooding periods of menopause. To quote the endometriosis activist Gabrielle Jackson:

Women are in pain … they're in pain with their periods, and while having sex; they have pelvic pain, migraine, headaches, joint aches, painful bladders, irritable bowels, sore lower backs, muscle pain, vulval pain, vaginal pain, jaw pain, muscle aches … But women's pain is all too often dismissed, their illnesses misdiagnosed or ignored.

One of my main focuses since joining this place has been tackling this medical misogyny. Medicine and medical research carries the burden of its own history—as deeply social and cultural as it is scientific. Women are not just small men, but medical research and the medical profession has historically treated us as such for centuries. Women were routinely excluded from drug trials until as late as the 1990s. It stands to reason that we've ended up with a healthcare system made by men for men.

Under the former government, male applicants for medical research funding received 67 per cent more total funding than women applicants. That's an additional $95 million every year. When we came to government, the minister for health tasked the National Health and Medical Research Council with achieving gender equity in its grant scheme. I'm thrilled that the NHMRC has met its target of fifty-fifty funding for men and women researchers across all levels of experience and seniority. We're also driving improvements in historic gaps in research representation through the NHMRC's Statement on sex, gender, variations of sex characteristics and sexual orientation in health and medical research. Earlier this year we invested up to $25 million through the MRFF into the impacts of fertility treatment, new predictive markers of pregnancy loss, and the impacts of perimenopause and menopause. Equal gender representation in research means research is informed by a diversity of experience, and this benefits us all.

As I deliver this speech today, I am reminded of my cousin Resa. At 60 years of age, Resa presented to an emergency department with numbness and painful tingling from her waist down. She was dismissed as unimportant. She was not even examined. She was sent home with paracetamol. She died that night, alone, from a ruptured aortic aneurysm. I can't help but think: if Resa had been a man in a suit and tie who had turned up at the emergency department with the exact same symptoms, would he have been turned away?

As women, we are twice as likely to die of a heart attack and half as likely to be adequately treated for pain. We're twice as likely to reject a hip prosthesis, because it's designed for a man's pelvis, not a woman's. We are more likely to be overmedicated, because clinical trials have been done historically on men. I could give more and more examples of that, but time doesn't permit that today.

What I do want to say is that our government is committed to amplifying the voices and experiences of women. That's why we conducted the #EndGenderBias survey, a survey of 3,000 women, healthcare professionals and peak stakeholder groups. The results were shocking but not surprising. Two out of three women reported healthcare related bias and discrimination. Women consistently reported feeling dismissed and disbelieved and being stereotyped as hysterical, a diagnosis that was only removed from official diagnosis list in the 1980s. They've been told they were faking it, doctor hopping or drug shopping.

The Albanese Labor government is acutely aware of these problems, and that's why we set up the National Women's Health Advisory Council to provide expert strategic advice directly to the ear of government. I have the privilege of chairing the council, guiding Australian expertise to provide targeted and effective health care for Australian women. The council established subcommittees to focus on four key areas: empowerment; safety; research; and access, care and outcomes. Together with the council, the subcommittees have been driving work on improving health literacy, workforce training, research gaps and priorities, and safe and equitable access to health care.

This is all critical work, because, as many women well know, merely being a woman indicates a higher risk for some of medicine's most challenging conditions. We are more likely than men to develop rheumatoid arthritis, be diagnosed with multiple sclerosis, develop Alzheimer's disease and suffer chronic pain conditions, and I haven't even started on menopause. There is a whole MPI alone on menopause and that is why we were pleased to co-sponsor a Senate inquiry into that very condition. Yet the conditions affecting women are the ones that have been historically underfunded.

Guided by the council and the testimonies of women around Australia, our government is putting our money where our mouths are on women's health. We have made critical investments in a range of women's health initiatives, including over $100 million to support women with endometriosis and pelvic pain by establishing 22 specialist endometriosis and pelvic pain clinics. We added two additional Medicare items to extend consultation times for specialist gynaecological care and $48.2 million has gone towards the elimination of cervical cancer, including launching the first national cervical screening campaign in more than 20 years. We've made it easier for women to get continuity of care through their pregnancy and birth with an endorsed midwife as part of a $56.5 million MBS package. We've invested $9.5 million for Australia's first-ever dedicated funding package or miscarriage, including collecting data, bereavement support and education. There has been $1.2 million invested to support healthcare professional training on menopause, free period products to remote First Nations communities, all of this on top of Labor 's reforms to paid parental leave, child care, family and domestic violence supports, housing, closing the gender pay gap, because women's economic and social freedom are key determinants of health.

