Medicare reforms are essential for creating fairer national abortion system, say advocates

by Tory Shepherd
Health experts are calling for Medicare item numbers for abortions and pregnancy counselling ahead of women’s safety ministers’ meeting

Medicare item numbers for abortions and pregnancy counselling along with specific funding for reproductive health are needed to create a fairer national abortion system, according to MSI Australia, formerly known as Marie Stopes.

State and federal women’s safety ministers are meeting on Friday for the first time since the Albanese government was elected. A 10-year plan to end violence against women and children, gender equity issues and the need for a specific plan for Aboriginal and Torres Strait Islander women are expected to be discussed.

Equitable access to abortion is also on the agenda. Abortion has become a contested topic in the wake of the US supreme court’s decision to overturn protections for reproductive rights – and criticism of Australia’s disjointed system is growing.

MSI Australia’s head of policy, Bonney Corbin, said gestational limits for rare late-term abortions, which vary from state to state, needed to be replaced with a more individual approach.

Currently, every state and territory has different rules and limits and access can be a “postcode lottery” depending on where you live, advocates argue.

Corbin said the target of universal and equitable abortion access was enshrined in the National Women’s Health Strategy. To achieve this would take a range of measures and it should be the responsibility of health ministers, not ministers for women, she said. “Universal access requires funding provided for states and territories that can be quarantined for abortion access as opposed to general health funding.”

There would need to be Medicare Benefit Schedule (MBS) items set up for telehealth for medical abortions, another for surgical abortions, and a range for support services from pregnancy counselling to specific care for culturally and linguistically diverse people, migrants and refugees, Aboriginal and Torres Strait Islander people and LGBTQ+ people.

“For some people it’s an easy and quick and empowering choice. For other people there might be other aspects of grief and loss they need to process – everyone will do that differently,” Corbin said.

Part of the solution would involve looking at who can use those MBS numbers, she said, with nurses and Aboriginal community health workers better able to oversee parts of the process.

Then there were issues around ensuring the procedure was safe from “reproductive coercion” – where an abusive partner was involved.

A national working group was needed to work through the issues including cost, potential complications and personal needs such as birthing on country, Corbin said.

The federal government does fund a range of abortion services, however it is up to the states how that funding is allocated. Many public hospitals, doctors, and other health services do not offer the procedure.

Gestational limits have always been controversial. They range from 16 to 24 weeks between the states and territories, after which different approvals or processes are required.

“It’s so rare that someone needs a later gestation abortion,” Corbin said. “It really is up to a patient in conversation with their doctor – having a limit puts a judgement on someone’s decision.”

A spokesperson for the federal health minister, Mark Butler, confirmed the government was committed to abortion access but echoed the prime minister, Anthony Albanese, who earlier this week said it was a matter for the states and territories.

“Equitable access to pregnancy termination services is a key measure of success in improving the sexual and reproductive health of women and girls as outlined in the National Women’s Health Strategy 2020-2030,” the spokesperson said.

“While the laws relating to pregnancy termination are a state and territory responsibility, including the conditions for a termination to be performed, the Labor government is committed to ensuring access to sexual and reproductive health care and addressing the underlying factors that limit genuine choice.”

On Wednesday, Albanese was asked on radio station 3AW if he was looking at requiring public hospitals to make abortion available as part of their funding agreement.

“No,” Albanese said.

“It’s a state matter … states control hospitals. In this country, we don’t control the health system – states control the health system. They deal with these issues, and we’re fortunate that in Australia we don’t have the sort of divisive debate that has occurred in the US, that we’ve seen playing out.”

He described the US supreme court decision to repeal Roe v Wade as “very unfortunate”.

At Friday’s meeting in Adelaide, the ministers for women will also discuss the appointment of a new commissioner for family and domestic violence. Catherine Fitzpatrick, who was appointed by the former Coalition government just weeks before the May election, had that appointment revoked by incoming social services minister Amanda Rishworth.

The Department of Social Services will formally advertise for a new commissioner to “play a key role in elevating women’s safety as a national priority and providing a strong voice for victim-survivors”.

The head of Anti-Poverty Week, Toni Wren, called on the meeting to also take action to “urgently address poverty and homelessness”.

Anti-Poverty Week’s research found that 95% of the poorest single-parent families are headed by women.

“We know that the majority of these single mothers left violent partners, and their current pathway is into life-long poverty,” she said.

  • The National Domestic, Family and Sexual Violence Counselling Service is 1800RESPECT or 1800 737 732.