Thursday, 16 February 2006
Therapeutic Goods Amendment (Repeal of Ministerial Responsibility for Approval of Ru486) Bill 2005
Debate resumed from 15 February, on motion by Dr Washer:
That this bill be now read a second time.
upon which Miss Jackie Kelly moved by way of amendment:
That all words after “That” be omitted with a view to substituting the following words: “ the House is of the opinion that the bill is unacceptable in its current form and the preferred policy approach should be:
- the Minister for Health and Ageing continuing to have the decision making role in relation to the approval of restricted goods as defined in the Therapeutic Goods Act 1989;
- the Minister being required to obtain written advice from the Therapeutic Goods Administration prior to giving written approval or refusal to approve; and
- the Minister’s decision being subject to disallowance by each House of Parliament”.
I rise today to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. There are those who have attempted to take the high moral ground in this debate by saying that support of this bill equates to support of abortion. That stance is not only wrong and misleading; it also overlooks the fact that there is no absolute right or wrong in this debate. Nor is there a high moral ground in either argument. Some might have reduced this debate to who is for and who is against abortion. It cannot be carved out into such a convenient, neat debate. Simplifying the debate into one about abortion overlooks the social pillar which makes this country a place in which I am proud to be the father of two adult daughters. It overlooks the rights of Australian women, and it betrays the freedom of informed individual choice. It also neglects the opportunity for experts to seek a less traumatic process for those women who have made one of the toughest decisions a human being can ever make.
This is not a vote in support of or opposition to abortion. It is a vote about choice. There are those who argue that RU486 and its introduction will increase the number of abortions in Australia. Based on the experience of those countries which have already legalised RU486 I can see no evidence that the introduction of RU486 would lead to higher abortion rates in Australia. I would hope that provision of choice through the introduction of RU486, should it be seen to be safe, would lead to a greater consultation and consideration of all options by patients and their doctors before the final decision is made, and that this would in turn lead to fewer abortions. No-one is arguing for abortion. No-one is pro-abortion. I certainly am not pro-abortion; quite the contrary. But the practice is an abhorrent reality in Australia now. The question is whether we as a democratic country give individuals the choice of a medically approved and medically supervised pharmaceutical abortion option or do we, on the other hand, continue to prescribe the intrusive surgical procedure to which women currently subject themselves, having made the decision to have an abortion.
This vote is about providing a medically approved option, not a political response to one of the greatest ethical debates of our time. While it is certainly a major public ethical debate, it is before that an agonising personal decision. I am not convinced that public office bearers such as us should have a guaranteed place in the politics of the personal.
There are those who want to define this debate in political terms. They say it is a hard decision, so politicians should make it. This is not a political debate, and that has been signified by the fact that we are not dividing along party lines and that each and every one of us must consider the issue through a personal, not political, prism. Frankly, if it becomes a political decision, there is no guarantee that the safety or otherwise of RU486 will ever be considered by the medical experts. It runs the risk of becoming a process tainted by prejudices on both sides, one that is simply too difficult for a pharmaceuticals company to navigate. The result would be that pharmaceuticals would not be put forward for assessment because of the lack of clarity and certainty in a politicised process.
Dr David van Gend said on the ABC two days ago:
You cannot meaningfully assess a drug designed to take life, using the same criteria as you’d use for a headache tablet or an ulcer tablet ...
I agree. Why, then, are we thinking about leaving that complex medical decision to a politician or a parliament? The use of RU486 is a medical decision for which we have an expert medical body. The TGA members are qualified to make such an exact medical decision, based on expertise, experience and knowledge. The use of RU486 is a decision which should be made in a medical environment between individuals and their doctors, with full consideration of the individual’s personal circumstances and needs.
Like it or not, abortion is legal in this country, and if a woman has made that decision it is not for me to judge what method is best for her to resolve that situation. That is a matter for her and her doctor. By what means we politicians have garnered the expertise to make such a precise technical and medical decision is unclear. In the main, we do not have the experience and we do not have the medical insight. I thank those in this place who do have that expertise—the members of parliament who are doctors, like the member for Moore—who have explained the greater health and social need for a medically approved pharmaceutical option.
The best path forward is to put in place a process using an expert, medically qualified body to properly approve the drug’s use. Therefore, I will be voting for a system in which those people who are best qualified to judge the risks of this treatment are able to do so. I also support the use of greater counselling and guidance as the only way to reduce the number of abortions in Australia. I agree, as do many members of this House, that that number is alarming and too high. I, like many other members who have spoken on this bill, including the member for Cowan, strongly believe that school sex education should be reviewed to play a greater role in the overall education of Australian children, thus avoiding unexpected pregnancies in the first place.
In conclusion, I would like to thank the many constituents who have contacted me on this issue and expressed their views. This has not been an easy decision for me, and I know that I cannot please all of my constituents with my final resolution of my position. But I have to return to my belief that politicians do not have a place in such an intensely personal and individual medical decision. I therefore support the bill as presented to the House.
In rising to discuss the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, I acknowledge that this is probably one of the most difficult debates that we will have in this House—as was the last conscience vote, on the embryonic stem cell debate. The interesting thing is that, in looking at this debate and at the contributions, the Australian public can see that politicians are people. Politicians are painted in a very negative light in the media. They are pilloried for being colourless. They are pilloried for not having values. They are pilloried for not having principles. But we have seen a very strong demonstration of those qualities in this House during this debate over the past two to three days. It shows that when we have the capacity to debate these issues we can show who we are as people and who we are as politicians. They are inextricably linked. You can be a person and a politician at the same time.
We have a debate, in my view, that has been characterised in several ways. Some have put forward the view that the debate is about a matter of process. Some have put forward the view that this is a debate about religious values and principles. Some have put forward the view that this is a debate about abortion. I think it is a debate about all of these things. Regardless of whether or not we use the term ‘process’, we as members of parliament are debating here whether or not we believe that approval for a particular drug and the power to determine whether or not that drug is released into the Australian community should be delegated to a body like the Therapeutic Goods Administration or whether the decision about the release of this particular good should be made by this parliament.
I have been very much taken aback by the level of response that I have received from members of my constituency about this debate. There is some level of discussion about a disengaged electorate, a disengaged population, but on this issue I have had one of the strongest responses that I have ever received—not through pro forma emails and letters from religious groups and otherwise but from individuals who were prepared to leave their name, their telephone number and their address. These individuals were prepared to talk about their experiences as a father or a mother or about their experience of having had an abortion. They were prepared to share their lives with me. I cannot take those considerations lightly, whether they have argued for this bill or against it. But I can say to this House that in my electorate, which has a very large number of families, the overwhelming level of response that I have received has been that I should not support this bill. That has been argued passionately and strongly.
This is not an easy debate to have, because it is inextricably linked with abortion. I do not think we can say that it is not. The drug that we are debating is a drug whose end process is to cause abortion. The question that we as parliamentarians have to ask is whether, when such a drug comes into this country or there is an application for a drug like this to come into this country—not just an abortifacient, which is what this drug is, but other potential next-generation drugs—we are going to allow the enormous responsibility for its approval to be carried by a body like the TGA or whether we are going to say that we have a right to make a decision on behalf of the Australian people, taking into account the Australian public’s views.
One of the great things about this debate at the present time is that an enormous array of views has been provided. That is what makes Australia a great democracy and it is what makes this parliament a great democracy. We are going to get divergent views about this issue. But we are having a debate about this matter because parliamentarians put forward their point of view that the present minister should be stripped of his capacity to regulate against a drug or to regulate whether or not this drug should be allowed in this country.
In reflecting upon this, my view is this: as a parliamentarian who has been elected to this place to make responsible judgments on behalf of the community, I believe that abrogating my responsibility by passing on responsibility for a drug like this or any similar next-generation drug would be a failure of my duty to the Australian people. A bond is made in a contract with people who elect you to this place.
In the responses that I have received from people, they passionately want me to advocate their particular point of view in this place. As I said, it is a huge issue within the community. To say that issues like abortion and similar issues such as embryonic stem cells are not issues that we should actively debate in this parliament in my view is wrong.
One of the contributors said that in America this issue has been dealt with—that the drug has been approved, that it is on the market. But I have received a letter—I think a number of parliamentarians have—from Roscoe Bartlett from the US House of Representatives, who is saying that they want to have the capacity to debate this issue again. Those who say that this issue will not come back on the table again if this bill is approved are wrong. These are issues of great social impact and moment.
I am not just talking about this particular drug as an abortifacient. There are other gigantic issues. It is the inexorable march of science versus a society which has values and principles, opinions and ethics. This is the clearing house. This is the place where decisions of that magnitude must be made. They cannot be made by an unelected body.
I am not here to contest that the Therapeutic Goods Administration is scientifically qualified to be making a judgment about whether or not this drug has the efficacy required or minimal side effects. I am not going to debate that in the House. These people are more qualified than I am to make that decision. But I am here to say that we, representing community values, principles and ethics, should be the ones who should make a decision about whether a drug that causes the level of unease and debate within the community should be released into that community. I will fight to the end of my political life to ensure that that principle remains.
My belief is this: a minister duly elected and appointed by the government does have a right to make a decision about whether goods of this nature—restricted goods; and, as I said RU486 is one example of a drug that could come onto the market—should be allowed to be brought into this country. I believe that both of the amendments are somewhat imperfect but well intentioned. I signal to this House that I intend to support those amendments and vote against the bill.
I want to mention one of the contributions I heard. The person was talking about pharmaceutical companies not wanting to apply—as though pharmaceutical companies are small backyard operations. Pharmaceutical companies are multibillion dollar industries. They have enormous clout. They have enormous lobbying power. We see their lobbyists strolling in the corridors. These are not backyard operations manufacturing drugs; they are organisations with enormous power and influence.
For some time I have had some concern about the value of some of the scientific research that has been paid for and funded by some of these pharmaceutical companies. Some people use the argument that, because there is unfettered scientific research that is presented to the TGA, the TGA should be the ultimate body that makes a decision. But bodies like the TGA can be wrong, particularly on issues like this. We cannot just say that the TGA has a divine right to make proper decisions and right decisions all of the time. I reject the idea that the TGA is a body that makes a perfect decision every time. We cannot say that. What happens if we have a new-generation drug—which could, for example, be grown out of embryos or something like that—where the drug company funds the research that there are no side effects and then 15 years later we see that there are. Then we are going to blame the TGA.
In essence, when a drug inspires community debate to the level that RU486 does and evokes the level of community response that this drug has, we cannot abrogate to that particular body our responsibility to make decisions about whether or not that drug should be released. The members of the TGA were not elected to contemplate the moral, ethical and values based reasons as to why a good should not be released.