Our position is clear: Labor invests in women's health. Yesterday we heard the Leader of the Opposition chastised by his own party room for a growing anti-abortion sentiment yet he still hasn't called for his own party senator to withdraw harmful anti-abortion bills from the parliament. Rather, Peter Dutton, the Leader of the Opposition, chooses to play a dangerous game of politics with women's lives—fitting for a man voted Australia's worst-ever health minister.

I would like to reassure women that their sexual and reproductive health care is a priority for the Albanese Labor government. We have no higher priority than strengthening primary care and ensuring women can access health care whatever it's about, wherever they are. Women deserve to have choice over their bodies. They deserve to have access to their preferred contraception and fertility care, and they deserve a health system that understands their needs, that supports their needs and their rights to have agency over their body.

We welcome the TGA decision to remove a number of restrictions on health professionals who prescribe and dispense Ms-2 Step. This sits alongside a suite of investments in women's reproductive health care. We have kicked off a gender audit of the Medicare Benefits Schedule, developed a contraceptive decision-making tool, are funding the AIHW to develop a national sexual reproductive dataset and we are funding scholarships for IUD insertion training because it is a surprise to some doctors that it can hurt. We are steadfast. Access to contraception, abortion and fertility services are essential health care. Every woman I talked to has a story. We owe it to the women who suffered—and those who should never have to—to be bold, to be fair and to have ambition for women. If anyone is going to do the work for women, it is this government.

Adam Bandt (Melbourne, Australian Greens) Share this | Link to this | Hansard source

I want to thank the member for Mayo for raising this important matter and for bringing this MPI to the House. Women's health is often neglected due to gender inequality and gender bias in our health system. Women must jump through hoops for proper diagnoses for menopause, travel hundreds of kilometres to access abortion, and, in some cases, just to give birth as well. Access to abortion remains a postcode lottery in Australia, with different rules, costs and availability depending on where you live. There are also barriers to accessing affordable contraception, sexual health care and maternity services, which are all harder for women in rural and regional communities.

Last year abortion was finally decriminalised everywhere in the country, but recent threats to reproductive rights in South Australia and in Queensland remind us how fragile abortion rights can be. Yesterday it was reported that the Leader of the Opposition told his party room that abortion was not a federal issue and that talking about it cost the Liberal Party votes. The Greens know what an appalling record the Liberals have on women's issues, including health, and it's no surprise that they would try to hide their real agenda of sending women back to the 1950s. The truth is that abortion is a federal issue, because ensuring that you can get a safe, local and free abortion is a federal funding issue. In my home state of Victoria, more than two-thirds of local government areas have no surgical abortion providers, and almost 40 per cent of the state lacks a pharmacy that dispenses medical abortion pills.

The Greens senator Larissa Waters, a tireless fighter for women's health, initiated a Senate inquiry into abortion and reproductive rights back in 2022, which recommended that the federal government ensure either that hospitals provide free abortions or that there be alternative local, affordable pathways to access this time-bound health care. That was one of 39 consensus recommendations, yet 18 months on the government hasn't even responded to that report. What kind of message does it send about women's health that, even with report after report showing reproductive health care remains inaccessible to many, the government is willing to let those recommendations gather dust? After the LNP win in Queensland and seeing the growing threats, I urge the government to look urgently and seriously at using its power to require public hospitals, who get federal money, to provide free abortions. This is something that the government has previously considered, and it's in the recommendations.

Women's health needs to be taken seriously, as well, at every stage of their lives. Last year the Greens initiated another Senate inquiry into women's health, this time around perimenopause and menopause, the poor access to diagnosis and treatments, and the impacts on women's financial security from the impact of menopause at work. A year of hearings delivered another consensus report, with strong recommendations around workplace policy, improvements to education and access to treatments. The government needs to adopt all those recommendations pronto. There were some horror stories heard during the Senate menopause inquiry about the cost of medication, shortages and disbelieving or underinformed GPs. One woman was controlling her menopause related anxiety and depression with MHT, menopausal hormone therapy, until she could no longer afford hundreds of dollars a month. She was forced to ask for Valium because it's PBS listed and $15 for a box of 50. There was one woman who asked her doctor if symptoms could be from menopause, and she said that all that he was taught in medical school was that menopausal women are either mad or sad. These are the stories that women are telling now. It's time for change.

