House debates

Wednesday, 15 February 2006

Therapeutic Goods Amendment (Repeal of Ministerial Responsibility for Approval of Ru486) Bill 2005

Second Reading

7:36 pm

Photo of Dave TollnerDave Tollner (Solomon, Country Liberal Party) Share this | Hansard source

First, let me put on the record my thanks to the many people of the Northern Territory who contacted me on this issue. Their emails, faxes, phone calls, letters and words—both for and against—have been of great assistance to me in the consideration of the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I have thought long and hard on this matter, and at this point in time I must disagree with the proposal to remove ministerial authority and to include RU486 in the list of restricted goods and leave the evaluation of the use of medical abortifacients to the Therapeutic Goods Administration.

As all members in this place know, I am a proud Territorian. I am acutely aware of my responsibilities to represent the people of the Northern Territory and to act in their best interests. David Gawler is a highly respected surgeon from the Royal Darwin Hospital and he works extensively within the Indigenous communities. He has real concerns for the people of the Northern Territory in relation to this bill, as he expressed to me in writing and in conversation with my office. Mr Gawler and many other people who have contacted me are very concerned that RU486 has been widely promoted for use by women in remote areas. In fact, it has been claimed that gaps in abortion services in these areas will be overcome by this drug’s introduction.

There are a number of reasons why such a proposal is not only ill considered but dangerous. First of all, the manufacturer’s protocol for the ‘safe’ use of RU486 stipulates that a woman having this type of abortion must see a doctor on day 1, 3 and 14. In many areas of Northern Australia, serviced by itinerant doctors, this would not be possible. Continuous medical cover is rarely available in most parts of Northern Australia.

There are also clinical issues. RU486 has some quite serious and potentially fatal complications which have been well documented, even by the manufacturer, including severe haemorrhaging and toxic shock syndrome. Professor Andrew Child, director of obstetrics and gynaecological services for the south-western part of Sydney and former president of the College of Obstetricians and Gynaecologists, has advised that the drug’s introduction would increase the risk of adverse outcomes, especially for women in remote areas. Just imagine in a typical wet season, with flooded airstrips and poor weather, how long it would take to airlift a sick patient suffering a complication from the use of RU486 from her remote location to hospital.

There are also well-documented communication problems in the north, where many Aboriginal people do not speak English. Indigenous women, in particular, who have an inadequate understanding of their doctor’s advice, may not follow the manufacturer’s instructions, and this may lead to nonattendance at required medical appointments. This situation can result in serious complications and even death.

Moving away from my specific NT concerns and looking more broadly, it must be recognised that there are also the psychological consequences to consider. I am deeply concerned at the lack of research in this area. Relative to a surgical abortion, an abortion using RU486 may be ‘easier’ initially, but what of the psychological consequences of delivering a dead embryo at home, with the associated pain and bleeding—apparently speculative, but I think they are obvious with commonsense.

Many supporters of RU486 have suggested that the drug’s use involves merely technical considerations. But it involves killing an embryo—a scientific name for an unborn child. At seven weeks, the developing limbs can be seen, the head is quite large compared to the trunk, the fingers and toes are present and the arms bend at the elbows. The upper lip is complete, and the external ears form elevations on the side of the head. The embryo is perhaps an inch or two in length.

This is not merely a technical issue of safety or efficiency—of whether medical abortions are to be preferred to surgical abortion. Are we living in an abortion mentality, a culture which is indifferent to killing an embryo? If that were the case, we would not even be having this debate.

The most common ground for abortion—psychiatric—is rarely of such significance as to impel the abortion provider to refer the woman for ongoing treatment by either a psychiatrist or a clinical psychologist. The counselling provided by abortion providers is usually perfunctory and is generally directed towards encouraging a woman to proceed directly to an abortion—not to consider the alternatives or the consequences. Women are rarely told of the risks of abortion: breast cancer, subsequent pre-term birth, low birth weight and illness. And what of the psychological consequences of delivering a dead embryo at home? Perhaps this debate should be about the support on offer for women seeking an abortion instead. It has often been suggested that the reason most women have abortions is the lack of support, sometimes in circumstances of financial difficulty or lack of support by a partner or spouse.

While most Australians accept that abortion is ‘necessary’ in some cases, most have a deep uneasiness about abortion. I agree with the opinion that the TGA would no doubt treat RU486 like any other drug and assess it from a purely technical viewpoint, having regard to safety and efficiency. Yet what is at stake is far more than safety and efficiency.

Look at the morning-after pill. Postinor-2 is an emergency contraceptive and is sold in a pack. Postinor-2 was relisted from schedule 4 (prescription only) to schedule 3 (over the counter) on 1 January 2004. Prior to this Postinor-2 was only available via prescription, although it was not subsidised under the PBS. It became available in Australia in July 2002. According to the publication Australian Statistics on Medicines there were 35,258 scripts for Postinor-2 dispensed in 2002; this increased to 79,735 in 2003. More recent figures, from 2004 when it became an over-the-counter drug, are not available.

A good friend of my wife, who shall remain nameless in this debate, was given the morning-after pill by her well-meaning and loving mother—similar to the way in which many parents give their children condoms. With no medical supervision and after some sustained use, my wife’s friend became quite sick. Upon visiting her doctor, she was told that her illness was a result of her overuse of the morning-after pill. What is more, she was told that she would never be able to have children. This was absolutely devastating news for her. We have been assured in this place that RU486, should it be introduced into Australia, will only be available on doctor’s advice and through prescription. We were told the same thing about the morning-after pill, Postinor-2.

I find something quite odd about this whole debate. There is no application at the moment to have RU486 made available in Australia—there has not been in the past, and I am not aware of any suggestion that an application is about to be made. It goes without saying that here in Canberra there are many people skilled in the political arts. There are people of all political persuasions who are paid for their rat cunning, their conniving ways and their ability to get an outcome by stealth. I have absolutely no doubt in my mind that a couple of these faceless tacticians are at work here.

Whilst I believe that most parliamentarians are debating this issue on its merit, I have no doubt that there are some who see this as nothing but a great opportunity to undermine the current health minister. I have overheard it said in the corridors that this bill is being called the ‘Get Abbott Bill’. The view of these people is that the current minister is unfit for the job because of his strong spiritual conviction. Personally, I am disgusted at this narrow-minded view and the political skulduggery that goes with it. Women deserve to have their health and, more importantly, their value taken more seriously than that. For all of the reasons that I have stated, and many more, I cannot support this bill.

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