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

On behalf of the chair, my colleague Senator Allman-Payne, I present the report of the inquiry of the Community Affairs References Committee on menopause and perimenopause, together with accompanying documents, and I move:

That the Senate take note of the report.

I want to start by thanking all of the witnesses who participated in this inquiry and all of the submitters who poured all of their love and their frustration and their raw honesty into the words that they shared with our committee. It was an enormous privilege to hear what they had to say, and I'm so grateful that the Senate provided that platform to listen to women and to listen to their experiences.

I'd also like to deeply thank the secretariat—in particular, Claudia and Apolline—for the detailed work they did in pulling together the wealth of evidence that has now gone into this excellent report. I'd also like to thank all of my Senate colleagues who participated in this inquiry and made it such a successful and interesting experience—in particular, the chair, Senator Allman-Payne; but also Senator Marielle Smith, who, of course, co-sponsored this inquiry reference with me; Senator Louise Pratt, also from the government side; and then, from the opposition benches, Senator Maria Kovacic, Senator Wendy Askew and Senator Hollie Hughes. The level of engagement from all of the senators on this inquiry was really gratifying, and I thank everyone for their work and for the passion with which they approached this topic.

We know that women have been suffering in silence for far too long, and we know that we often don't pay enough attention in this place, frankly, to gender equality in the women's health space. This was the reason why, almost a year ago now, not only was I the first person to say the word 'perimenopause' in federal parliament but I recognised that there was a deep need for the lack of policy in perimenopause and menopause to be redressed. So it was with the intention of trying to establish an evidence base and to hear from women in the community so as to give us the information we needed to develop that policy that I was proud to propose this inquiry be undertaken. I'm very pleased that not only was the inquiry co-sponsored by the government but there was unanimous support from the chamber to do this necessary work.

It sends a really powerful message that after almost a year of hearings—and we had quite a few of them; seven in fact—we've reached a consensus report. I want to acknowledge that, whilst some additional comments were made by coalition senators, everyone has signed on to these recommendations, and they're very strong. They're perhaps not quite as strong as they would be if it was just me writing them, but this is part of democracy, this is part of compromise, this is part of bringing together the evidence base and making some suggestions to government.

I'll briefly run through some of the key recommendations. We're really pleased at the strength of sentiment and the consensus report that has been produced. We urge the government to read this carefully and to please respond within the timeframe that you're meant to, unlike on the reproductive health care inquiry report, which was also a consensus report, that sadly has been gathering dust on a shelf of the government benches now for almost 18 months. Let's not repeat that, hey, because women deserve better.

I also want to flag that, whilst some women experience almost no symptoms of perimenopause or menopause, and that's great for them, there's a real variety of experiences, and women experience mild, moderate and sometimes extremely debilitating symptoms. This is affecting them not only in the healthcare space but also in the work space. Part of the intent of this inquiry was to look at both health policy and workplace policy, so I'm pleased that we were able to do that.

I want to start in the health space. We heard horror stories from many women who already lacked the education to work out that what they were experiencing was in fact perimenopause, but, when they went to seek some advice from their GP, many times their GP didn't put the pieces of that jigsaw puzzle together either. GPs are obviously very busy, they're very bright people and they've got a lot to stay across, but this inquiry heard that we really need to better educate GPs on this particular issue. One hour in undergrad is not enough. We also need to give them the tools to make sure that, when they're seeing patients, they've got electronic prompters to help them work out, 'Okay, maybe this person is perimenopausal,' and to acknowledge that the age range for when perimenopause and menopause can happen is in fact a lot broader than perhaps you might expect.

We heard that not only was it hard to get a diagnosis—and sometimes women had to go to multiple different GPs before they felt heard; they didn't feel disbelieved or dismissed—but, once they were able to get a diagnosis and some treatment prescribed, actually the most modern and often most suitable treatment for them was simply out of reach for their financial means. We took evidence that the most up to date treatment with the fewest possible adverse impacts, the least possible slight increase for cancers, is not on the PBS. We took evidence that, if you're on the full suite of MHT—which is the new word for HRT, menopausal hormone therapy—with both oestrogen and progesterone, and sometimes also testosterone, it can cost you up to a hundred bucks. In fact, one witness said it cost $297 per month for her to get the treatment she needs. Clearly, she could afford it, but I can't think of many other Australians that are in a position to afford it, and no doubt she made sacrifices to be able to spend that amount of money on her treatment.

So we heard that the treatments need to be affordable. We also heard there's an awful shortage of them. That's wreaked havoc for people who might have a prescription for a particular type of MHT, but it's then discontinued, it's hard to get a GP appointment to get a substitute, the substitute is not quite right and they've got to go round to 12 different chemists to try and get their script filled. What an absolute nightmare. The recommendation from this committee was that we look at ways of addressing those shortages and that we look at ways of addressing the financial cost of getting appropriate treatment.

We heard that big pharma wield an awful lot of power in that decision-making process and that, effectively, if they decide that they don't want to go on the PBS, you can't really compel them, and, therefore, Australians can't get affordable medicine. There's got to be a way around that. This committee recommends that the government consider finding a way of making MHT more affordable for Australian women and people who need it. So we invite you to brainstorm some solutions, perhaps look at some of the international examples that the committee looked at, and find a way to make sure that MHT and other treatments are both affordable and accessible. So there was really powerful evidence in the health space.

We then took quite a lot of evidence about what to do in the workplace, and I acknowledge that this was the more contentious element of the inquiry. We did reach consensus that, clearly, people wanted flexibility. If they were suffering debilitating symptoms—and, as I said earlier, not everybody does, but for those who do—what they wanted most was understanding and awareness from their employer, and then the right to have flexibility, such as the right to maybe start a bit later if they'd had an absolutely rotten night's sleep, the right to be able to take a toilet break when they're having really heavy bleeding or the right to request to work from home if they just were not up to the job that particular day. This committee recommends that that flexibility be included in our fair work laws—a right to request flexibility on the basis of perimenopause and menopause. I think that is a really good, strong recommendation.

We also encourage employers to work with their employees and develop perimenopause and menopause policies. We need to bring this issue out of the shadows. There should not be a stigma around something that more than half of the population go through. Part of how we dispel that stigma is a national education campaign for everyone. That's important. But employers need to actually consult and talk with their staff and together have a workplace policy about this issue that will enable people to feel more comfortable raising this issue and generally reduce that stigma.

The third part of the workplace piece is leave. I approached this inquiry thinking we should have menopause leave. I want to acknowledge that I changed my mind during the course of this inquiry. I listened to the evidence and I was persuaded, for a number of reasons, that actually what would be more beneficial for a larger number of people would be reproductive health leave. That would ensure that people with all sorts of different issues can have the benefit of that leave. It would also mean that men can take it too if they want to go and get the snip or if they want to go with their partner to the first scan of their baby. I think it's important that we make sure that this leave is available for everyone, including men who might need it too, because flexibility might not be enough when those symptoms are really debilitating. I acknowledge that that's one of more contentious recommendations, but the Greens strongly support the union campaigns and the campaigns of many advocates for paid reproductive healthcare leave.

I'm really pleased that we got this inquiry up and, again, I really thank everyone for their participation in it. I look forward to the other contributions.