As one of our first election policy announcements, the Greens have said that we will make MHT free, with PBS and other subsidies worth $50 million, and have a campaign to increase awareness among healthcare professionals and the general public. No-one should be priced out of the health care that they need. We must ensure that effective treatments are accessible to all. As we head towards another election, the Greens will announce a suite of election policies focused on ensuring that health care is available to everyone who needs it in this country, tripling the bulk-billing incentive and ensuring people can go and see a GP, a nurse and psychologist for free at free local healthcare clinics.

The average out-of-pocket cost to see a GP is now over $40, and that's on top of skyrocketing rents, grocery prices, petrol prices and other bills. It's no wonder that more than a million Australians are delaying or forgoing GP appointments each year due to cost. In this wealthy country of ours, everyone and every woman should have access to the health care that they need.

Lisa Chesters (Bendigo, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on this matter of public importance as well and welcome the topic that has been put forward by the member for Mayo. It's great and refreshing to be able to have this debate on the floor of our parliament. We have lots of health debates in this place, but this is possibly the first time that I can remember participating in a matter of public importance about women's health. So it is welcomed that we are having this honest conversation about where we are at when it comes to women's health in this country.

I want to acknowledge the Assistant Minister for Health and Aged Care and the Minister for Health and Aged Care for backing in and introducing a lot of the reforms that I will talk about today—reforms that not just affect people in my electorate but will support and help people across our country. I'm very proud to be part of a Labor government that is working to improve women's health and putting it front and centre on the agenda. We are listening to women in addressing the systematic bias within our health system. As the Assistant Minister for Health and Aged Care has told us, we instigated the review into medical misogyny. The fact that we've even acknowledged it's an issue is a step up for this place compared to what we've seen from the previous government. In the recent budget, the Albanese Labor government made a historic announcement committing $49 million towards improving services to help women access treatment for complex gynaecological conditions such as endometriosis. Medicare will also now pay the same fee for consultations required for other complex gynaecological conditions. This is just one area where we're seeing improvement.

Also in the budget was $160 million for tailored services to tackle the bias and improve access and a review of MBS items to identify the bias and better balance the health system. We've heard examples of how that has been improved. There will be more access to choice and support for women during pregnancy, including longer antenatal and postnatal consultations delivered through participating midwives. I know this is something that people in my electorate welcome—that ability to engage with your midwife post birth as well as pre birth. There is funding to continue strategies to prevent early-term birth and improve participation in maternity services. There is support for our First Nations community to have birthing on country. That has happened under this government, because we've listened to and worked with community on how we can deliver that. There is also the investment into general health, which is enabling more women to access health services.

The investment in tripling the bulk-billing incentive for children under 16 and people on concession cards is seeing more women access health services. Far too many women in my electorate who are on a healthcare card did not access health care if they couldn't see a bulk-billing doctor. It was in free fall. So to know that they can access a bulk-billing doctor is a weight off their minds. Too often, the mums and the grandmas were putting the money that would have paid that gap fee into feeding children and grandchildren or supporting their family members to access health care, and now they don't have to do, because this government invested in tripling the bulk-billing incentive and introduced cheaper medicines.

Another thing this government has done since coming to office is the investment into endometriosis. I am the co-chair of the Parliamentary Friends of Endometriosis Awareness, and we welcome the continued investment by this government—over $107 million to support women with endometriosis, including funding to establish specialist clinics to help people. Australia's first endometriosis and pelvic pain clinics were opened by this government—22 across the country, including one in my electorate. The bid that was put forward by the Bendigo Community Health Service really has achieved amazing things, not just for women accessing their services but in the way in which they've been able to educate and engage the broader medical fraternity in my electorate. We're seeing the lift in education and awareness amongst GPs. There is support for sexual and reproductive health, for all women to have the form of contraception that they choose. We're investing $1.2 million to support healthcare professionals to train around menopause. I know that this is an area, like all areas of women's health, where we need to do more, and this government will.

Monique Ryan (Kooyong, Independent) Share this | Link to this | Hansard source

I thank my colleague the member for Mayo for raising this very important issue. Two out of three Australian women report health care related bias and discrimination, including delays in diagnosis and delays in treatment. It's worse for women who don't speak English as a first language and for Indigenous Australians. It's not as simple as pure misogyny. Much of the entrenched systemic conscious and unconscious bias in our medical system reflects either a lack of understanding of physiological differences or a lack of respect for the significance of that variation.