I feel very strongly about this point. I was very heartened by the comments of the Prime Minister about ministerial accountability and responsibility, about elected officials making decisions. I look forward to seeing a further application of that in some other issues that we will debate. On issues of our time, issues that cause huge social impact, that resonate strongly in the community, that affect large sections of the community and run against people’s faith, values and principles, this is the place to make a decision. This is what we were elected to do. As a duly elected representative of Holt, on behalf of my constituents and exercising the principles that I enunciated, I will not support the bill but will support the amendments.
In looking at this issue—and I have studied it for some time—I first of all looked at why the Minister for Health and Ageing made the decision he made. It seemed to have provoked a reaction amongst the women in the Senate. I searched, without discussing it with him, for information that was in the public arena. First of all I looked at the international experience, which is something that I think we all do. I found that, at the moment, the United States Food and Drug Administration, FDA, are currently investigating the drug RU486. They had made a decision previously but they have come back for a re-examination because of some problems that have been obvious in the American community. There is a congressional subcommittee looking into the original application and whether or not it was appropriate or flawed. There is currently before the United States House of Representatives a bill calling for the suspension of sales until the safety of RU486 is confirmed—House of Representatives bill No. 1075. I think if there is concern of that strength in the United States, the responsible minister would have to take note of that.
Italy is restricting imports of RU486. A trial that was being conducted with RU486 has been suspended because accidental abortions have occurred with women taking this drug in their homes. That is the Italian experience. A trial was also commenced in Canada. It was suspended and the drug has never been registered in Canada.
A responsible minister would note these things and make a decision for the Australian people, given advice that he received from the officials he asked. The Chief Medical Officer of the Commonwealth was specifically asked by the minister about the use of the drug RU486 in country areas. In addition, the same view has been expressed in a letter circulated to us by David Gawler, a consultant surgeon in the Royal Darwin Hospital. He specifically mentioned that he believed that there would be particular problems in the use of RU486 by Indigenous women in remote areas of the Northern Territory. Dr Alan Eggleston, a senator, who has practised as a GP-obstetrician in remote areas of Australia, expresses a strong point of view. He says:
So, from my point of view, I cannot see any net gain to the Australian community from permitting RU486 to be made available in Australia as a means of terminating pregnancy instead of using the currently available and safe surgical methods ...
I think the evidence bears that out to be the truth. It is said that RU486 is a safe drug. If one assesses the problems that have occurred with RU486, if one compares the accident rate with this drug as compared with a surgical method of abortion, it is three times more likely to cause a death up to the 49th day. Those are the world statistics. If you take it across the term of the pregnancy you get another result. For up to two months it is 10 times more likely to cause a problem. So it is not safe as compared with a surgical system. So a responsible minister, noting these things, would have to say, ‘I want to put a brake on this release and the assessment of this product for the Australian community because, internationally and from our own experience, it is not at all clear that it is a safe product.’
The history of this drug is that no large pharmaceutical company in America would take on its manufacture. One of the pro-abortion lobby groups in the United States formed a company called Danco. They registered in the Cayman Islands and they proposed, and went ahead with, the manufacture of RU486 in China. That is the current situation.
On its own this drug will produce 60 to 80 per cent of successful abortions. But to achieve a 93 to 95 per cent successful abortion it has to be used in combination with another drug called Cytotec. The two drugs in combination produce that result. But there is a residual group of patients left. It is interesting the Danco firm requires women to make a statement they will consult their physicians; they will have a surgical procedure if this process fails. There are a whole lot of let-out clauses with the use of this drug. I do not think, to use the words of one of our colleagues in this place, it is ‘cherry picking’ to say that this drug should not be used.
A paper by Greene in the New England Journal of Medicine shows that RU486 at eight weeks is 10 times more fatal for the mother than a surgical abortion. My colleague said that the procedure has equal risks to surgical procedures. I am afraid that is not accurate, if one looks at an authority such as the New England Journal of Medicine. With the support of Mr John Wilks and Dr Obeid we have been able to examine this matter. These two men have written extensively on this issue and live in my electorate of Mitchell.
It has also been mentioned that there are already drugs on the market that will produce the same results. One is methotrexate, a drug that should not be used to achieve an abortion. The advice that I have is that to say it is equivalent and on the market already is inaccurate. This drug is used where the life of the mother is at risk and it is a last, desperate measure; it is not something that is used generally. To propose that there are already drugs available is not accurate. I am sorry that one of my colleagues has presented these facts as being accurate. I believe the arguments used in the Senate were more based on women’s rights, which is an important issue, than on the risk factors. The minister has weighed the risk factors and has said that we should not proceed to make this drug publicly available. He has exercised an appropriate responsibility.
A survey of 1,200 adults was conducted by the Southern Cross Bioethics Institute in Adelaide, which looked at their attitudes to RU486. When the participants were presented with eight arguments in favour of legal access to RU486 and then eight arguments against it, 36 per cent said they thought the arguments in favour were stronger than the arguments against, 43 per cent said the arguments against were stronger and 21 per cent could not decide. There was a slightly greater number in favour of the arguments against the use of RU486 in that sample. But when the arguments in some of the material on the international experience that I have spoken about were put to younger women—that is, those potentially more likely to use RU486—they responded very much more strongly against it and for holding a decision on it until there was greater certainty. Women of child-bearing age, those most likely to be affected, said there should be a delay in a decision. Over 60 per cent said that; whereas older women held about the same position as previously, without the explanation. There has been a narrow focus by some and I think it is unfortunate, because it is not a very compassionate view and does not seek the best results for women. They have focused on women’s rights rather than on the risk factors.
In this parliament we need to assess the risk factors as well as the right factors, and that is our responsibility. If we make decisions people do not like, they have the opportunity to scrutinise our decisions. If the TGA make decisions, people do not have the opportunity—no matter how well trained and how well informed the TGA may be—to scrutinise their decisions. The TGA, the Therapeutic Goods Administration, is a non-elected group. From listening to some of the speeches of my colleagues, it seems to me that one future role of the parliament may be to debate whom we should appoint to boards. Then we could let them make the decisions and we could go home while they ran the country! That would be a completely inappropriate role for the parliament. We could debate whether a person has adequate status, academic level and experience to fill an important position, whether it be on a wheat board or in the Therapeutic Goods Administration. We could debate that and then we could go home and let this administration make decisions. It would get to a point where we could encourage voters to vote for whom they wanted on various boards and not have a parliament at all. The logical extension of walking away from the responsibilities for which we are elected is to build distrust in the parliamentary process, because it means that nobody can be held responsible for important decisions.
RU486 is not the same as other drugs. I think that has been demonstrated. I think the minister has a role with respect to this on behalf of all of the community. To have an authority decide whether or not a drug fulfils the purpose for which the manufacturer says it is manufactured is one thing, but for it to then decide whether it should be used and whether there should be wide use of it is another. This is just one drug; there are no other drugs in this category. Why is it in this category? It is in this category because it is not a therapeutic and it is not a diagnostic. It brings about the conclusion of life. Other drugs may do that as part of their process, but that is not their purpose. This drug is different. We are elected to deal with public policy. We are not elected to administer or to give policy advice. That is the role of authorities like the Therapeutic Goods Administration. We are elected to make those policy decisions, and we should cherish that opportunity. We should value it and proceed to take the hard decisions. That is what people expect us to do.
Just because we have abortions in Australia does not mean that with RU486 we are now just introducing a new technique. This is a new policy. This is something different, and we have to deal with it as a new policy. It is not a change in technique. It is like saying that, because we can have exploration across the whole face of Australia, we should go and explore in the Great Barrier Reef. We make a special policy for things that are different. This is a special policy. The minister’s decisions, as I have said, are supervised. He can confront the press and he can be questioned.
The amendment to the legislation that has been moved by the member for Lindsay does the following. First of all, the Therapeutic Goods Administration gives an opinion to the minister. The minister assesses that, makes a decision and makes both public. Following his public announcement of the advice received from the Therapeutic Goods Administration, these matters come to the House as disallowable instruments. That means that within 15 days the parliament can vote for or against the minister’s decision. If it is carried, that decision will stand.
If we have the opportunity, I will vote for the member for Lindsay’s amendment. If not, I will vote for the member for Bowman’s amendment. But I will vote against this bill.
According to 87 per cent of Australians, there are too many abortions. Many people today have said that they disagree with the number of abortions. I am going to hold those members to that, because not one of them has put a proposal to this House for a significant change to the number of abortions. There has been no proposal for education programs, no proposal for counselling programs and no proposal for support programs. I intend to drive that, because we need to bring about those changes.
The debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 has produced very diverse and colourful contributions. At the outset I was prompted to reflect on the plight of people who are denied access to lifesaving drugs because of cost as distinct from not having access to a particular drug because it is in a restricted category. The breast cancer drug Herceptin is a case in point. There is no discretion for the minister to make a determination to allow a woman access to the drug at the PBS price where that drug is the only drug which, in the opinion of her oncologist, can prevent her death from breast cancer. The cost of a course of Herceptin is $60,000. In a recent case involving a constituent of mine, the only way a woman in need of that drug could access that drug was if her parents would mortgage or sell their house to pay for the drug to save their daughter’s life.
The answer to an inquiry to the office of the Minister for Health and Ageing, or indeed to the minister himself, is that he is powerless to do anything. It has to go through bureaucratic processes. So if you cannot raise the money in the case of a lifesaving drug, you die. Thus I would argue that the health minister needs more discretion, not less. I would like him to have the power to approve drugs to be cost effective to save the life of a life in being.
I know Tony Abbott and I consider him a friend. I believe he is a fine health minister and administers his department as a reasonable man. I accept his assertion that a vote in favour of the bill would amount to a vote of no confidence in him as it would say the House considered that he would exercise his discretion other than in accordance with the best interests of the Australian people. I do not believe this to be the case. I will thus vote against this bill. For the same reasons I will vote in favour of the Kelly amendment. I do not believe that the TGA is the font of all wisdom; for example, I thought its handling of the Pan Pharmaceuticals manufacturing scandal was very poor. I thought its handling of the investigations into Celebrex and Vioxx was equally poor.
In the course of debate on this bill I have listened to all the arguments and the opinions and considered the issues at great length. My office has received a large variety of communications, the most numerous being campaign material. Individual letters showing original thinking were very rare but valued. I found threatening correspondence contemptible. I would like to thank the people of my own electorate who took the trouble to write, to phone or to email me their thoughts. I am grateful for their wishing to participate in this discussion.
It is not often that members have the right to cast a free vote in this place and be bound not by party lines but by our individual consciences. It is a rare occurrence and the responsibility of this conscience vote is indeed overwhelming, particularly in view of the huge volume of information that has been provided to all members on this important private member’s bill.
Before making my decision to support the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, I weighed up and considered very carefully the facts and information provided in relation to the bill. I have listened to both sides of the debate in both chambers and read and studied the views of the community. I would like to put on record my sincere thanks to all those people who have contacted my office by phone, by email and by letter. The input from many individuals, people I highly respect, has also been welcome.
