House debates

Wednesday, 15 February 2006

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

Second Reading

12:30 pm

Photo of Stephen SmithStephen Smith (Perth, Australian Labor Party, Shadow Minister for Industry, Infrastructure and Industrial Relations) Share this | Hansard source

I support the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. For reasons which I will outline, I do not support the amendments. It has been suggested by some that this bill, this debate, is not about abortion. I do not agree; I think it is about abortion. It clearly is. I do not think we should pretend otherwise, nor should we shy away from that. So far as abortion is concerned, my starting point is that abortion is a matter of conscience for the individual concerned. The choice to have or not have an abortion is a matter of conscience for the individual woman in consultation with her medical advisers. This is not a view I have come to lightly or quickly, but over the years of my adulthood that is the view I have come to hold. I also strongly believe that as a matter of conscience we should not seek to impose any one view on anyone else. We should not, and I do not, criticise others for their views or their choices in this matter.

In Australia as a nation-state we have over time addressed the abortion issue. And we have come as a nation-state to a number of conclusions. First and foremost, it is a matter of conscience. This itself is reflected in our approach to this parliamentary debate both here and in the Senate. Second, abortion is legally available under state and territory law as a medical procedure under certain conditions. Under Australian state and territory law abortion is a legally available medical procedure for women to choose. Third, the Commonwealth—the Commonwealth generically, as the Prime Minister says these days; namely, the parliament, the government, the Prime Minister and the minister for health—generically accepts this approach and position. That is done through Commonwealth funding and financial support of abortion as a legally available medical procedure, whether that is through Commonwealth funding for state public hospitals, through Commonwealth financial support for private hospitals or through Medicare through items under the Medicare Benefits Schedule or the Medicare safety net. That has been the case for some considerable time.

The threshold decision on abortion so far as the Commonwealth is concerned and so far as this parliament is concerned was made nearly 30 years ago. That occurred in the Lusher debate of 1979, where this House resolved:

... this House is of the opinion that the Commonwealth Government should not pay any medical benefits for or in relation to the termination of pregnancy unless the procedure is performed in accordance with the law of a State or Territory.

No Commonwealth government has sought to disturb that approach since then. It is open to members, senators, ministers or prime ministers who conscientiously disagree with that approach to seek to disturb or change that position and approach. But the key point is this: this parliament long ago made a threshold decision that abortions are legally available medical procedures for women to choose under the laws of the states and territories, and the Commonwealth parliament and the Commonwealth government accept that and fund that.

I make that point because I have seen the argument that to agree with this bill is to abrogate responsibility as parliamentarians and to leave the question of abortion to faceless bureaucrats. Mind you, these so-called faceless bureaucrats are the same people—scientists, medical practitioners, clinicians, specialists, experts—to whom we leave the decision making to judge the safety and appropriateness of medical procedures and pharmaceuticals. We leave it to them on the public policy basis that these decisions are best made by experts reliant upon the best scientific and medical advice, not by ministers, members or senators. That is why this parliament established the Therapeutic Goods Administration. As a matter of public policy, the parliament believes the TGA is best placed to make those decisions.

I make this point about threshold decisions and the legislative framework because I believe there is an appropriate analogy here. The last occasion this House had a conscience vote and a conscience debate was in respect of stem cells. We said that was a matter of conscience, and as a parliament we made a threshold decision. We determined the parameters of the use of stem cells for research and we expressly prohibited a range of approaches. Having determined the parameters, members of this parliament are not now in every laboratory or every research facility making day-to-day clinical or research decisions. Those day-to-day clinical and research decisions are made on the basis of science in accordance with the legislative framework and the threshold decision this parliament has made.

The same is, in my opinion, true of this debate. Having accepted the parameters and the threshold about abortion, the issue of this bill is whether a particular medical approach, a pharmaceutical, should be available in addition to surgical procedures for abortions under state and territory laws. The judgment has to be made whether that is a safe and appropriate medical procedure and approach. I believe that decision is best left to clinical, scientific, medical expert advice. That is the best way to judge the risk and the appropriateness of its use. As I said earlier, that is why as a parliament we established the Therapeutic Goods Administration.

I believe things are qualitatively different now than when this parliament made its previous decision in 1996. The TGA is now in a position to review international experience of over a decade. RU486 has been used in the United States of America, the United Kingdom, New Zealand, Israel and France for over a decade. The TGA can assess the clinical and medical experience from those countries. The TGA, in my view, is best placed to judge the risks, not a member or minister of this parliament. I have seen no argument which would persuade me that RU486 should be treated differently—should have a separate or different approach—to the 50,000 or so items which the TGA has previously dealt with. I do not believe that this is an abrogation of responsibility. I believe that it is a sensible public policy judgment that the TGA is best placed to make that assessment. I oppose the amendments because they would simply see this same debate brought back here on a case-by-case basis.