Women spend more on their out-of-pocket medical expenses than men. Women's pain is more likely to be seen as emotional or psychological rather than biological. Women in pain are more likely to be offered minor tranquilisers or antidepressants than analgesia. Women are less likely to be referred for diagnostic investigations when they see a GP.

Medical research focuses more on male patients, this despite the fact that our body composition is demonstrably different. Our organs and our skeletons are different. Our chemistry is different. Our experience of pain is different. Many women spend months or years of their lives incubating humans. This is a time in which we are specifically excluded from clinical trials. Why provide anything other than basic obstetric care to a pregnant woman? In many cases it's not recognised that our cholesterol, our lipids and our other metabolic markers vary as much with our menstrual cycles as with our diet or our genetics.

When women have a heart attack our symptoms are different from those of men. Our outcomes are often worse. Our cardiovascular disease is diagnosed, on average, seven to 10 years later than men's. Women with serious heart attacks are half as likely as men to get proper treatment and twice as likely to die within six months. Those figures are twice as bad again for Indigenous women.

Although it affects almost one million Australians, it takes an average of seven years for women to be diagnosed with endometriosis. More than 10 per cent of women giving birth in this country experience what they describe as obstetric violence. While much of this relates to a loss of choice and control, which is systemic, some does relate to actual physical injury.

We have a system which fails to ensure that women in rural and regional centres have sufficient access to reproductive advice and treatment. In many cases women can only access faith-based services, which will not provide contraception or termination services, even after rape or with non-viable pregnancies. They won't provide IVF or family-planning advice. And a woman undergoing a caesarean section can't have a tubal ligation at the same time. Men would not put up with this restriction of care.

There is further intersectionality in the experiences of trans and gender-diverse people. They speak of concerns regarding their bodily autonomy, sexual harassment, refusal of access to health care, poor treatment and a common lack of medical understanding of their specific healthcare needs. Complex and chronic medical conditions, especially those dealing with gender and with gynaecological issues, need sensitive treatment. They can't generally be addressed well in a 15-minute consult. But our medical system pays more for shorter consultation for minor ailments. It rewards speed, not need. It pays $253 for a 15-minute vasectomy, but only $88 for a 45-minute IUD insertion. It doesn't yet cover the cost of gender-affirming surgeries like chest surgery or genital reconfiguration.

The government has taken steps to address these issues. It has established the National Women's Health Advisory Council to address medical misogyny and to assist in implementation of the National Women's Health Strategy. I want to acknowledge the real and ongoing efforts of both the assistant minister for health and the minister for health in this space. But there is much more to do, and it needs to be done effectively, equitably and with urgency. This is not just a women's problem.

Sally Sitou (Reid, Australian Labor Party) Share this | Link to this | Hansard source

I agree with the final line of the previous speaker, the member for Kooyong, at the very end of her speech. This is not just a women's problem because women's health is important for all of us. If we don't get it right not only do women pay the price but our whole society also pays a price. If we don't understand the unique challenges that women go through—if we don't do the research, if we don't care, if we dismiss their pain—then not only do women suffer but we all suffer.

It was something that my family suffered. My paternal grandmother—there was an unspoken story in our family for a very long time that after giving birth to my father she wasn't 'quite right in the head'. There was a period where my father was temporarily taken away from her. We never really spoke about it; we didn't really know why. It was something that was very much left undiscussed in our family. When I had my own son and I had the extraordinary care of early childhood nurses and GPs, they sat me down and spoke to me about the potential for postnatal depression and the symptoms to watch out for. It was then that I realised what my paternal grandmother had gone through. It is very likely that she had been suffering from postnatal depression. Instead of receiving the care and support that she would have been provided had she had my father a little later on or in Australia, her symptoms were dismissed, and she had her child taken away from her.

It is that story which really inspired me to have a women's health forum in my electorate. I loved having the Assistant Minister for Health and Aged Care, Ged Kearney, there. In this place, we are privileged to serve alongside some extraordinary members of parliament, but I have to say, if I were to have a favourite, the assistant minister for health is certainly right up there. She is an inspiration for the work that she does in this place but also the work that she did prior to coming here, and I think her nursing background has really guided the extraordinary work that she continues to do.