As members of parliament we are elected by our constituents to make the tough decisions, and there are times when not all will agree with the decisions we make. I know my decision to support the bill will upset some in my constituency, but I have not taken my position lightly or without a lot of thought and consideration. In the brief time available to me today I would like to explain why I have made this decision.
This debate is not an abortion debate. It is not a debate about the morality of abortion or the principles and values of members elected to this House; this is a debate about the process of approval—a debate about separating politics from medical decision making. The abortion debate happened many years ago. Abortion is legal in this country. Men and women democratically elected to our state and territory parliaments made laws with regard to abortion and the criteria that must be met to terminate a pregnancy. These laws have been in existence across this country since the late 1970s.
That is not to say that abortion is not a very difficult and sensitive issue. We have certainly witnessed that by the emotions evoked in the community over the last few weeks. There is not a person in this place, nor I would suggest in this country, who supports abortion. All of us would prefer that no woman were ever confronted with the trauma of an unwanted or non-viable pregnancy, but it is not my position to pass judgment on a woman’s decision to terminate a pregnancy. That decision is between a woman, her doctor, her partner and her family.
As an elected member of this House it is my responsibility to ensure that a woman is able to undertake a termination in accordance with state and territory laws, knowing that this country provides the safest and most effective means available under medical supervision to undergo that termination. Of course, we would all like to see fewer abortions—that goes without saying—but that is a debate for another time. That is not what this private member’s bill is about. As I said before, this bill is about the process for approval of a drug known as RU486; it is not a debate about my position on abortion nor indeed the parliament’s position on abortion.
That brings me to the bill before the House today. I think it is important that the community understands what is being debated and why we are having this debate. This debate is about who is best equipped to identify, assess and evaluate the risks of RU486, a drug which belongs to a special category of drugs under the Therapeutic Goods Act 1989 known as restricted goods. It is my view that the Therapeutic Goods Administration is the body to undertake that process. I do not have the expertise, nor, could I respectfully suggest, does the minister for health, to undertake an evidence based risk evaluation of RU486.
In my view, members of this House and of the Australian community who are concerned about the safety and efficacy of this drug should welcome a scientific, evidence based evaluation by the TGA. That evaluation by eminent specialists, all appointed by the Minister for Health and Ageing, will ensure that women in this country can make an informed, safe and educated choice about whether or not they undertake a medical termination or a surgical termination. Women should be provided with all the options available to them so they can make that informed choice.
It is important that the community understands that access to a medical termination using RU486 is not about over-the-counter, do-it-yourself termination. Access to RU486 is not about making abortion easier for women. To comply with state and territory laws, terminations—whether procured medically or surgically—require medical oversight and approval. If a state requires that a woman satisfy physical and mental health tests before qualifying for a surgical abortion, she will be required to satisfy the same tests to have a lawful termination using medical methods.
So, who or what is the Therapeutic Goods Administration? What is the make-up of this body, and what is its role? The TGA is a unit of the Australian government Department of Health and Ageing. Its role is to carry out a range of assessment and monitoring activities to ensure that therapeutic goods available in Australia are of an acceptable standard, with the aim of ensuring that the Australian community has access, within a reasonable time, to therapeutic advances. The current government and former governments have trusted this body to assess the safety and effectiveness of tens of thousands of medicines, many of them dangerous, and it is my view that that trust should continue in the future. I repeat: the TGA is an arm of the Australian government Department of Health and Ageing.
A committee of the TGA is the Australian Drug Evaluation Committee, or ADEC, a committee that was formed in 1963 and given the role of providing independent scientific advice on new drugs, within the policy framework of the time, to the federal government. The Minister for Health and Ageing appoints the members of the Australian Drug Evaluation Committee. The appointments to the committee include six or seven core members and 10 to 20 associate core members. The make-up of this committee—the eminent men and women appointed by the minister—is impressive. They are leading specialists in a variety of medical fields. In my view, they are highly capable of assessing and evaluating the safety and the efficacy of RU486. These eminent people are not faceless, unaccountable, undemocratic bureaucrats; they are appointed by the minister and accountable to the minister.
Based on this information, it is my belief that the TGA, with such eminent men and women, has the ability to assess the quality, safety and efficacy of this drug. With no disrespect to my colleagues, I do not believe we are qualified, nor do we in this House have the expertise or ability to undertake the assessment process of RU486. This is a job for the experts, and those experts are in place, appointed by the minister, to carry out that assessment process.
I am more than satisfied, and I would like to assure my community, that this evaluation committee can and should undertake the assessment process and report back to the Minister for Health and Ageing on the safety and efficacy of the drug so that Australian women, in consultation with their medical practitioners, can make an informed decision about a medical termination if and when they are faced with that situation.
Over the last couple of days there have been many speakers on this bill. There have been emotive arguments and many different points of view, and the spirit in which the debate has been undertaken is a credit to all in this House.
On a final note, I would like to comment on the amendment that has been put forward to the House by the honourable member for Lindsay and on the second amendment that has been flagged by the member for Bowman. He has indicated that he will table that amendment during the consideration in detail stage. I have taken the time to read both those amendments, and I reject them. I do not support either of the proposed amendments. I will be supporting the bill as it stands.
A free vote is not easy. It is up to the individual to weigh up the arguments, the issues and the public input, to do their own research and evaluation of the information that is available and to satisfy themselves on the integrity of the bill before the House. I am satisfied that the Therapeutic Goods Administration is the appropriate and best equipped body to undertake the expert assessment, to weigh up the medical evidence and to deliver a considered judgment about the risk and benefits profile of the drug. I commend the bill to the House.
I rise to speak in support of the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. Yesterday afternoon in the Main Committee in the debate upon the appropriations, when I thought that I would not have this opportunity, I made some brief comments, and I welcome this chance to expand upon them. Through my duties in the chair, I have sat through three hours of this debate, a debate that I think gives great credit to this chamber. Members have taken this opportunity of a debate where their views are based upon their consciences and have done so with great thought and great deliberation. I think that that has characterised the way in which this issue has been handled in both chambers of the parliament.
I would only have criticism of the actions of perhaps two of my parliamentary colleagues. The wearing of an offensive T-shirt in support of a position did not help the tenor of the debate. Whilst I defend people’s rights to sloganeer, I think that when we get to this level we have to be very careful about the way in which these gestures are construed. And I regret that the member for Hughes has made comments that are so widely open to interpretation. Five per cent of those in my electorate are Muslim. They are great contributors to my electorate. They are great contributors to the community in which they live. Given that, on balance, the views shared by those people are shared by people of wider and different religious views, I do not think that those comments added anything to the debate.
The comments that I intended to make in this place when I was being driven into the house this morning have actually changed, partly because of what I have heard over the last hour and partly because Father Eugene, a former constituent of mine, is in the gallery today. He knows that we have different views. But I say to Father Eugene that I have always appreciated the way he has approached me, in a non-threatening way, and how he has always challenged me to make a decision on the matter before me based on the values that I have grown up with, acknowledging that there are different views. I never thought that I would say this but I have missed his guidance over the last few days, even if I will have failed him yet again.
I can say to Father Eugene that I have been approached by his former parish, which has consistently put similar views on these matters of conscience. I have tried to be consistent as well. His successor as parish priest said to me in a letter that ‘Catholics are copping it’. I would hope that that was not how this debate was being seen, because that would be a regrettable perception.
The people that I represent are from a variety of backgrounds. Ironically, when I was first elected a number of decades ago, I represented the electorate in the Australian parliament that had the greatest percentage of Catholics, with 44 per cent. They were mainly from Italian and Maltese backgrounds but, in the same way that Australian migration has changed, Catholics from all parts of the globe have come together on the basis of their faith. St Francis of Assisi parish in Mill Park is an example of this.
Muslim Australians in my electorate and people of various faiths make a great contribution to the community lives of those I represent. I am always heartened that people will come to me to discuss these issues and that they will give me the opportunity to defend my position. Whilst the representations that I have received might be modest in number compared with those of other members of parliament, that is the wont of my electorate. I understand that they represent a deep body of feeling, so I do not discount them on the basis of that modest number.
Why have I come to my conclusion? In part, it is because I have had the opportunity in this place to see how the TGA and the pharmaceutical industry work and how the approval of drugs has been undertaken in the past. Accordingly, I have come to the conclusion that there is no reason that RU486 should be treated in any special fashion.
This morning I was heartened by the member for Mackellar’s logical extension of the argument that this power should remain in the hands of the minister, which is that the minister should have this power with other drugs. That is the logical, consistent outcome if you believe that the present system should continue, and I do not believe that that should happen. I believe that it should be treated like the tens of thousands of other drugs.
Other contributors have discussed some of the literature about the safety of RU486. If we went through the literature on a number of the other 50,000 drugs that have been approved, I would be certain that you would find similar safety issues. However, we are not expert enough to make judgments on those matters, and it is not as if we as elected officials have abrogated our responsibility. The TGA operates under a legal and regulatory framework set by this parliament to ensure the quality, safety and efficacy of drugs, including those of higher risk. I would expect the TGA, as it has done in the past with other drugs, to take on board evidence that has been presented to the United States Food and Drug Administration and other bodies.
This debate is not about the approval of the drug; it is about the process that might be used for that approval to go forward. To discuss it in the context that we think there is finality decries the TGA’s opportunity to go about its business. Given that RU486 can be used not just as an abortifacient but for other purposes that I think people would not debate—for instance, as an anticancer drug—let us remember that what we are asking the TGA to consider is the safety and efficacy of this drug in a process that is legal, and that this piece of legislation does not in any way go to the legality of abortion or otherwise.
As I said in the Main Committee yesterday early afternoon, the fact that the member for Warringah is the minister at this particular point in time does not sway me on this bill. I regret that he would think that the passage of this bill is a vote of no confidence in him.
You should not be such a sensitive petal. The context of the matter is that either his predecessors or his successors as minister may have absolutely different views that people might perceive as driving them. In that context, I do not really care what those views are. I think that we should see this as a drug that can be treated in the same fashion as other drugs. It is on that basis that I have come to this conclusion.
I once again thank those from my electorate that have approached me. I look forward to continuing to discuss matters such as this with them. We have to come to a mutual understanding of what drives us. In the past I have appreciated that people have realised that we, as a collective of individuals, bring value systems and beliefs from a variety of backgrounds but with great honesty, with great directness to our electors and on the basis that we think we are using our conscience votes in the best interests of those the legislation will serve.
In all conscience, if there is a process that might give a woman an alternative to consider in consultation with her medical practitioner and her family, of course those decisions will be made on an assessment of the risk and what is best for the situation. Nothing changes because of this legislation in the way that we do those things. There is risk not just in procedures like terminations, where we discuss the use of the drug in a medical procedure or the alternative surgical option. In many other processes that have a degree of risk, whether it be the use of a drug or a surgical procedure, these decisions have to be made between the medical practitioner and the patient.
I believe that in this debate the chamber has done itself great credit. I indicate my support for the legislation that is before us and my opposition to the amendment that is before us and the amendment that has been foreshadowed.
