Abortion access is about will, not equipment

3 minute read

Professor Brendan Murphy wants better access to public hospital abortion services as part of the new National Health Reform Agreement.

The Secretary for Health believes the “patchy” provision of abortion services in public hospitals has less to do with availability of equipment and more to do with “whether the health service is willing”. 

The recently released Senate Community Affairs Committee’s report into universal access to reproductive healthcare stopped short of recommending public hospitals’ government funding be tied to the provision of abortion services. 

Instead, the committee recommended that “all public hospitals within Australia be equipped to provide surgical pregnancy terminations, or timely and affordable pathways to other local providers”. 

Professor Brendan Murphy, under questioning from Greens Senator Larissa Waters at Senate Estimates late last week, said the issue of public hospital access to abortions was likely to be on the agenda at upcoming health ministers meetings and would be part of the negotiations for the new National Health Reform Agreement, beginning in July 2025. 

“Any hospital that undertakes obstetrics and gynaecology procedures is physically equipped to [perform terminations],” said Professor Murphy. 

“It’s a question of whether they want to set up the clinical systems to support that – whether they have the counselling services and, frankly, the clinicians are willing to do it.  

“It is a big issue. General access to both surgical and medical abortion and other reproductive services is quite patchy in the public hospital systems that the states and territories run. I don’t think it’s so much a capital or infrastructure issue.  

“It’s more a model of care issue.” 

Professor Murphy said the Department of Health and Aged Care could not direct states and territories as to which services they provided in state-run public hospitals, because the current NHRA did not specify particular services. 

“This is one of the issues we have raised with the current [midterm] review of the National Health Reform agreement,” said Professor Murphy. 

“We would like to see equity of access to health services. Not just reproductive health services – some state and territory public hospitals don’t provide, for example, dermatology clinics anywhere in rural or regional areas.  

“We think this is a legitimate issue for the National Health Reform agreement to look at in its next iteration. We have flagged that there does need to be equity of access and a proper spread of clinical services in the public health system.” 

Senator Waters pressed further, asking Professor Murphy whether he had specifically advised that public hospitals should provide terminations. 

“Not every public hospital or service should provide terminations, but we think there should be proper access to the full range of public hospital services across the public hospital system, particularly in rural and regional areas.” 

Ms Fifine Cahill, from the DoHAC’s health system strategy division, said the NHRA was negotiated between the Commonwealth and all state and territory governments, and any changes to it in this regard “would similarly need to be agreed by all of those governments”. 

“The review is scheduled to report to all health ministers by the end of this year,” said Ms Cahill.  

“The current iteration of the National Health Reform agreement runs through to the 30 June 2025. We would anticipate that between the end of this year and that date there would be further agreements between governments about what the next iteration [looks like].” 

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