In that room, alongside the assistant minister, we had some extraordinary women panellists. Janu Dhayanathan, who's the ambassador for Children's Tumour Foundation, has neurofibromatosis. She shared some really personal examples of how she was dismissed in the healthcare system. Sue Advani founded Haathi in the Room, an organisation designed to help break down the stigma of mental health in the subcontinent community. I was inspired by these panellists and really appreciated the honesty and frank discussion that we were able to have that night. There were extraordinary moments. It was quite emotional as so many women shared their personal stories of how their pain was dismissed in the medical system.

So I'm really excited to be part of this government that is taking women's health seriously and putting it at the very forefront of our agenda, and I thank the minister for health and the assistant minister for health for doing that. We have put significant funding into ensuring that women's health is improved at the research and data collection level and improving women's health outcomes when it comes to maternity care and research into miscarriage and pregnancy loss so we have a greater understanding of why that's happening and how we can prevent it, as well as things like longer consultations for patients with complex gynaecological conditions. There is so much work that has been done in this space, and it's something that I'm extraordinarily proud of.

At the very local level, I have convened a women's health reference group, and it is full of wonderful local GPs, physiotherapists and gynaecologists who really want to do things at the local level. I'm inspired by the words of a local physio who said, 'There is no reason that women should have to live with pain,' and, Georgina Claxton, I think that is a motto that we all ought to live by.

Helen Haines (Indi, Independent) Share this | Link to this | Hansard source

It's pretty rare to stand up at an MPI and hear from members of parliament that are really on a unity ticket about an issue as important as gender inequities in health, and I thank the member for Mayo for bringing this to the attention of the House. I'm old enough to remember when anything related to women's health was considered women's problems. That covered the full gamut. It was talked about in hushed tones or not talked about at all. I'm really grateful for all the contributions from the previous speakers. It's a really important topic.

Before coming to this place, my life's work was as a nurse, a midwife and a public health researcher. I've seen firsthand the gaps and inequalities faced by women in accessing health care, in research, in funding and in diagnoses up close, day by day. These gaps are even more pronounced in regional, rural and remote Australia. These gaps and disadvantages affect women throughout their lives.

Let's start in early childhood, where girls are much less likely to be diagnosed with conditions like ADHD than boys in childhood, with diagnoses generally coming much later in life. Moving into the teenage years, women face an average delay of between five and 6½ years in getting diagnosed with endometriosis after first experiencing symptoms. At the other end of life, symptoms of heart attacks are less likely to be recognised in women than men. In the same way these gaps follow the women throughout their lives, they also exist throughout health care. Right from the research that does not include women or doesn't focus enough on women's health issues to the funding of services and procedures to diagnoses, these gaps are there every step of the way.

A recent Senate inquiry into menopause and perimenopause made 25 recommendations for reform but, at multiple points, the final report called out the lack of research, data and information about menopause, something that happens to half the population. This lack of research, this silence, contributes to stigma that stops women from seeking or receiving the health care they need and often means women are prescribed drugs that are not specifically designed for them. Women are 75 per cent more likely to experience adverse reactions to prescription drugs compared to men. Looking at this issue, recently published research from the Australian National University found women are not just smaller versions of men but need specifically designed medication.

We cannot talk about the gaps in funding and services for women's health without talking about reproductive health care. I am happy to co-chair with the member for Canberra and the member for Wide Bay the Parliamentary Friends of Maternal Health. We have heard loud and clear from women, from consumers, from midwives, around the significant gaps in the way that women access childbirth services and postnatal services, and we have heard loud and clear the evidence based approach of continuity of midwifery care that can address those issues. It is so thrilling to me as a midwife to know about the work the government has done in this space around endorsed midwives and I thank them for that—there is more to go!

A recent study by Women's Health Victoria showed the postcode lottery of sexual and reproductive health access across the state and it showed service deserts, where 67 per cent of local government areas did not have any listed surgical abortion providers, 45 per cent did not have any listed medical abortion providers and 60 per cent did not have any listed medication abortion dispensing pharmacies. In mid 2023, just 17 per cent of GPs were providing medication abortion services. Could you imagine a men's health issue where more than 80 per cent of GPs did not offer treatment? It simply would not happen.

This is a short speech, so I cannot cover the further complications and disadvantages for Indigenous Australian women, culturally and linguistically diverse women, and LGBT IQ women and people. There are extra challenges for those communities in accessing health care which must also be addressed. Before finishing, I do want to make it clear that gender norms that harm women in health care can also harm men and boys. Men are less likely to seek health care and are more likely to use drugs and alcohol in harmful ways. Indeed, my postdoctoral research shows there are significant gaps in care for men in the transition to fatherhood.