I am very pleased today to be speaking to the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. Before I commence with my thoughts—and I have listened intently to many of the speakers that have appeared before the House—I would like to thank my constituents and the many people who have written to me and emailed and telephoned me. I thank them for their considered views. As an elected representative I value their input greatly. I also want to thank my colleagues for the manner in which they have conducted themselves. This is the third time that I have had a vote of conscience in this House. I have respected the views that others have held, even though I have not agreed with them on some occasions. The Minister for Health and Ageing is sitting here at the moment. I value and respect his enormous capacity as the minister for health, but on this occasion I will differ with him.
There are very fierce emotions as this abortion debate rages. Whenever we talk about access to abortion it elicits emotional responses around the world. We have already had that debate. Abortion has been legal in this country for over 30 years, and it has been used by millions of people all around the world. An estimated one in three women have had an abortion, so it is not an unusual procedure and it is not uncommon. It is a decision for a woman and her doctor—not men, not other women and not the law-makers. Nor is it about morals or laws; it is about safety. This is what this issue is about today: safety. It is about what the research of the medical and scientific experts says—the scientific evidence that is there before us. I am prepared to accept it and base my decision on just that.
I will do that with any issue placed before me in this parliament as an elected representative of the people of Petrie. I base every decision that I make on behalf of my constituents on the facts that are presented to me. Emotion will certainly come into it. How could emotion not come into any argument that comes into this place, or any bill? That is always inevitable. But it is our job, and it is our responsibility as elected leaders from our electorates and our country, to divorce emotion from fact.
Under various state laws a woman’s physical and mental condition, as well as her economic status, are factors which doctors may consider in deciding whether to perform an abortion. There are roughly 80,000 abortions a year in Australia, making abortion the most common operation in this country of 21 million. The government’s medical plan covers the cost, at a huge financial cost to the community. Many forget the risks associated with undergoing any surgical procedure under anaesthetic. Anyone who has had the misfortune of going to an abortion website knows abortion is quite a traumatic experience and often causes physical trauma. And we are talking about an emotional experience here, whether we are talking about RU486 or an abortion.
Simplistically, RU486 is technically just an accelerated form of the morning-after pill. It is administered orally, but the monitoring and the follow-up by the prescribing medical practitioner involved is far more intense. It is less invasive. Anyone who has been admitted to hospital for any type of surgical procedure knows that it is far less confronting and a far less traumatic experience to front up at your local family doctor to be administered the pill than to be told to strip, to be sedated, to be wheeled into an operating theatre, to be confronted with a team of strangers in surgical gowns and masks and to have a drip inserted into your arm before being knocked out. Any adverse reaction to RU486 can be dealt with by a medical procedure.
The number of abortions undertaken in this country has been gradually declining, largely because of better sex education in schools and greater availability and access to contraceptives. They are the answers to cutting the abortion rate. But more work needs to be done regarding educational opportunities in schools and educating young people about better sex practices—not to deny access to the procedure of abortion, whether it be surgical or non-invasive, such as RU486.
RU486 is much safer and much more accessible than other abortion procedures. Women in rural and country areas are far more likely to have access to a doctor in a medical practice than to an abortion clinic. It is more likely that the patient will be known to their local doctor, who will have the patient’s full gynaecological and medical history. The patient is more likely to be open to discussion about the procedure and its consequences if they are in a comfortable environment with their family doctor, who is experienced in handling any complications.
What is the difference between interfering with the development of a mass of cells, a foetus, and the use of the contraceptive pill, which interrupts the fertility cycle of a woman, or the morning-after pill, which tricks the body into thinking it is not pregnant, through the use of hormones? Similarly, RU486 is a steroid that blocks the hormone progesterone, which enables the egg to remain lodged in the wall of the uterus. Women who take it must also take another drug two days later, which prompts contractions in the uterus. This procedure requires care and follow-up attention by their doctor, but it is non-invasive and effective in 92 to 98 per cent of cases.
Many here have argued against the therapeutic goods amendment bill removing a minister’s right to veto and they say that 11 women overseas died after being administered RU486. What about other drugs? What about Viagra, which researchers in the US have found causes five fatalities per 100,000 prescriptions? In addition, how many people around the world have died taking aspirin? All drugs have risks. Even though far fewer women are thought to have died from complications arising from taking the medical abortion pill RU486, we seem to be inundated with alarmist warnings about the dangers of this particular drug. This is despite the fact that the Royal Australian College of Obstetricians and Gynaecologists and the Rural Doctors Association of Australia have given evidence to a Senate inquiry that the properly administered and supervised use of RU486 is no more dangerous than taking aspirin or Viagra, which has been approved in this country since 1998. There are risks with every medication, just as there are extreme risks every time we go under anaesthetic for a surgical procedure, whether it be a knee reconstruction, an adenoid operation or getting your appendix out—or, in this case, termination.
I cannot accept the Laming and Kelly amendments that have been put forward to the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, which I am speaking about today. Both these amendments defeat the purpose of the bill, which is to remove ministerial and parliamentary oversight of these scientific and medical decisions. As politicians, we have to base our deliberations on information and facts from medical and scientific experts and evaluate that evidence. With these amendments, we would need to continue to pass judgment on the safety and efficacy of RU486. The amendments would ensure that every application for RU486 and other such drugs would be evaluated by the TGA and debated in parliament. We would then have this endless parliamentary process with divisive debates about abortion, which would go on for weeks. These amendments will be much more restrictive than the current arrangements, which have seen RU486 effectively banned in Australia. Under these amendments, not just the health minister but any member of parliament could object to the approval of RU486 and force the parliament into a long and protracted debate about abortion. That is why I will not be voting for the amendments.
Millions of sensible, educated women have been seeking surgical abortions for years. They will still seek these terminations, whether by surgical termination, which carries risks and has been legal in this country for 30 years, or by ingesting a pill—in this case RU486. This drug will make a large number of surgical terminations redundant in terms of convenience, cost and accessibility.
We pride ourselves on being a nation with the ability to embrace technological developments and changes—the latest in IT and the latest in biotech breakthroughs. So why bury our heads in the sand when it comes to medical advances and developments that can improve the lives of millions of women—and millions of Australian women—who are faced with this situation? It will happen anyway. Why not make it less intrusive, as safe and accessible as possible and as inexpensive as possible so that it can be of benefit to all Australian women?
I think this issue, issues like it and the debate in the parliament confirm something that I have believed for a long time: the science and the knowledge we acquire from science, as hard as that is, are the easy part. It is how we as human beings adjust to new knowledge and, in this case, relatively new pharmacological ways of addressing a very vexed issue that is the much more difficult task. In fact, if all the scientific problems of life were ever solved, all of the important questions would still remain unanswered.
A generation ago in this country, the decision was made that under certain circumstances abortion would be lawfully available to women. There are many of us, myself included, who live uncomfortably with that fact. There are others amongst my colleagues on both sides of this parliament, for whom I have a very high regard, who in an ideal world, I suppose, would like to see those laws at the very least tightened up somewhat and in some cases perhaps even repealed. If you had listened to even a part of the debate that we have had in the last week or so through both the chambers, you would be forgiven for thinking that, in fact, we had revisited the basic issue of abortion itself.
I am privileged to be not only a parent and a member of the parliament but also, in a former life, a medical practitioner. The member for Lalor said of the health minister, ‘He is not a doctor.’ People who have medical or nursing or scientific qualifications bring no more or less to this debate than anybody else. Their views on this are no more or less important than the views of those who are not trained in any medical sense. In fact, it has often been my experience that people who are not medically trained bring a greater depth of wisdom to many of these issues. A lot of the problems in the medical profession derive from doctors not knowing when to stop as much as knowing when to start.
I spent 13 years of my life after graduating in medicine practising medicine, nine of them predominantly in a low-income housing area in the satellite suburbs of Hobart. Hobart is a capital city and large in many ways, but compared to Sydney, Melbourne and Brisbane it is not a large city. Whilst I saw surgical abortions being performed during my training, I have not ever actively participated in them, but I have had experience of women coming along to see me requesting a termination. I have also looked after and cared for women who have had terminations—and I have friends today who had terminations in earlier parts of their lives—and I can say that, with perhaps some few exceptions, there is not a woman who has had a termination of pregnancy who is not emotionally affected by it. It is just a question of degree.
In a city like Hobart in the mid to late eighties and the early nineties, it was interesting to see the ways things would happen. Educated women with money would get on a plane and go to Melbourne to have their pregnancies ended in an anonymous way, and life would go on. There were pregnancies within marriage, sometimes as a consequence of infidelity, sometimes as a consequence of failure of contraception and sometimes as a consequence of assault within the marriage or, indeed, by those close to a married couple.
Those who had less wealth had a choice. One choice, of course, was to continue with the pregnancy. In my own case I can only say that I did whatever I could to try to make sure that women were informed of all of the choices before them and had access to those who could counsel them in a dispassionate, humane and caring way. But those who had less wealth were required to book into the public hospital. People would know that they were there, they would know why they were there and of course the women would submit to a surgical termination.
What is being considered here is not whether or not abortion should be available in Australia. It is whether or not another option for procuring abortion should be available to women. Much has been said about the maternal death rates from abortion. No-one in this place should forget that the foetal death rate from abortion is 100 per cent. But the maternal death rate is about two per 100,000 for surgical abortion, and it is about that or slightly less for the use of RU486.
Anyone who thinks that women are going to enthusiastically embrace abortion because RU486 is available, whereas with only a surgical option they would continue with the pregnancy, is in my opinion seriously misguided and not sufficiently availed of the circumstances under which these decisions are made. RU486 will mean that in most cases a woman will go through a very painful, very messy and very prolonged period, relatively speaking, of having the foetus expelled from the uterus. In some ways, if you have ever had anything to do with women making these decisions, it is actually easier to submit to an anaesthetic and a surgical termination because someone else is doing it to you; whereas in consuming a drug you are obviously heavily participating in the process of procuring that abortion. Whatever any of us think, the reality is that about half a million women throughout the world will die this year from the consequences of unplanned pregnancy and from illegal abortion. Sadly, the reality is that there has always been—and there is today and there always will be—a demand for abortion. No matter how hard we try or whatever the moral values that any of us bring to the issue, that is the reality we face.
The question here is whether the health minister of the day should actually have a power of veto over the Therapeutic Goods Administration considering the safety and the efficacy of RU486 and making it available in the Australian community as it currently is in many countries throughout the world. I actually feel very sorry for the current health minister, who, in every other aspect, is doing an excellent job. But something the member for Lalor said is right. She said, ‘It’s not about you, Tony.’ It does not matter in this sense whether we have a coalition or a Labor government—and let us hope that it will be a coalition government for the foreseeable future. You could have arguably the most pro-abortion health minister—if there is such a person in this place, God forbid—but that veto will not ever be lifted to allow the TGA to consider it because, within any government, the pressure brought to bear on that minister from his or her colleagues and those who feel very strongly at the extremes of the debate is such that it will never, ever be exercised.
