Marielle Smith (SA, Australian Labor Party) Share this | Hansard source

I also write to speak on this report. As deputy chair of the committee, I want to thank my colleagues who participated in this inquiry, particularly the chair, Senator Allman-Payne, and my colleague Senator Waters for her initiative in bringing it forward and her willingness to allow me to co-sponsor it with her and for her genuine commitment to improving women's health outcomes too. I also want to thank the experts, academics, advocates and professionals who participated in our inquiry and presented to our public hearings. We are grateful for your expertise. I thank you for your contributions in an area that perhaps hasn't been appreciated or heard in the way it should have been for a very long time. I really hope our committee and our inquiry help to change that.

Most of all, I want to thank every woman who provided a submission of her own lived experience or who came to our many hearings around Australia to share her story with us. Some of these stories were shocking and confronting, but everyone was genuine in their desire to create change. Especially those women who shared very intimate details of their healthcare journeys and very harrowing stories of their healthcare journeys, I want to thank you for doing that with our committee because your evidence shaped the recommendations in our report.

Nine months ago, when we referred this inquiry, I spoke of the need to shine a light on this issue and to spark a national conversation which could be part of addressing some of the stigma and discrimination which surround these issues. We expected to hear from women across the country, but I think all of us were a bit overwhelmed and surprised by the number of submissions that came in and the impact it has had on women who were able to share their stories. I have been working on issues of women's health for a long time and it is clear that, the deeper you dig, the more you find that women's experiences of pain are too often dismissed and ignored, whether that's for periods, endometriosis, PCOS, issues related to pregnancy, maternal health care, mental health or all the way through to menopause. Women tell us they are not always believed and they are not always getting the good-quality primary care that they deserve. They tell us that their pain is dismissed or carelessly attributed to other causes. They tell us that they are labelled as 'irrational', 'emotional', 'hysterical' or 'crazy' and of the devastating impact of these statements.

It's almost like when we are taught about women's health at school the journey begins at puberty and ends at childbirth, like nothing of significance or consequence happens in a woman's life after that, as though her health journey simply disappears. But that is absolute nonsense. Menopause isn't an optional part of ageing. It will affect every woman lucky enough to reach middle age at some point in her life. So why does it feel like our society hasn't been prepared for that? Why is it the case that our health system is letting so many women down? So many women have walked into their GP's office and have not felt heard and able to access good quality advice and care. Why has the stigma that surrounds menopause been able to impact and infiltrate so many aspects of a woman's life?

It was appallingly clear to us through the course of our inquiry that medical professionals are not being properly taught how to treat menopause effectively and that there's not enough contemporary training and professional development to ensure that, when a woman walks into her GP's office, she is getting good quality, up-to-date and accurate care. We heard in our committee that medical students receive as little as one hour of training in menopause. Again, menopause is not an optional part of a woman's life. It's something that affects 50 per cent of the population. It's time for that to change.

Many of our recommendations go to what needs to happen within our healthcare system when it comes to training medical practitioners and clinicians and providing them with professional development and support so that when a woman walks into that consult, she gets good quality care the first time around; she's not shopping around to five or six different GPs desperate for help. We've heard this from women time after time. If they couldn't get good quality care and didn't know where to go for good quality information, they started scrolling. When they started scrolling, they were overwhelmed with junk products and junk advertisements for products that could do more harm than good.

Socia media can be an enormous benefit for women. It can provide incredible opportunities for peer support. But throughout this inquiry, I spoke of my own algorithm, my own Instagram page, targeting me and marketing me with products to treat menopause. We need to make sure we're looking at these products. We need to make sure that the TGA is reviewing them. There is validity in considering how some of these products are labelled. We have recommendations that go to that, the TGA, and women in regional and rural areas, for whom stigma can take a different shape. We know that country women, like the country women in my family, just tend to get on with things. That stigma looks a bit different. We also know that, in many of these communities, you don't always have more than one GP or more than one option, so shopping around isn't possible. And if woman's GP isn't providing that good quality care and doesn't have up-to-date information on the treatments available for menopause, then there are very little options for her. One woman spoke to me of her need to drive hours and hours to find a GP qualified to provide her with good quality care.

We also heard throughout our inquiry that the evidence base on the impacts of menopause just isn't sufficient. We know menopause doesn't affect every woman in the same way. Many, many women will go through perimenopause and menopause flawlessly. They won't have a symptom that impacts their ability to participate in the workplace. They won't need care from their doctor. They won't need medication. There might be some annoyances, but it won't seriously impact their lives. But there are some women for whom menopause can be really troubling and present really serious challenges and obstacles to their participation in the workplace. We were thinking about those women when we made our recommendations around the workplace and what might need to change.

Our recommendations focus on flexibility and what we can do to give women a right to request that flexibility. For example, workplace adjustments. For many women that's a small change, like being able to prop a desk fan up on your desk while you're at work can make a difference. A breathable uniform can make a difference. If you usually catch the peak-hour train and you're going through a hot flush, it might be helpful to catch the 9.05 train every now and then, so there's that little bit of flexibility in your starting time at work.

Small changes can make an extraordinary difference. We want women to have the right to request them, and we want workplaces to start talking to the women in their places of work about what makes a difference to them. However, there are different challenges for women who don't work in offices. If a woman works in an early learning centre where she is subject to the need to maintain ratios, she is often outside. For a woman who works on the till at a supermarket or for a woman who's working in a factory or construction, there's no desk to put a desk fan. Changes to uniforms aren't going to cut it.

This is where we think there needs to be more research done into what flexibility and workplace support look like for these women and whether reproductive and sexual health leave is actually the answer for them. I admit a lot of the evidence we received about what could change in the workplace came from women in white-collar workplaces. If we're going to support the women who feel like their economic participation is impacted by some of their symptoms, that conversation needs to be much, much broader, and so do our policy solutions. So we've called for research there. We've called for more work to be done and for that to happen in government.

Again, I reaffirm that not everyone will experience negative symptoms of perimenopause and menopause. For many, many women, this will not be a journey that causes distress or impacts their ability to thrive at the peak of their careers. But, for a number of women in our community, it will have an impact. There are things we can do in our healthcare system, changes we can make, which would provide extraordinary relief, and there are small changes we can make in our workplaces—changes which might be the difference between a woman at the peak of her career being able to continue at work or go for that promotion and her not being able to do so. If we're not having a conversation in our workplaces about that, those things won't change.

We have 25 recommendations. I thank the committee for the generosity they extended in trying to get to recommendations which we could all stand up and support. I think they're sensible. I think they're reasonable. I'm proud of what we've done to spark this national conversation together. But it's now over to us as a government and to workplaces across Australia—especially, may I say, the medical profession—to get up to speed on perimenopause and menopause. Women are waiting for change, and it's time we delivered that for them.