It is fair to say that in all these issues the Assistant Minister for Health and Aged Care, Ged Kearney, is giving it a fair crack when it comes to addressing the issues for women's health. I acknowledge all the work the assistant minister has done and is doing in achieving for women and girls of Australia, and I hope that as a parliament we follow her lead in this space for a long time to come.

Carina Garland (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

I really welcome the opportunity to discuss the very important issue of women's health and I thank the member for Mayo for bringing this to the House's attention today. I know how important this issue is to my local community in Chisholm. I have had multiple roundtables, a survey and consultation with experts in the field of women's health in my electorate, including with the fabulous Assistant Minister Ged Kearney. I am really grateful for the feedback that has been provided to me from my constituents.

Unfortunately, there were many heartbreaking stories of women not getting the help that they needed, of not being listened to, and of years of going to doctor appointments without establishing a diagnosis. I have had experiences like that too. It is really hard, so I am so proud to be part of a government that is working to improve women's health outcomes by listening to women and by addressing systemic bias is in the health system. We know right across the country from hearing from so many women that there are too many experiences of delayed diagnoses for conditions from endometriosis to heart disease. Women have their pain dismissed and struggle to get support for issues like menopause and miscarriage. A very common issue, polycystic ovarian syndrome, does not even involve cysts on ovaries, yet the poor understanding in the health system has meant that women have not been diagnosed properly and that their health systems and their endocrinology has been poorly understood.

In the recent budget, the Albanese government has made a historic announcement, committing $49.1 million in investment to provide approximately 430,000 more services to help women across the country with complex gynaecological conditions, such as endometriosis, receive consultations of 45 minutes or longer. This is to have proper time with a medical professional, to have a proper conversation and to be really listened to. Medicare will now pay the same fee to a gynaecologist to see a woman for a long, complex consultation as other specialties, such as cardiology, gastroenterology and a range of others. This has been a structural inequality in our health system that's gone on for far too long. I'm so pleased that we are rectifying this.

We are sequentially working through the health system to dismantle longstanding biases. Our overall investment in women's health in the 2024-25 budget was $160 million to tailor services, tackle bias and improve access. This included a review of NBS items, including long-acting reversible contraception and diagnostic imaging, to identify bias and better balance the health system to the needs of women; more access to the care of choice during pregnancy for women, with $56.5 million to support longer antenatal and postnatal consultations delivered through participating midwives; funding to continue strategies to prevent pre-term and early-term birth in participating maternity services and First Nations communities to reduce the number of babies born too early; and scholarships that will allow health professionals to undertake training on delivering long-acting reversible contraception services. This is in addition to support for education and awareness about miscarriage for women, their families and health professionals; our $6 million to support a trial of outreach health care in women's crisis accommodation and services; and so much more.

Our commitment here—yes—is economic, but it's also about highlighting the importance of women's health and the empowerment that women have in making choices about their health. Everyone deserves access to safe, affordable health care, no matter where they are living, whatever their background is and no matter their gender. We've made significant investments in women's health, and I know that there's more to be done. I'm looking forward to working with our wonderful team in the health portfolio in order to deliver more for women's health, which is something that has been sadly neglected for far too long.

Sophie Scamps (Mackellar, Independent) Share this | Link to this | Hansard source

In Australia, too many health issues specific to women have been misunderstood, overlooked, underresearched, underfunded and undertreated for decades. Today I'll touch on just two of these many health issues that women face. Around one-quarter of women aged between 30 and 50 years suffer from heavy menstrual bleeding, where blood loss may be so bad that women are confined to their home for days every month. This regular heavy bleeding can cause severe iron deficiency and anaemia, in turn causing debilitating symptoms like fatigue, breathlessness, irritability, dizziness, fainting, confusion, depression, headaches and brain fog—all of which can have a devastating impact on a woman's quality of life.

Despite being so common, awareness and understanding of the problem is low amongst women, and it is undiagnosed by health professionals. Women often assume it is normal and so don't seek help. I wholeheartedly thank and acknowledge the work of health professionals, such as Dr Talat Uppal in my electorate of Mackellar, who is working passionately and tirelessly to improve the awareness and management of this very common condition.