It is a similar situation with the amendments that are proposed here. Those who strongly oppose abortion—the member for Lowe, the member for Warringah and the member for Sturt, whose convictions should be admired—should definitely not support this amendment bill. But for those of us who live, no matter how uncomfortably, with the current arrangements in Australia there is no intellectually honest basis for not supporting the amendment bill. It has been said that we do not want ‘faceless’ bureaucrats making these decisions. As we have heard, these are not ‘bureaucrats’ where that is used as a term of derision to describe public servants. These are men and women who bring scientific and medical expertise to the task in terms of assessing safety and efficacy.
The traditional Liberal view is that, wherever possible and practicable to do so, we should return decision making not just from the bureaucrats to the elected members of the parliament but to individuals to make their own decisions. We have invested a lot of political capital and philosophical determination in workplace relations in that regard. We do so in relation to the hard-earned money of Australians in relation to tax. There is arguably no more powerful a driver of human need and behaviour than that of reproduction. It is more than appropriate—indeed, entirely consistent with the Liberal view—to put that decision making in the hands of the woman, her doctor and hopefully also her husband or partner. That is what this is about.
If the amendments proposed by the member for Bowman or the member for Lindsay are carried, we will be repeating this exercise every six to eight weeks. I do not know whether this has been covered here—I have been flat out with defence matters—but for those who are in what are known as marginal seats, imagine going through this issue every six or eight weeks. If the member for Lindsay’s amendment is carried and the health minister does not allow the TGA to consider approving RU486, the parliament will have no authority or power to overturn that veto.
I am privileged to be the member for Bradfield. Many of my constituents will not vote for me after what I have said, but my task here is to bring judgment and wisdom to decision making in the parliament in the national interest. I too believe in One Holy Catholic and Apostolic Church, the forgiveness of sins, the death and the resurrection and the life ever after. I am a Catholic, albeit far from a perfect one, and the attacks on the health minister and others who have adherently sought to remain true to their Catholicism are despicable. Such adherence is to be the subject of admiration and not derision, under any circumstances.
I will be supporting the amendment bill. I will do so, as with all my colleagues both for and against, consistent with my own judgment and free will—and thank God we live in a country where we can have these sorts of issues determined in this place.
I enter into the debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 with a very troubled mind, because what should be a debate on the approvals procedure for a drug has been turned by pro-choice and pro-life proponents into one on the broader issue of abortion.
I would like to place on record my appreciation to all who have made contact with my office. In most cases the views have been presented with passion and strong conviction. In all cases they have been presented through the prism of one’s values, morals, ethics or personal experiences in life—and so it is with us here in this parliament.
It is no secret that I have been raised as a Roman Catholic—how good a Catholic is a matter of conjecture; I am certainly very fallible. How much the doctrine of the church influences my decisions is a question that has been asked by some of my constituents. In the last conscience vote in this House, members of the church were disappointed with my stance on stem cell research. By being a member of a government with a border control policy which includes detention centres, I have been accused of betraying the basic principles of Christianity, an accusation that I strongly reject.
At moments such as these, I am reminded of a statement by one of humankind’s great intellects, Albert Einstein, who once said, ‘Science without religion is lame; religion without science is blind.’ In the end, as difficult as it may be, we try to enter into debates of this kind conscious of our values, experiences and beliefs, while at the same time determined to introduce good laws for our country.
The debate on the approval of a drug like RU486 is one that bears great complexity due to the moral and ethical consequences it raises. We cannot run away from the fact that we are elected into this place to at times make tough decisions—there is nothing tougher than questions encased in moral and ethical clothing. Abortifacients such as RU486 are not just any other drug. To claim it is strictly a therapeutic drug and that the TGA should treat it as they would any other drug is misleading; it is not a convincing argument. In fact, it is made more out of convenience and mistrust. To ban RU486 because it will lead to an increase in abortions is also not a convincing argument. As has been mentioned by a number of my colleagues, the passing or rejection of this bill will not in itself lead to one more abortion being carried out in this country. International experience with the drug attests to that claim.
I am not voting on an abortion bill; my colleagues in the state parliaments have that privilege. It is in their jurisdictions that the legality or otherwise of abortion is determined. The application of the state laws governing abortion still has precedence, no matter how we vote here today. If the community want those laws changed, I urge them to reopen the debate with their state representatives.
In my home state of Victoria, abortion is covered by sections 65 and 66 of the Crimes Act and its interpretation is covered by case law, a law otherwise known as the Menhennit ruling. In other words, an abortion is essentially lawful in Victoria if it is considered necessary to preserve the woman from danger to her physical or mental health. This position has stood since 1969 and it is one that I certainly strongly support.
The question I therefore need to consider today is who is best able to determine the approval process for what I consider to be a non-therapeutic drug that has undisputed ethical and moral consequences—the minister for health, the parliament or a body of well-credentialed, well-meaning scientists and experts?
What sets this parliament and our great democracy apart from sham democracies or even totalitarian states is the fact that we are accountable to the people for our decisions and the laws we pass. The TGA, as well meaning as it may be, is not directly accountable. It considers the scientific facts, including the safety and efficacy claims of the pharmaceutical company. I appreciate that, if the evidence is such that a drug either is found to not deliver on its efficacy and safety claims or receives community-wide disapproval, we can always revisit the TGA decision by passing another law.
However, today we have an opportunity to put into place a number of amendments that will uphold our parliamentary responsibility on laws which have undisputed strong moral and ethical consequences, while at the same time making full use of relevant bodies such as the TGA.
As law-makers, we turn to the experts for advice on so many tough decisions, be they in Treasury, defence, health, foreign affairs or communications. We do not turn to these professionals to make the decisions, and certainly not decisions that have undisputed ethical and moral consequences. If we abrogate our responsibilities on these matters to bureaucrats, then what are we doing here? Are we not simply giving greater currency to the poor perception of members of parliament which already exists? If we are doing it because it is convenient or we are fearful of the dilemma it places us in, then perhaps we are in the wrong job. To say that passage of the amendments will mean that we may have to face these decisions again in the future can only be a weakening of our democratic process. We have the responsibility as elected representatives—not the bureaucrats.
The relevance of the claim that pharmaceutical companies may not seek approval for fear of running the parliamentary gauntlet also eludes me. Pharmaceutical companies comprise some of the most powerful and influential organisations on the planet.
With the progress of science, it is only a matter of time before new, non-therapeutic drugs enter the market and, like RU486, throw up complex moral and ethical dilemmas. Passage of this legislation would set a dangerous precedent and signify a serious abrogation of our responsibility to represent the Australian people.
Issues of this kind do cause sleepless nights. They cause us to reflect on our own beliefs, values and experiences. That to me is not such a bad thing to do from time to time as representatives of the people. I will be voting for the amendments proposed and, if the amendments fail to get up, I will be voting against this bill.
It has been said that the debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 is not a debate about abortion. That proposition is both right and wrong. It is right in the sense that we are not debating a change to the law governing abortion, but it is wrong in the sense that we are debating the process whereby a drug to terminate a pregnancy can be approved. To suggest that RU486 is just another drug is patently absurd. I believe that to treat it as we would any other drug is unsustainable. That is why—for the reasons I will enumerate—in the end I will vote for the status quo.
These are never easy issues. I want to say at the outset that I think this has been a very good debate. I am not somebody who shirks from free votes. They are good to have from time to time on these issues. I think parliament rises to its greatest heights when we have debates of this kind. A free vote encourages people to examine their beliefs, to reflect upon their experiences, values and attitudes, and to deal sensitively with a difficult issue.
Every man who enters this debate should be conscious of the reality that abortion is something that has for women, and particularly those who have experienced it, a special impact and a special character. No man who enters a debate of this kind should forget that. He should not lightly pass over the trauma that would face any woman who decided on a termination of pregnancy. I do not think there are any women who have abortions happily or willingly or capriciously. As somebody who has quite conservative views on the subject, as you all know, I hold that view strongly.
This debate has confirmed the fact that the Australian community is unhappy with the high level of terminations in our society. I think there are too many terminations and I think people on different sides of this debate would agree with that. I think a significant majority of the Australian community would oppose any change in the current law on abortion. I do not think a majority of Australians would support a tightening of the law. That is my view, as a representative, however inadequate, of the Australian people, and I think that is their view. However, I believe that, side by side with that conviction, they are of the view that there are too many abortions. That does not mean to say that I am happy myself with that majority view, but it happens to be the reality.
All of us must bring to this place a combination of idealism and pragmatism. In those circumstances, we have to ask ourselves: given the majority view of the Australian community about the present law, what can we do as a nation to reduce the number of terminations? I believe that more can be done to provide people, on a voluntary basis, with counselling and support in relation to alternatives to terminations. I believe very strongly that more should be done, and I will be putting forward that view in the appropriate places in the weeks and months ahead.
I think the Australian community is saying: we do not want to take away the choice that exists under the present law, but we want to provide women who might not want to have a termination with greater support and encouragement to continue their pregnancy. That attitude probably encapsulates what the majority of people who think seriously about this issue—and I am sure everybody does—would want to bring to this debate.
The issue is, very simply: what should be the approval process? We are not dealing with a flu tablet. We are dealing with a drug that has the capacity to terminate a pregnancy. I acknowledge that, if you are looking at the morality and the ethics of this, a surgical termination has the same moral and ethical implications as a termination using this drug. It cannot logically be argued otherwise. There are obviously safety issues and there are obviously medical considerations.
In relation to those who support the bill, I do not cast any aspersions on the people in the Therapeutic Goods Administration. I am sure that, if they are given the power, they will bring to this issue conscientious, professional, responsible consideration. They have served this country well. I do not reflect in any way on them. In defence of my great mate the minister for health, I do not believe for a moment that if this parliament passes this bill it is a reflection on him or a reflection on his government. Uniquely, perhaps, I had an opportunity a couple of weeks ago to reflect negatively on the minister for health and I chose to retain him in the portfolio he now occupies because I think he has been an outstanding health minister. While he performs in that outstanding fashion he will continue to be not only the best friend that Medicare has ever had but also an absolutely outstanding health minister.
If I am forced to choose between the status quo and the bill, the reason why, in the end, I will vote against the bill is essentially the reason outlined by my colleague the member for Deakin in a very thoughtful and moving speech a few moments ago. It is a question of us performing our representative duties.
There is just a whiff in this whole debate—if I may say so, with the greatest of respect to many close friends and colleagues of mine who are going to vote differently from me on this issue—of ‘This is a little too difficult and controversial so let’s give it to somebody else.’ I am disappointed, may I say, in that attitude because, in the end, we are elected to make decisions on difficult issues. Life can be very difficult; it can be complicated; it is never simple. I do worry about a proposition which says, ‘We have got this difficult issue so let’s give it to some experts.’ In the end, on an issue like this, aren’t we, with proper advice, as expert as anybody else?