If the Prime Minister, the Minister for Health and Ageing or any other member or senator in this parliament as a matter of conscience disagrees with the threshold approach that the Commonwealth has taken or with the legislative framework that exists, it is open to them as a matter of conscience to do something about it in moving to take away Commonwealth financial and funding support for the current framework. I do not believe that will occur. I do not believe that the Prime Minister or the Minister for Health and Ageing would do that—and that is because, I believe, a clear majority of Australians believe that the current framework is appropriate, based as it is on regarding it as a matter for an individual concerned, on the basis of medical advice received from a medical practitioner.

I have seen some criticism that to adopt such an attitude is to promote abortions. I find the idea of one abortion profoundly distressing—let alone how profoundly distressing it must be for a woman who has to choose to have an abortion or not have an abortion, whether the reason for the abortion is the health and safety of the woman concerned, the fact that the sex causing the pregnancy had not been consented to by the woman concerned or that the pregnancy was unplanned.

It was said earlier that slogans in this area are not useful, and I think that is right. But my attention has been drawn to the comment of a former President of the United States, who said that he wanted abortions to be safe, legal and rare. If you want abortions to be rare, in my view, you have to be up front about sex education in schools and in the wider community and up front about contraceptives. If you want to ensure that abortions are minimised or rare, you have to be up front about prevention.

It has been suggested also that this is a debate or an issue where only women can have a view; that men are not entitled to have a view. I profoundly disagree with that sentiment. We are all equal members of our society. But, just as equally, I strongly agree with the view that no woman or man should seek to impose her or his view on an individual woman who is making a choice about whether to have an abortion or not.

As part of this debate, some have suggested that the Minister for Health and Ageing has been attacked for his Catholicism. I do not attack or criticise the Minister for Health and Ageing or anyone else for being a Catholic or for not being a Catholic—for holding religious views or not holding religious views. It has to be said, though, of the Minister for Health and Ageing that, as a member of public office, he does wear his Catholicism on his sleeve. This will see some supporting him and some criticising him. In my experience, the vast bulk of practising Catholics, whether they are in this place, in public life or in the wider community, do not wear their Catholicism on their sleeve. They practise their Catholicism quietly, conscientiously and reverently.

If I were to utter in public a criticism of the Minister for Health and Ageing, it would be this: advertently or inadvertently, he seems to have made this issue and abortion the sole test of Catholicism. I do not believe that that is right. Members of the Catholic community that I speak to have diverse views on abortions; they have diverse views on RU486. Some—or many or the majority; I do not know, and I do not seek to quantify it—devout practising Catholics do not follow the church’s teachings and rulings on these matters. But I do not believe that makes them any less of a Catholic. I do not believe that this issue is the sole or single test of Catholicism or faith.

I have, for example, in my own electorate in Perth been subject to the views of a woman over 70 years of age who is a devout Catholic, who tells me advisedly and assuredly that, when it comes to abortions, ‘Stephen, it has nothing to do with the Pope; it has nothing to do with you as a member of parliament. It is something for the woman concerned in consultation with her own doctor.’ So there are diverse views, as far as the Catholic community is concerned.

I might just draw from an example that I found in the West Australian in February 1998, where a Catholic woman who had had an abortion regrettably had that matter made public. The woman became pregnant when her husband’s vasectomy reversed itself. The woman, who was named as ‘Sue’—although that is not her real name—was Catholic, had three children and also had had three stillborn babies. She is quoted in the West Australian as saying:

We are people—

referring to herself and her husband—

who value human life. We approached this decision with a great deal of difficulty. I believe my God is a forgiving God. My God will forgive me for what I have done.

There is the view of one devout Catholic who had an abortion. It was a profoundly difficult decision but, if in the end she had done the wrong thing, her God was a forgiving God and her God would forgive her.

I have not seen an argument that would persuade me of anything other than that the correct public policy position in this area is that the question of the use and availability of RU486 should be left, in the usual manner, to the scientific, medical and expert advice of the Therapeutic Goods Administration and that, if the Therapeutic Goods Administration authorises its general availability, medical practitioners in individual cases should make decisions about its use in particular circumstances, depending on their expert medical advice. I commend the bill to the House.

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