Then there is menopause. Fifty per cent of the population experience it, and symptoms can last for 14 years, yet it has been a taboo topic for decades. Hot flushes are just one of the 34 uncomfortable or debilitating physical or psychological symptoms. Twenty-five per cent of women suffer severe symptoms. As Professor Susan Davis, a past president of the International Menopause Society, said: 'Anyone who suggests that most women can live with their symptoms is ill informed.' Yet the culture of silence around menopause and the lack of adequate training of health professionals has meant that women have been needlessly struggling with its impacts—both health and financial impacts—for decades. It was truly shocking, as the Senate inquiry into menopause heard, that medical students may spend as little as one hour on menopause training during their six years at medical school, and I certainly experienced that as well.

Then there was the poorly designed Women's Health Initiative study, which came out in 2002 and which drew misleading conclusions that hormone replacement therapy may cause more detrimental than beneficial effects. This study set back women's health for over two decades. Numerous studies have come out since to show the safety and clear benefit of menopause hormone therapy, but the widespread panic it caused amongst both women and health professionals alike continues to have repercussions to this day, so much so that a recent study found that 85 per cent of all women in high-income countries do not receive effective treatment for their menopause symptoms. Women are also missing out on the other benefits of menopause hormone therapy, including reducing the risk of osteoporosis, diabetes, dementia, cardiovascular disease and certain cancers.

Then there are the financial impacts of poorly managed menopause. The lack of workplace policies to support women during menopause is causing women to retire prematurely. On average, women intend to retire at age 64 but are leaving the workforce at age 52 on average. Women retire seven years earlier than men, often at the height of their careers and often when menopause hits. Almost half of women who retire before the age of 55 cite health as the reason they stopped work. Research and modelling done in 2022 estimates that, even if just 10 per cent of women retired early because of menopause symptoms, it would equate to a loss of earnings and super of more than $17 billion for our economy.

So the recent inquiry into menopause was very welcome, and I strongly support the urgent implementation of the inquiry's recommendations, including such things as the establishment of the national menopause action plan to drive best practice in menopause care; the public awareness campaign on menopause and perimenopause; improved training for both medical students and health professionals; additional Medicare rebates for menopause consultations, including longer consultations and mid-life health checks; and, lastly, a guarantee that the best forms of menopause hormone therapy are affordable and accessible for all women who need it.

Jerome Laxale (Bennelong, Australian Labor Party) Share this | Link to this | Hansard source

I won't beat around the bush. Women have been let down due to gaps in medical research, diagnoses, funding and health services associated with their health. Women have been dismissed, overlooked and underserved by a system that was never designed with their needs in mind. For decades, women's pain has been dismissed, their diagnoses delayed and their health deprioritised. I thank the member for Mayo for bringing this matter of public importance on women's health to this place because it's something that we all need to hear about and talk about.

I say to the member for Mayo and to all those listening to this debate that, as a government, under the leadership of the Assistant Minister for Health and Aged Care, we are doing a lot to address inequality in women's health, and rightly so. We're addressing with urgency and purpose the painful delays, the funding gaps and the discrimination embedded in health care. From investments to targeted reforms, we're making it clear that women's health can no longer be sidelined. We are committed to listening to women, to understanding their unique health challenges and dismantling the structural inequalities that have persisted in the medical system for far too long.

I'm very fortunate to be able to share one example of this action delivered in my region. During Women's Health Week I had the privilege of visiting the Hunters Hill Endometriosis and Pelvic Pain Clinic with the Assistant Minister for Health and Aged Care. It was really inspiring to see the dedicated work happening there. This clinic is one of 22 established across the country as part of a $58 million initiative. It's a place where women can receive the multidisciplinary care they need, from pain management to specialist consultations, all in one location. This model should be the standard and not exceptional. The opening of this clinic is a step towards ensuring women are seen, heard and treated with the care that they deserve.

To me, it's outstanding that, on average, it takes seven to nine years for a woman to receive an endometriosis diagnosis. Imagine enduring seven to nine years of pain, frustration and uncertainty all while being told it's just part of being a woman, seven to nine years of pain often dismissed by healthcare providers as normal or psychosomatic, seven to nine years of suffering in silence, seven to nine years spent waiting for someone to take your symptoms seriously. That isn't just a delay; it's a denial of care and dignity.

I'd like to ask every man in this place and in this country to picture what it would be like going to your doctor, describing severe and ongoing pain, and being told time and time again that it's just stress, in your head or a normal part of being a man. What if for nearly a decade your pain was dismissed, chalked up to overthinking or a lack of resilience? That's the experience of countless women in the health system. It's a systemic failure, it's not good enough and it's long past time we addressed it.