It is said by some, including a number in this debate, that parliament can always come back and change the law if it is not working. The difficulty is that we all know that, once you pass control of something like this out of the hands of the parliamentary or government or political process, it really does not occur. In the nature of things it goes on and becomes all too difficult to change and that really does not happen.
I have looked at the existing provisions. Whilst I prefer the status quo to the bill, I think there is a lot to be said for the amendment that is proposed by the honourable member for Bowman. I think his amendment is a very good one because it really says to those people who say, ‘Why can’t you go through the process that exists in relation to other drugs,’ that, because of the importance of this, you have a disallowance procedure at the end which is available to a majority in either house of the parliament. I think that strikes a good balance, if I may say so. There are those who argue that this is like any other drug—it is patently not like any other drug; we would not be having this debate if it were—and that we should therefore leave it to the experts.
Under the amendment of my friend the member for Bowman, we are leaving it to the experts to give the advice but we are specifically reserving to ourselves, in relation to this particular drug, a power of disallowance. I think that is reasonable. I do not think it is extreme. I think it strikes a balance. It recognises the strength of feelings. It pays proper respect to the role of the experts. But it also reserves unto us, who are ultimately accountable to the Australian people, a decision-making device which is more likely to be invoked when the public really wants it than the more tortuous process of going through an amendment.
There are things that should properly be assigned by parliament to others. But I say to those who may not share my view on this issue that it is never an excuse to the Australian people to say, ‘It’s not my decision; it’s been made by somebody else,’ because, in the end, if they do not like it, they will hold you accountable. That has been my experience in life. In politics, if I say, ‘I’m sorry, that was made by an independent authority,’ their normal response is, ‘You’re the Prime Minister. Fix it.’ That is not a bad response, because the Australian people have a healthy idea of what democracy is all about.
We all passionately believe in parliamentary responsibility and we believe that there should be a greater esteem for our institution. We worry, in this very iconoclastic age, about the decline of respect for parliament. We should not worry too much about that because we do live in an iconoclastic age, but we contribute to that view, in my opinion, if we vote in favour of this measure.
I conclude by saying that I think this has been a very good debate. This brings out the best in people. It has been characterised by the odd contribution that I wish had not been made—particularly, I have to say again, the quite offensive remarks made about a devotional practice which all of us know is peculiar to Catholics in our community. That was highly offensive and deserving of the rebuke that it received.
That is not to say that people who hold the opposite point of view have not come to this debate in very good faith. And it is not something that should be determined solely on religious grounds. Whatever our own religious faith is—and mine is well known—people of no religious faith can hold a similar view to mine and equally people of strong religious faith can hold an opposite view from mine. I am not seeking to divide people—none of us should—on the basis of religious belief.
But in the end I will not support this measure. As a member of parliament and somebody elected by the people of the division of Bennelong to represent them, I feel that on something as important as this I should reserve a final say to myself as their representative. That is why I will vote as I have explained.
I join with the Prime Minister in congratulating members on both sides of the House for the quality of the debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I have had the opportunity to watch a lot of the debate in my office as a sort of background noise to the many other things that we do. To be able to look up and see people struggling honestly to arrive at the right conclusions on this matter has been, frankly, inspirational.
I have been in politics now for a very long time—though not as long as the Prime Minister. All too few occasions like this occur in the House. It is a wonderful thing when they do. They speak well of all of us. We are not simply identikit clones of some ad agency’s decision as to what a politician ought to be; we in this place are much better people than that, and I am proud of my colleagues. On this occasion I am not only proud of my colleagues on my side of the chamber; I am actually quite proud of my colleagues on the other side of the chamber as well.
From all of this I draw very different conclusions than the Prime Minister does. I think that in the end this is a fairly simple proposition about who in our community is appropriately deputed the task of determining whether a drug is safe to be let into the community and on what terms and conditions it is let into the community. Despite the many qualities that reside in people in this House, with the possible exception of one or two, there is absolutely nobody here with the capacity to make the scientific judgments concerned.
On the other hand, it is the duty of legislators, state and federal, to determine whether or not there should be abortions—period. The decision to be taken by us, or more particularly by our colleagues at a state level, is this: under what terms and conditions should a termination of pregnancy take place and should the restrictions on that termination of pregnancy sit within the Criminal Code or sit within health regulations? And, if they sit within health regulations, at what particular point in a pregnancy is what particular action permissible?
We legislators have to have that debate. That is the one that we confront. At the federal level, because it does not often come before us in that form, the debate we confront is how it is to be afforded, how it is to be paid for. This is certainly a debate of relevance to legislators, and it is on this debate that our constituents should act upon us. These are the judgments which we are qualified to make—by our humanity and our representivity. That is the point of time at which we ought to confront abortion issues—when they come forward to us on the basis of whether or not that procedure should be permitted under law. I will say a little more about that later, but that is an abortion debate.
The question about whether or not a drug is a suitable thing for any medical purpose—and this particular drug has purposes beyond termination of pregnancies—is a matter of very difficult scientific judgment. The TGA does not simply make decisions about flu tablets. The TGA makes decisions all the time about life and death drugs—drugs which can preserve life and drugs which, if misused, can terminate life. There may be no intention to terminate life when those drugs are employed. The TGA makes decisions about drugs which can conceivably have horrendous side effects. Members of the TGA do not enter into any decision in this regard without a proper concentration on all those possibilities. By their scientific expertise, they are vastly more likely to arrive at correct conclusions about these matters than anybody in this chamber, and it should be appropriately left for them.
From time to time in the debate I have heard people make statements that these are bureaucrats taking the decisions. These are not bureaucrats. There are no bureaucrats on the TGA. They are scientists, making decisions fully cognisant of the fact that, when they make errors—as was the case in the instance of the prescription of the drug thalidomide—the consequences are truly horrible. And it does come back to them and the way in which they take their decisions. If there are horrendous side effects from the approval of this drug, it will come back to them. They will have to confront the consequences of their decisions in that regard, and they are fully conscious of it.
If this legislation is passed, I do not believe that this drug will be approved tomorrow. That will not happen. What will happen is that, if somebody puts up a proposition that they wish to make it available in this country, there will be an extensive series of scientific tests and examinations. Then the drug will be released, if it is to be released, under a set of terms and conditions which will apply to the way in which a doctor may administer it and the set of afflictions—and there will be more than just abortion considered if it is permitted—for which it is appropriate. Some people argue that it is a very appropriate cancer drug in certain circumstances.
The TGA will need to have a view about the circumstances in which it will be deployed by doctors and will have to put down some very strict guidelines associated with it. With all due respect to colleagues here—who are amongst the most intelligent and effective human beings in this country and who have the honour to serve in the great democratic palace of the nation which this building is—none of us here knows anything about that. None of us here can make that judgment. All of us can have an opinion on abortion. There is no question about that. Were there a piece of legislation here which dealt with the issue of the termination of pregnancy period, I would trust the judgment and the expertise of every person in this chamber to arrive at a correct conclusion on that to the very best of their endeavours. But that is not a subject that is before us now.
I cannot think of another issue in my 25 years in politics that has, from time to time, more exercised my mind than the issue of the termination of pregnancy. My own views on this have gone through changes in the period of time that I have been a member of parliament and the life experiences that I have confronted on the way, many of which have had nothing to do with my life in parliament. I start with the premise, and I still hold the view, that abortion is killing. Therefore, it is something that cannot be conducted lightly; it is something that has to be seriously thought through. When I started in politics my view was that the legal system and the Criminal Code ought to reflect that. That is no longer my view. Tested in the experience of community opinion and community practice, I know that to persist with that view produces a large number of very unsafe procedures and great dangers to women. Therefore, I cannot continue to hold that view, the principle being confronted with the practicality.
Courts and legislators at the state level, over time, I think have arrived at a sensible modus vivendi as far as terminations of pregnancies are concerned. I have to ask myself in conscience: what is there left for me? The courts and legislators have decided that basically this is an issue between women and their doctors. I can live with that. I think that after all the testing, if you like, in the public arena, that is a position that has been arrived at. But I am neither a doctor nor a woman. So what does it mean for me? It means this for me: the acceptance of personal responsibility, should my opinion be sought by anyone, on that issue.
As a father of three daughters and as a husband it is never beyond the realm of possibility—and thank God it has never happened to me—that I will be invited to have an opinion. If any woman were to approach me and seek my opinion on whether or not she ought to have a termination, my advice would go along the lines of the moral commitments that I have in that regard, with the added statement by me that, should she decide to go ahead with the child, and it was a person with whom I had a direct responsibility, I would do my very level best to make sure that she was able to live comfortably with the decision that she took. But I would also say: ‘If you take another decision on this, I do recognise it as your right to take that decision.’ I have learned over time that that is the position that I will live with.
I get back to this bill. Nothing in this bill invites me to any of the decisions that I have been referring to in the remarks I have been making—either personal or public. Nothing in this bill invites me to do that. All this bill invites me to do is to make a judgment about whether or not it is the minister who is the appropriate person to approve a drug—any drug—or a body of scientists. For me it is a no brainer, quite frankly. It is simply commonsense that a minister does not have the scientific capacity to arrive at that judgment. Obviously, the vast array of drugs that are approved in this country do not come before this parliament and do not come before ministers, on the very sensible grounds that virtually nobody would conclude that we are the appropriate place for this to be considered. This is the appropriate place when the TGA may make, over time, an error; it is not an unreasonable thing for us to bring to this place a complaint and to use the grievance debate or something like that as a sounding board. But to be the ab initio judges of what ought to occur is actually absurd; it is just not sensible. We have to extract from this our feelings on the legal and moral issues related to abortion and just use commonsense about what is the appropriate way to approve a drug.
I think the level of focus that has been on the minister’s moral convictions has been unfair. This minister temporarily holds the position of minister for health. I can think of ministers on both sides of the House who have a very different moral outlook from him, and I can think of ministers in the future on both sides of the House who will have a very different moral outlook from him. It really is not about Tony Abbott at all or Tony Abbott’s convictions. As I have already indicated, there is some level of moral sympathy on my behalf with his convictions in this area. And I understand his difficulty, having the moral convictions that he has, presiding in the portfolio that he does.
I happen to know the situation in Britain, where there is a member of the Labour ministry who turned down the ministry of health on the grounds that she has some profound convictions in relation to abortion which mean she does not feel that she can sit easily with that. This is a law that has been passed by the House of Commons. She does not sit easily with the notion that she has to sign off payments for the procedure—so she does not take that job, on those grounds. If it is impossible, in any part of it—I would not, for example, suggest that a pacifist along my frontbench ought to necessarily be appointed by me as Minister for Defence. I would think that that person would make a very good contribution in some other area, but it is not wise to place people in portfolio positions where their moral convictions are challenged. If it is difficult for Tony Abbott to handle these things then he ought to have a word with his boss about where he ought to be situated—he ought to do that. But what he ought not to do is suggest that we have here an issue of confidence in him. This is not an issue of confidence in Tony Abbott; this is an issue of sensible statement about where decision making ought to reside in relation to the approval of drugs, dangerous or otherwise.
