Larissa Waters (Queensland, Australian Greens) Share this | Hansard source

I move:

That the Senate—

(a) notes that inadequate funding and lack of workforce planning has closed or restricted many maternity and reproductive health services around the country, particularly in remote and regional areas; and

(b) calls on the Health Minister and National Cabinet to urgently work to resolve the maternity and reproductive healthcare crisis and ensure all families can access quality care across Australia.

You don't need to look very far to find a recent story about the healthcare crisis—waiting times for appointments, lack of access to basic health services, cost of services forcing families to make a decision about whether to go to the doctor or whether to pay the rent, the availability of medicines and burnout amongst healthcare staff. All of these things are felt even more acutely in rural and remote areas.

It's a crisis affecting all areas of health care and all areas of the country, but today I'd like to focus on the impacts on maternity and reproductive healthcare services in my home state of Queensland. Last year the Greens initiated an inquiry into barriers to accessing sexual maternity and reproductive health services and education across Australia. That inquiry has received about 2,000 submissions, which is a testament to the importance of this issue to so many. When the hearings kick off in a few weeks time I'll look forward to hearing more about the experiences that people are having across this country and finding solutions—and then begging the government to implement them.

Two key principles of the national consensus framework for rural maternity services were that women should have access to safe maternity care as close as possible to where they live and that any decisions about the development, sustainability, downgrading or closure of rural maternity services must be evidence based, transparent, subject to independent impact assessment and taken in consultation with the local community. It sounds good, but none of those principles are being achieved in Queensland.

In June 2019, a Queensland rural maternity task force highlighted the need for action in workforce planning and resourcing to address barriers to access. The report opens with this observation:

Every day in Queensland, rural and remote women leave family and business, travel long distances on rough roads often without the security of mobile phone coverage, and endure financial, social, and emotional hardship just to access the maternity care that urban people have on their doorstep.

That task force made a series of recommendations. The President of the Rural Doctors Association of Queensland, Dr Matt Masel, has said that not only has there been little progress but, in fact, the inequity confronting rural and remote women has only worsened.

Maternity units remain under considerable strain across my state. The Biloela and Gladstone hospital maternity wards have been on bypass for many months, forcing families to travel a significant distance to Rockhampton just to have their babies. My Gladstone based colleague, Senator Allman-Payne, is going to talk a lot more about that situation and the devastating impact it's having on the families. Despite the desperate pleas to the Queensland Department of Health, it looks like the women in the Gladstone community and in Biloela will be waiting until at least midyear before they can give birth in their own towns.

Meanwhile, staffing issues threaten to derail plans to resume the delivery of babies at Cooktown hospital and to establish a birthing service at Weipa hospital. Doctors are concerned that staff shortages could see restrictions on obstetrics at Innisfail Hospital. For many First Nations women in northern Queensland, these are familiar stories. Far too many First Nations women and pregnant people are forced to travel to larger centres to give birth away from country and away from family support.

This crisis in maternity healthcare access is replicated in access to reproductive health care. Too often, whether or not someone can get unbiased, timely advice about their options and, if they choose an abortion, access to safe, supportive abortion care depends on their postcode. Abortion care is health care and it should be accessible to all those who need it, no matter where they live or how much money they have in their bank account.

In Townsville and Rockhampton, Marie Stopes had been the only provider of surgical abortions for many years. In 2021, the service closed. They told me that it closed because they couldn't get the financial support they needed from the government to keep the doors open. Since then, women and pregnant people living in Townsville have had to travel hundreds of kilometres to Brisbane, generally, often at huge expense, to terminate an unwanted pregnancy. They only have a small window in which they can do so legally.

In October last year the Queensland government gave $1 million to the Townsville Hospital and health services to restore surgical termination services to the region to try to refill that gap, but it was announced last week that those services will be delayed again, until at least mid-March, while Townsville Hospital recruits the necessary staff. For pregnant people in the region who are nearing the 14-week limit for surgical abortions, that additional delay will mean the difference between accessing an abortion locally and having to travel to Brisbane and needing the funds to do so.

The additional stress, uncertainty, cost and risks that the lack of services is causing pregnant people in regional Queensland is unacceptable. We cannot have a situation where people facing an unwanted pregnancy can only access safe and supportive abortion care if they have the resources to travel. Likewise, we can't have a situation where people feel forced to elect a caesarean birth to minimise their risks. We shouldn't have a situation where families who have been supported by a midwife throughout pregnancy are forced to give birth in a distant hospital without continuing that midwife support or where parents from First Nations and culturally diverse communities are separated from their families into a daunting, unfamiliar and clinical environment at a time when they most need cultural support.

We need immediate and long-term solutions to address maternity and reproductive healthcare access issues. We need comprehensive and system-wide planning of rural maternity services, including workforce rotations. We need abortion in public hospitals. We need more recruitment and retention initiatives and incentives, better work flow management and funding to make it happen. We need to expand Medicare coverage for midwifery services and home births to give families more choice about how they birth. Bundled funding and continuity-of-care models have been recommended in the women-centred care strategy and by the participating midwives task force in the previous MBS review, and we need to start listening. This government needs to start listening. We need more birthing-on-country initiatives led by Aboriginal community-controlled health organisations. Services need to be designated to meet the needs of diverse communities in consultation with the communities they serve. We also know that attracting doctors and midwives to regional areas is made harder by the lack of housing, the lack of schools and the lack of social infrastructure.

Improving the lives of people in the regions demands a holistic approach. We need action. I know that this is an issue that the Minister for Women, Senator Gallagher and the Assistant Minister for Health and Aged Care, the Hon. Ged Kearney, take seriously, and I look forward to working with them and any member in this place to tackle those barriers that are preventing women from accessing the health care they need when and where they need it.

Women have been waiting far too long to get access to basic health care. The situation is getting worse, and we deserve better.