That's why this government is taking action. We are committed to delivering a healthcare system that works for everyone, not just some. We're prioritising issues like reproductive health, mental health and chronic conditions affecting women, backed by over $350 million in dedicated funding. We are advancing targeted solutions for women's health needs. Our commitment goes beyond the clinics I mentioned earlier. We're funding specialised training for healthcare providers and reducing diagnostic delays that have held women back for far too long. By investing in this training, we're creating a health system equipped to address the complex realities of women's health.

We're also expanding mental health services for women, with a focus on those affected by trauma and postpartum issues. By creating more trauma informed support, we want to build a mental health response that genuinely supports women and recognises their unique experiences. We're adding vital services to the Medicare Benefits Schedule that directly benefit women. This will mean more appointments, more subsidised treatments and easier access to essential health care. When it comes to preventive health care, we're not taking shortcuts. By expanding cancer screening programs for breast and cervical cancer and investing in more awareness activities, we're helping more women catch these diseases early, ensuring better outcomes and relieving the emotional and financial burden of late diagnosis.

To every woman who has been told to wait, to bear it or to be strong, I want you to know that this government hears you. Under the guidance of the health and aged care minister and his very hardworking and committed assistant minister, I have absolute confidence that they will build a health system that respects women's experiences and affirms their dignity.

Bob Katter (Kennedy, Katter's Australian Party) Share this | Link to this | Hansard source

In Tolstoy's War and Peace, there is a great quote. The corporal says: 'I gave her the bread, and she gave the three pieces to her children and she left nothing for herself. Is she not hungry?' The sergeant major says, 'She is a mother.' We talk about the survival of the fittest and Charles Darwin. That led to the Nazis, didn't it? We didn't descend from people that carried weapons; we actually descended from people that were mothers, that mothered their children and looked after them. You can have your attitudes on abortion. To me, it's very good because you're vanishing from the gene pool. The sooner the better would be my opinion.

Having said that, I don't think that there's any feeling for the mothers that are traumatised by a situation where they proceed with something like that. They have been programmed for 3½ million years to be a mother, and suddenly they're doing the opposite. I don't think they're going to get away with that. No-one addresses the trauma of the mother that is confronted with this situation and does something, in many cases, that she regrets for the rest of her life. There should be a looking after of the mother, before and probably afterwards too, sadly. I'll say that.

As for the Greens and their attitudes, where I come from we get the monsoonal rain and everything is green, and then it turns brown and it blows away. I think that's a wonderful metaphor for those that sit behind me. Ultimately, it is whether you survive as a race of people. If you are a vanishing race—and we are vanishing at a faster rate than anywhere else in the world except for five nations, the last time I looked. We are vanishing faster than any other group of people on earth, and that is the price that you will pay. You will be gone from the gene pool. You can read history books and prehistory books, and you can see the mistakes that people made in their survival. They're not with us anymore, those people.

I'll conclude on this note. In the Torres Strait the women were the producers of food. They had fruit and vegetable gardens in the backyard. Yes, the men fished, but the women grew fruit and vegetables. In some 200 or 300 meals that I had in the Torres Strait when I was minister, I did not have any food from the mainland at all. It was mangoes and bananas and sweet potatoes and yams and taro and, of course, fish and dugong and all those things as well. When I went up there last time it was really sad, because the governments in this place took away from those women the right to have their vegetable gardens. Now they have to get fresh fruit and vegetables from the mainland, which are overripe by the time they get there, and they can't afford to pay for them. They've said this again and again and again. This place has ignored the cries of those people in my homeland of Far North Queensland and in the Torres Strait. We have ignored them.

There is a terrible day coming for us. There's a word that describe nations that eliminate a race of people. You took away the right to fish, because we had to protect the Great Barrier Reef, but what about protecting the people that have lived there for 40,000 or 50,000 years? What about protecting them? They should care about them. There's little made of the fact that the Great Barrier Reef is 350 kilometres away. I don't know how some poor beggar going out in a tinny is going to adversely affect the Great Barrier Reef. You took away their right to fish and you took away their right to have a vegetable garden, so you're starving them to death. They are dying on a massive scale from diabetes. There's not a single person in this place I've heard raise their voice about it. You don't care about them. You were crying to hell about the yes/no vote, but what are you doing about the people that have the highest death rate, maybe, in the world? Their life expectancy is 56! Is that something to be proud of as a nation—that their life expectancy is 56?

I'm talking about women because they were the people that provided the food. (Time expired)

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

The discussion has now concluded.