It is for those reasons that I take the decision to vote in the way I will. I will support the bill. I say again, as I started: I am most impressed with the way this debate has been conducted, the way views have been expressed on both sides of the House, the expertise that has been brought to it. I have learnt a lot more about the drug, I might say, than I have learnt before. I still do not think, however, on the basis of listening to that debate, that I am in any better position than I was when the debate started to be the approving authority for its distribution. Nevertheless, the research that people have done has been truly magnificent and I do congratulate all members on this. We should leave this place without any bitterness in our hearts towards any person involved in this debate but with the very greatest pride that we are elected by the people to be here.
I rise today to speak on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. The purpose of this bill is to transfer the approvals process from the Minister for Health and Ageing to the Therapeutic Goods Administration. However, the debate has broadened to include the drug RU486, women’s rights, the claimed advantages for rural women and the actual abortion debate. I will now attempt in the time available to address these issues separately, as they have been raised as a part of the debate.
First, I will go to the issue of transferring responsibility for approval to the TGA. From the start, let me say I am against this bill for a number of reasons. I do not believe in abrogating my responsibility as an elected representative of the community on issues as important as life itself. The drug RU486 that we are debating is an abortifacient, yet it is the same drug prescribed under the name mifepristone that helps preserve life as a therapeutic drug in the treatment of certain cancers and tumours. The TGA rightly has the power to approve drugs that preserve life, but when there are moral issues attached to the use of a drug—and by that I mean the use of a drug that ends life—then the process of ministerial approval, the scrutiny of the parliament and the judgment by the community of those that made that decision at the ballot box is the correct process. On the issue of the drug RU486—and I admit that, unlike some of my colleagues in this House, I am not a doctor—I have extracted the following from expert opinion. To quote Edouard Sakiz, the former chairman of French drug company Roussel-UCLAF, which developed RU486:
As Abortifacient procedures go RU486 is not at all easy to use. In fact it is more complex to use than the technique of vacuum extraction ... A woman who wants to end her pregnancy has to ‘live’ with her abortion for at least a week using this technique. It’s an appalling psychological ordeal.
According to Dr Michael Green, Professor of Obstetrics, Gynaecology and Reproductive Biology at Harvard University:
RU486 had 10 times the mortality risk of surgical abortion in the first 7 weeks of pregnancy (which is its recommended time limit for effective use, although even then between 5% and 8% of women will need a follow-up surgical abortion).
So dangerous is RU486 to women’s health that pro-choice radical feminists such as Dr Renate Klein, Associate Professor of Women’s Studies at Deakin University in Victoria, are adamantly opposed to the drug. She describes RU486 as ‘a modern version of backyard abortion—unsafe, painful and deeply scary’.
How does RU486 work? It is reported in journals that RU486 is a synthetic steroid which works by blocking the effects of progesterone, the natural hormone which is required to maintain the lining of the uterus during pregnancy. RU486 starves the womb of progesterone, the lining of the womb breaks down and it is lost along with the developing embryo or foetus. Up to four visits to a hospital or a clinic are necessary to complete the process. The success rate of RU486 on its own is not high. For pregnancies of up to nine weeks gestation mifepristone is normally taken by mouth on its own. If the embryo or foetus has not come away within 36 to 48 hours, a prostaglandin is given. For pregnancies of 13 to 24 weeks gestation, mifepristone is taken by mouth. This is followed by a prostaglandin by vagina. If the abortion does not occur within 24 hours after the start of treatment, a repeat course of gemeprost will be given. In both cases, if the treatment fails, the baby will be aborted by a surgical method—that is, either vacuum aspiration or dilation and curettage.
There are side effects. Is this safe? According to the journal, the use of RU486 may cause any of the following: haemorrhage requiring blood transfusion, severe pain requiring strong pain killers, incomplete abortion, rupture of the uterus, vaginal bleeding, abdominal cramping, nausea, vomiting, diarrhoea, headache, muscle weakness, dizziness, flushing, chills, backache, difficulty in breathing, chest pain, palpitations, rise in temperature and a fall in blood pressure. What I am illustrating here is that the number and diverse nature of the side effects of RU486 point to the fact that these are powerful chemicals. In fact, Dr Germaine Greer, speaking at the Best for Women gynaecologists and obstetricians conference in Sydney in 2002, described RU486 as a powerful and unpleasant succession of experiences. She said:
These are violently active chemicals and they have violent reactions on the organism ... What is the situation in which a woman would undergo that kind of assault?
One of the most spurious arguments being put forward in this debate goes to the advantages for rural women. To quote from RU486: misconceptions myths and morals:
There is much about RU 486/PG that is fraught with risk and problems. As we have queried, what is the meaning of a ‘private’ and ‘de-medicalized’ abortion that requires three or four doctor’s visits to a specialized centre, includes the taking of two and perhaps five hazardous drug combinations, is accompanied by vaginal ultrasound, and too often has complications ranging from moderate bleeding to severe pain and, for some women, blood transfusions? If this is a private and de-medicalized abortion experience, then the word ‘private’ has lost its definitional moorings.
I do not profess to be a medical expert, but I am prepared to listen to expert opinion provided in the various submissions. Another argument advanced is that this is a women’s only issue. I must say I am personally and deeply offended by those claims that this is solely a women’s issue and that men should butt out. The last time my wife and I had children, I seem to recollect that I, as a mere male, actually had something to do with it. Whilst I agree that it is the woman’s body that is carrying the baby, and I accept that the physical and mental aspect of unwanted pregnancy may be greater, speaking as a male I can assure you that men suffer the same mental anguish and torment in an unwanted pregnancy or abortion. Men should never be removed from the decision-making process, not legally nor morally, to end the life of a baby. I only need to remind members in this House of how we are inundated with correspondence in relation to fathers’ rights to have access to their children for them to know that that mental anguish would be no different from deliberating and grieving over an abortion.
On the issue of abortion itself, I have on previous occasions stated my personal Christian convictions not only in this parliament but also to the community that I represent. I am encouraged by the letters and phone calls of support on this issue. The number of contacts on each side of the argument from my electorate show clear support for the status quo. That being said, I do respect but do not agree with the views of many being put to me in this House to support this bill.
This week I received an email from a very well-respected doctor in my electorate, who wrote:
I am writing to you to encourage you to vote against the private members bill, giving the TGA the right and responsibility to license RU486.
As Tony Abbott says, this is not like other drugs, this is a drug that kills human life. Having practiced obstetrics for ten years in the bush, and having continued to care for women during pregnancy here, I have no doubt that an embryo is a human life, nor do the women who grieve for their miscarriages.
Even women and doctors who believe in abortion, do so with a sense of knowing it is fundamentally wrong. People are generally ashamed of terminations of pregnancy, and usually do so because it is presented to them as an option that “solves” their problem.
People who argue for women’s right to choose are arguing on behalf of many premises and rights that I also believe in, BUT when it comes to a decision as to whether an individuals right to do anything in society infringes on another human beings right to simply live, then the choice must go with an individuals right to live.
Recently I saw a young teenage girl who had travelled to Sydney with her mother, had an ultrasound that confirmed her pregnancy to be 19 + weeks (what does that mean was it 20 weeks? was it more?) The mother cried when she saw the baby on ultrasound, the girl would have felt that baby move inside her.
That baby would have had to be cut up, dismembered to be removed from her uterus by suction curette. This is apparently legal but obviously so wrong. The termination was performed in Macquarie St. This is where our society is going. Bob its time to make a stand.
If RU486 is licensed our society will continue to treat the value of human life with less and less regard.
Thanks for your time,
Dr. Mark Adamski
Is it about right to life? But whose life? The hypocrisy that has surrounded this debate is perhaps the easiest argument to reject. I cite the example of those who argue strongly for the preservation of life in the death sentences handed down to Bali nine drug convictees Andrew Chan and Myuran Sukumaran, and the recently and sadly executed drug courier, Van Nguyen. These people go to great lengths to urge governments to do more for the unfortunate souls in Third World countries who die of starvation and disease every day, yet in the same breath advocate abortion, the wilful ending of an absolutely innocent life.
As a parent of twins who were born very prematurely and as one who sat by the humidicrib for weeks on end to pray and watch a child not much bigger than a barbie doll fight for life, I find it truly amazing that today a premature baby can survive at 21 weeks and incomprehensible that today a child can be aborted at the same age or older.
Why can’t those who advocate for the life of a convicted drug dealer advocate for the life of the unborn? When people argue about the morbidity and mortality of backyard abortions, they forget that the mortality of legal abortions is 100 per cent for the innocent baby. How bitterly ironic it is that people will defend abortion as somehow being a kinder alternative to the unborn child, often saying, ‘I couldn’t adopt the child. I couldn’t bring it into this world.’ What of the needs of the childless parents desperate to adopt a child?
Rejecting this bill will not, unfortunately, alter the status quo of the often quoted 100,000 abortions each year. Perhaps that is an argument that needs to explored in the state parliaments of Australia, which have the legislative responsibility for abortion. The decision that I have come to will allow my mind to rest easy. But I try to understand the anguish and torment of the parents that have made the decision to have an abortion and what they must go through. I am not without empathy for the difficult and sometimes awful situation pregnancy can represent. I will stand on my decision today, accountable to this parliament and to the people I represent, and that is something that I will never walk away from.
As the member for Braddon, I wish to thank all those from my electorate and from all corners of Australia who have written, faxed, emailed and phoned to put their point of view forward. Many have said, and I wholeheartedly agree, that this debate is not about abortion. It is not for this House to debate the rights or wrongs of abortion, because abortion is lawfully available within all state and territory jurisdictions of Australia. This debate is about whether or not the availability of an abortive agent like RU486 should be subject to the administrative processes of a bureaucratic body which is not accountable to the constituents of Australia or subject to ministerial accountability.
This debate is concerned with the proper regulatory process for the approval or disapproval of a drug designed to terminate a pregnancy. The role of the Therapeutic Goods Administration is to regulate the availability in Australia of therapeutic drugs that are designed to prevent or cure an illness. Herein we have a dilemma. Is pregnancy an illness? Is an unwanted pregnancy an illness? In my conscience I have to say no, an unwanted pregnancy is not just another illness requiring a cure but rather the result of a range of attitudes and the consequence of behaviour.
It is a tragedy that in Australia up to 100,000 abortions are performed each year. Along with many constituents in my electorate, I struggle with this sobering figure. As a parliament it is our responsibility to promote greater family planning in an attempt to reduce the number of abortions and the associated consequences, both physical and psychological.
