Louise Miller-Frost (Boothby, Australian Labor Party) Share this | Hansard source

I'd like to thank the member for Bonner for sharing her deeply personal story that beautifully explains the importance of Women's Health Week.

I speak with a little authority, I hope, on the topic of women's health. I have decades of personal experience—I'm not going to tell you how many decades—with the health system as a woman, through puberty, decades of polycystic ovary syndrome, fertility, high-risk pregnancy and childbirth, postpartum care—that would take a couple of hours to talk about—and, dare I say it, perimenopause and menopause. In a past life I also ran women's health and safety services in the central northern Adelaide health service, a unit of SA Health, providing services to two-thirds of the female Adelaide population and also statewide breast screening. My portfolio included two women's health clinics that specialised in working with women who faced additional barriers to accessing health care, particularly preventive and screening services, through their cultural background, poverty, domestic violence or coercive relationships. I ran a community midwifery service, two domestic violence services and a perpetrator rehabilitation unit as well as multiple BreastScreen sites and buses that travelled to remote areas such as the APY Lands.

The experience of women in the health system is often one of not being believed. Their pain isn't believed or is minimised, and their symptoms aren't believed or are normalised. I recall taking a call from a family whose 14-year-old daughter was having her first period and was in severe abdominal pain. We sent a doctor out, who told her that her pain was normal and that she'd get used to it over time—that this was what being an adult woman was like. She was crying, guarding her stomach and very distressed that this was the future that she was looking at for her adult life. When she was still getting worse a few hours later, her parents arranged for her to see another doctor, who diagnosed her with appendicitis and sent her to hospital for an emergency appendectomy. Her pain, unrelated to her women's issues, had been normalised and minimised, and the rationale of period pain meant she had a substandard medical experience that could have been life threatening. It's little wonder then that women with endometriosis typically take up to seven different doctors and between seven and 10 years to get a diagnosis, let alone an effective treatment plan.

Improving the health and wellbeing of all women is a key priority for the Australian government. The experience of women in the health system is not the same as the experience of men. Women experience delayed diagnosis across a wide range of conditions and diseases and tend to use healthcare services more than men. This includes GPs, specialists and hospital admissions. Women spend more on out-of-pocket healthcare costs than men, and younger women spend more than men their age, partly due to maternity care and the higher prevalence of chronic illness.

In 2023 the #EndGenderBias survey looked at the unique barriers and gender bias women face in Australia's healthcare system. From across the country there were 2,570 responses about women's own experiences. Two-thirds of women reported that they experienced health care related gender bias or discrimination. Gender bias in health care has a far-reaching impact on women's lives. Women report feelings of abandonment, shame, blame and self-doubt. If you're repeatedly told that the pain isn't real but in your head, where do you take that? Women report significant financial burden and lost educational and career opportunities from untreated or ineffectively treated conditions. Delayed diagnosis and treatment lead to disease progression, fewer treatment options and worse health outcomes. Conversely, women recounted positive health experiences that stemmed from strong interpersonal interactions and relationships. When you find a good doctor or a good midwife who you gel with, that's gold.

We also know that medications and treatments are standardised on men. It used to be that medications were trialled on male uni students, typically white, wealthy, 21-year-old men—hardly a standard population, let alone relevant to women, who have different hormone profiles, which interact with medication. We know the classic heart attack symptoms that get taught—crushing chest pain, shortness of breath, pain radiating to the shoulder or jaw—are the symptoms of men, and this a significant impact on the treatment and care you might get if, for instance, you're a woman with typical women's heart attack symptoms, which are often much more subtle and different. A Sydney university study found that women are half as likely to receive an appropriate diagnostic test and treatment for heart attacks. It's little wonder that women have much more poorer survival rates than men. Six months after a heart attack, women are twice as likely to have died than men.

Of course, women with other barriers—language barriers, cultural barriers, poverty barriers, social isolation barriers, geographical isolation barriers—and those experiencing domestic violence or coercive control, or a combination of all the above, experience even worse health outcomes. We know that women of colour are even more likely to have their pain ignored.

The Albanese government's National Women's Health Strategy outlines a national approach to improving health outcomes for all women and girls, particularly those at greatest risk of poor health, and aims to reduce inequities in health. The Australian government is investing $792.9 million through the 2025-26 budget to increase the capacity of the primary care workforce to support women's health needs, increase access to services and make both services and medicines more affordable. This includes $159.9 million to make it easier for women in Australia to access and afford long-acting reversible contraception, LARC, one of the most effective and reliable methods of contraception. LARCs are extremely effective and reliable and are a cost-effective way for women to manage their fertility and contraception, but the uptake in Australia is considerably lower than comparable countries around the world. We have around a 10 to 11 per cent uptake, whereas in Sweden, the UK and parts of Europe it sits just under 30 per cent.

Needless to say, when choosing contraception, the woman's doctor plays a fairly important role. If your doctor doesn't feel confident inserting the LARC, than you probably aren't going to have it offered to you. So this women's health package includes $71.5 million to increase four LARC item fees in the Medicare Benefits Schedule and the creation of new items for nurse practitioners to claim these services. This measure will incentivise healthcare professionals to provide LARC insertions and removals with no out-of-pocket service costs through better remuneration.

We're also providing $64.5 million for increased endometriosis and pelvic pain, perimenopause and menopause management and support, including another 11 new endometriosis clinics on top of the 22 that are already in existence. We have an endometriosis clinic in Glenelg, in my electorate, and the stories I hear from women who've found their way there are inspirational. In many cases, they've suffered for decades. It affects their ability to hold down a job and therefore to have income and retirement savings, to have a social life or an intimate relationship and to exercise or maintain their general health. They spend their lives at home curled in a ball on medication.

The endometriosis clinic is Multi-D. It not only helps people through a coordinated care plan between the GPs and the specialists and the allied health professionals but helps them develop plans, similar to an asthma plan, to work out their triggers, recognise early symptoms and know what to do when that happens and went to seek further help. For many of these women, the most important part is finally being believed and then putting all of the other symptoms together and understanding they're all part of the same condition.

We're investing $26.3 million to implement a temporary new health assessment MBS item for women experiencing menopause or perimenopause. This will be introduced for an initial two-year period. This is another area where women get substandard care. They're expected to just continue on, yet there are often long-term, life-impacting health impacts from not managing your menopause symptoms. So to be able to have a doctor spend that time to have a look at what is actually happening in your life and provide you with the treatment that you need so that you can manage the symptoms and any long-term health effects that come out of that is so important and will be life changing for so many women.

Deputy Speaker Mascarenhas, this is Women's Health Week, and I'd like to say to you and to all the women here, 'Say yes to you.' It's time that we looked after ourselves.

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