Claire Moore (Queensland, Australian Labor Party) Share this | Hansard source

I know that we have limited time this afternoon, but it is really important that we have a discussion about the Health Insurance Amendment (Medicare Funding for Certain Types of Abortion) Bill 2013. I do not have the privilege of being on the Finance and Public Administration Committee which considered it. But, as people would know, there was interest and we read the submissions. It is important to know that this kind of bill is not isolated to Australia. This type of legislation has been proposed in many countries of the world over the last six months. There have been attempts at this kind of legislation in several states of the US, in Latvia, in parts of Russia and in a whole range of other countries. That is all on the record. Very similarly worded bills have been put up. That does not mean that it should not be discussed, but we need to understand that the type of legislation being proposed is not peculiar to Australia.

One of the aspects of the bill is that it looks at the issues around United Nations declarations. I celebrate the fact that we are looking at a range of UN conventions and declarations to which Australia is a signatory. I saw no-one during our recent committee hearing nor in general discussion in Australia who in any way supports any discrimination against women—and discrimination in the form of terminations of girl children in particular. That has been a point raised. That was the focus of the UN declaration.

The relevant part of the UN cross-agency statement that was quoted, both during the committee hearing and also this afternoon, talks about the fact that states have the obligation under human rights laws to respect, protect and fulfil the human rights of girls and women. It refers to the ICPD, which I keep almost by my bedside and to which I have referred many times in this place. Principle 8 of the ICPD of 1994—which has been reinforced consistently—says:

Everyone has the right to the enjoyment of the highest attainable standard of physical and mental health. States should take all appropriate measures to ensure, on a basis of equality of men and women, universal access to health-care services, including those related to reproductive health care, which includes family planning and sexual health. Reproductive health-care programmes should provide the widest range of services without any form of coercion. All couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so.

The declaration then talks about any preference given to male children, to sons, and about the horror of any discrimination against women and women who are giving birth to children. We all agree with that. We need to work forward from that.

But one of the core aspects of the discussion is that all states must put in place a range of support mechanisms so that women and their families can make effective and responsible decisions. The bill before us is giving one narrow response to this issue. Indeed, as Senator Madigan pointed out, what he has put before our parliament is quite specific. We need a wider response. We do not need to put all the focus on one medical element, a focus that does not reflect the views of the Australian community.

A number of submissions to the committee questioned whether the issue of sex selection abortion was real in Australia. Senator Madigan has pointed out one case. I am not doubting the evidence that came before the Senate committee, Senator Madigan, and I do not think that anyone should impugn any evidence that comes before a Senate committee. However, a wide range of evidence was documented by organisations such as the Australian Foundation of Women and also the Reproductive Choice group that looked at the Australian community and our birth rates. That evidence pointed out that the Australian sex ratio at birth now is 105.7 male births per 100 female births and that is within the normal range of 102 to 106. They are not things that I have made up. This is the scientific and statistical basis to look at the rates of birth in our country. There is nothing there that points out that there is any dominance of or preference for male births over female births—or indeed female births over male births. There is no evidence from any change in our birth rates that people are making conscious sex selection decisions and terminating births on that basis.

I am also concerned that we are impugning parents—and particularly mothers—of some specific backgrounds in saying, 'If there is an issue, it will be mothers and families of this particular ethnic background.' I find that difficult. In looking at our Australian community, one of our responsibilities is to ensure that our values and our way of life is shared by all the people who live within it. That is what being part of the Australian community means. We see it when people take on citizenship in the pledges that they make. Impugning one group and inferring that because they happen to come from a particular country where there is sex selection—and we know it, and we heard Senator Madigan point out a couple of those countries—that will automatically translate to how they live and make choices in Australia is not a fair process and could lead, in the worst possible scenario, to a focus on women from particular backgrounds who are choosing to take medical advice about their options with pregnancy.

Remember that what we are talking about is the right of women in our country to make choices about, as ICPD principle 8 says, the children that they will have and the number and spacing of their children. The core aspect in this argument is that the Medicare payments in our country reflect the medical practice in our country. It is a clinical process in terms of women having the right to have personal and private discussions with their medical practitioners about the choices they want to make. I am concerned that if we put more regulation into this process about making sure that there are lists or data kept on the choices and the background to choices it may actually cause women to not have the freedom and the strength to make decisions and to take advice that they need. In this debate we consistently hear about force and coercion and fear. We want to minimalise that environment so that women have that personal security, when they seek medical advice, that it will be just that: personal and secure. That is the basis of our medical system.

We also heard a number of people talking about their concerns about how we are going to move forward if we begin to have this kind of intrusion into what is an Australian right and an Australian freedom: the ability in our country to ensure that people across the board do understand their rights and do understand their responsibilities. We had evidence in the committee, which I have read, that talks about the medical practitioners—the NHMRC guidelines, which are already there and which we rely on for our medical practitioners to understand their responsibilities and their relationship with their patients. In terms of the protections that are already in place in Australia, we do have systems that allow appropriate practice and appropriate understanding.

Should there be a fear about processes such as sex-selection abortion coming into our country, we need to ensure—and in fact we have a responsibility to ensure—that effective information is made public to tell people what rights and responsibilities they have in Australia. We need to refer, as Senator Madigan has done so well, to the various UN conventions that are in place giving people that understanding, that freedom and that responsibility. And I definitely support that. What I do not support is a single approach that is focusing on the Medicare payments, which is one way of highlighting a presumed problem that I genuinely do not believe we have in our country. I hope that through the process Senator Madigan has put in place there will be an openness around discussions on this issue so that we do not hide—we do not run away from the process—but we do not automatically presume guilt. And that seems to me to be the bottom-line message of this legislation: we presume that there is a problem, we presume that certain people are taking actions—which we do not support. We do not believe that any child or any sex or any person should be treated differently on the basis of their gender. It is not the Australian way. It is certainly not the way that has been promoted in a range of UN processes.

I was lucky enough to be at the Beijing women's conference, and these issues were openly debated. At that conference we had women—and some men—from around the world who share a commitment to equity and equal rights. They also share a very strong commitment to reproductive health, reproductive education and reproductive equity. If, through this bill, we actually restate those processes and get that agenda clearly on the record, the bill will have had some success. I do not believe that we need another regulation within the Medicare system that relates specifically to a problem that has been identified somewhere else. I do not believe that that is the methodology or the process we should use. In terms of what we can do, I think it is important that we actually look at what is occurring in Australia, see whether there is any concern raised by Senator Madigan and check that out. But I also believe that if a practitioner has a particular concern they have the right to not provide a service. And that is certainly within the process and something we have talked about before.

I am really pleased that I was able, in the discussion in this area, to work with a couple of young women. I particularly want to acknowledge Maddie and JD, who are really interested in our future and the issues of women's rights in this country. They, through this process, have received the information from the committee report. They have actually looked at what was happening internationally. They are the ones who actually pulled out the information from the various UN declarations and conferences. We need to focus on ensuring that women have free choice, that they have safety and that they have a sense that, through the medical practices in this country, they will be getting effective information and support rather than having the sense that there is something fearful or worrying about the actions they take.