One of the arguments for increasing the availability of RU486 to rural and isolated women is that it provides choice where surgical abortion facilities are not available. However, lost in this argument is the fact that genuinely rural and isolated women do not have ready access to emergency facilities, and any time delay in reaching appropriate help could be very serious and even fatal. Therefore, this neutralises the argument that there are widespread benefits for rural and isolated women.
The greatest gift in life is to create another life, and I acknowledge the agonising decision for those who decide to end the life of an unborn child—a decision not taken easily.
I do not believe that it is the role of the Therapeutic Goods Administration to consider the ethical and moral questions that this drug raises, and those questions are unavoidable. The role of the Therapeutic Goods Administration in Australia is to regulate the availability of therapeutic goods. It is required to consider public health and safety. Therapeutic goods are those given to prevent or cure an illness, to promote wellbeing. My conscience cannot resolve that RU486, an abortion drug, is a drug designed to end the life of an unborn child. Further, the Therapeutic Goods Administration is neither elected by nor accountable to the community.
Accordingly, mindful of the concerns of the majority of my constituents and after wrestling with this issue, I cannot support this bill. However, I note the proposed amendments on the table, and I will support those amendments which retain ministerial responsibility or provide parliamentary scrutiny.
Like other members, I have thought long and hard about this issue and the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 that has been presented to the House. The first observation I would make is that many of the speeches that I have been able to follow that have been made during this debate have been of great interest to me. I am impressed with the thought and the effort that so many members have put into considering this issue.
Let me begin by saying that my view on the issue of abortion is that I feel comfortable with the laws that we have in the various states and territories of Australia. I think they strike the right balance, and I do not think that in this parliament we should be taking steps which will change the implementation of those laws. Having said that, I can obviously see—and this is why we are having a debate on this matter—that RU486 is a controversial and difficult issue. If this were simply a technical matter, we would not be having a great debate on it. The time of the Senate and of the House of Representatives would not have been so substantially devoted to it.
I have said publicly before now that my in principle decision is that, if a drug is deemed to be safe and can be prescribed by a doctor, I do not have any objection to the drug being used. And it is my view that, if that were to happen in relation to RU486, that would not change the abortion law in this country at all. A lot of members have spoken about the issue of abortion. For me, this debate does not really boil down to being about abortion laws, because it is my judgment that, in the end, this is not going to change the abortion laws in this country.
This debate is actually about whether the decision on final approval—not on preliminary approval, not establishing the technical safety of the drug, but the decision on final approval—should continue to rest with the Minister for Health and Ageing, or whether instead it should be approved by the Therapeutic Goods Administration. I do not agree with the Leader of the Opposition about this; the Therapeutic Goods Administration is a body of public servants. Many public servants work with me and for me, and I have enormous respect for the Australian Public Service, but it is a decision that is made by public servants using the delegated authority of the Secretary of the Department of Health and Ageing. So the choice for me is whether I think that, in the end, the minister should make the decision on something which is obviously highly controversial, as is proven by the fact that we are having a debate on it, or whether the decision should be made by the delegates of the Secretary of the Department of Health and Ageing through the Therapeutic Goods Administration.
I am an elected member of parliament myself. I represent the people of Mayo in the Adelaide Hills, Fleurieu Peninsula and Kangaroo Island. They send me here to Canberra, and have done so on many occasions, to represent their interests and make decisions on difficult issues. I sometimes wrestle with difficult issues, but it is part of the job. In the end, I am happy to make decisions on difficult issues. I am accountable to the parliament and ultimately I am accountable to the people of Mayo.
Having said all of that, the two proposals that have appealed to me most in this debate have been the amendments put forward by the member for Lindsay and the member for Bowman. In fact, of the two, I think the member for Bowman’s is the better amendment. If the first of those amendments does not get up, I am going to vote for the second one, which will be the member for Bowman’s amendment. The whole concept here of having a preliminary judgment made by the Therapeutic Goods Administration or the minister and then the parliament having the capacity to disallow that decision puts the matter back into the hands of the parliament. On something as controversial as this, I think that is entirely appropriate. So, as I have said, I am going to support the amendment of the member for Bowman in particular. I think that is a very good and very sensible amendment, and I hope other members will consider doing that. It is a compromise. It does keep the power to make the final decision with the parliament. It leaves the final decision on something which is manifestly very controversial with the representatives of the people. But, having said that, obviously the Therapeutic Goods Administration’s judgments about the safety and appropriateness—in a technical sense—of the use of this drug will be a very important consideration.
I do not want to detain the House for long in expressing my views on this matter, but let me say in conclusion that some people—in the media, substantially, and one or two parliamentarians—have interpreted this debate in the context of the Minister for Health and Ageing. My view of the minister for health is that he is a person of enormous principle. Of all the members of parliament I have known over 21 years—and you can imagine that in 21 years I have known a few—I do not know any member of parliament more principled than the minister for health. He passionately believes in things. He is not just here to fill a seat or to get a parliamentary salary or a ministerial car; he is one of those people who has come here to make a difference because he believes in things. Usually I agree with him and sometimes I do not, but he is a person who deserves the admiration of the country for his passion and his principle.
I have to say, without wishing to inject too harsh a tone into this debate—because it does not deserve too harsh a tone; it deserves consideration—that some of the criticisms of the Minister for Health and Ageing have been quite effective in pushing me away from this bill. I have felt very uncomfortable with some of the things that have been said about the minister for health. I was especially offended by the T-shirt worn by Senator Nettle—I was appalled that it was produced by the YWCA, or so it said on the T-shirt; I do not know whether that is fair or not—because it had not only a tone of abuse towards the minister for health but a tone of sectarianism.
I am a Christian—I am actually an Anglican—but the Catholic Church is the great spiritual leader of Christianity in the world. There is no question about that. Even though I am an Anglican, I concede that point. The Catholic Church is the great Christian church. Even though I do not see the Pope as my leader, the Pope nevertheless is the great spiritual leader of Christianity. Sectarianism in Australia was one of the truly ugly components of our past, which I myself thought was well and truly out of the way and that I had seen it die in my lifetime. Some of the comments that have been made about the Catholic Church and Catholicism have caused me great offence, and I do want to put that on the record. The Catholic Church has stood for great things and does stand for great things, and it deserves great respect, even if you do not agree with them. I am an Anglican, so there is obviously some point of theological disagreement there, but it is not substantial.
My position, in conclusion, is as simple as this: I support the amendments. If either of those amendments is carried, then the amended bill would win my support. However, if the amendments fail, I will not support the bill and I will vote against it.
Like many other members in this House, I have been subject to some strong lobbying in relation to the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. Some are in favour, some are against. Of course, a number of those lobbying have targeted me because I am known by many as a committed Christian. Until I stepped down at the end of last year, I served as the President of the Australian Parliamentary Christian Fellowship. Therefore, there is an expectation that I will take a similar view to that of many Christians in Australia and of course take note of the views of church leaders.
I would say up front that my Christian faith is a very strong and significant part of my life and one of the reasons I came into this House. I have attempted to be a faithful follower of Jesus Christ. It is clear to those who know me well that I have often failed, but still I press on towards the mark. However, I have taken views on issues in the past that did not reflect the popular Christian view of the time—namely, I voted for the amendment in 1984 which proposed the decriminalisation of homosexual relations between consenting adults, when the Crimes Amendment Bill was put before the New South Wales parliament; I voted for stem cell research in 2002; and now I will be voting for this bill.
There is not a uniform Christian approach on these issues, and there are a number of members of the Parliamentary Christian Fellowship who plan to vote for the bill before the House. I am unashamedly a Liberal on these issues of social conscience. I believe it is healthy to have a range of views amongst Christians. One thing I am sure of is that Christ’s significance in my life does not diminish because of my support for this bill. Tolerance, acceptance and forgiveness are hallmarks of the Christian life, and my approach on these issues is motivated very much by the Christian concept of grace. It is this philosophy and approach which motivated me to take a strong interest in the treatment of asylum seekers in this country. I was compelled to be part of a reform agenda when I was confronted with stories of detainees who had been held in detention for some years. There were many who opposed my stand on these issues, but I was encouraged by the support I was given by many church leaders.
The bill before the House separates out the decision on abortifacient products from the minister to the Therapeutic Goods Administration. The minister appoints a group of experts who examine the suitability of pharmaceuticals on medical grounds for release to the general public. I believe it is inappropriate for the decision to be made by the minister and should rather be made by those who are expert in the field and who, by virtue of their training, are better equipped to make a sound medical judgment based on empirical scientific fact.
It is clear that the opponents of this bill are trying to turn this debate into one that is focused on the issue of abortion. They are a little late, because this issue was the subject of at times heated debate up to 30 years ago. In every state, either the parliament voted to allow abortion or common law was extended to permit it. I am personally opposed to abortion, but we are legislating here for the people of Australia and we must separate out the issues of church and state. The fact is that any woman who wishes to have an abortion in this country is already able to have one. Presently, termination of an unwanted pregnancy is carried out by a surgical procedure. The introduction of RU486 would provide for an alternative method, thereby providing a simplified and less invasive means of terminating a pregnancy. There is no doubt that we need to provide more funding for counselling services both before and after abortion and more funding for sex education and for child support for those who decide to have the child.
Some would argue that there are risks of death from RU486, as has been evidenced overseas. However, it is clear that the incidence of mortality has been very low, and lower than for other drugs. The drug has already been prescribed extensively in Europe, North America, the United Kingdom and New Zealand, to name but a few. In each of these countries, RU486 has been found to be effective and safe.
According to opponents of RU486, 10 deaths have been linked to the use of the drug. This is indeed a great tragedy, as is the avoidable loss of every life. However, the Australian Medical Association and Rural Doctors Association advised the Senate committee that the proper and supervised use of RU486 is no more dangerous that the use of the off-the-shelf pain killer aspirin.
The President of the AMA, Dr Haikerwal, believes that, in relation to the deaths caused by infection and septicaemia:
The cases reported of people dying from infections really are the same... complications that you get with any gynaecological procedure.
But he goes even further. He states that he believes that in some cases the use of RU486 is indeed safer than the current practice.
The use of RU486, being a non-invasive method of terminating pregnancy, could in fact improve health outcomes for women. The current surgical method means that if things go wrong, such as a doctor perforating the cervix during the procedure, a woman can be rendered infertile or have reduced likelihood of having a successful pregnancy later on, when her circumstances may be different.
It is also argued that the availability of this drug would lead to a significant increase in abortion. This has not been the experience in overseas countries where the drug has been introduced. Some would also argue that the approval of an abortifacient is a moral decision and would be more appropriately decided by this parliament. This may have been the case when the legality of abortion was decided, but that issue was settled long ago. We are now debating the question of the means of termination and who should make the decision on what medical and surgical options are available to women who have decided for one reason or another to terminate their pregnancy.
Because we are talking about a medical procedure, surely this decision should be taken by a medically trained and expert board. The minister has the ability to appoint not only people of professional expertise but also people of moral integrity.
Then there is the question of the amendments proposed by the members for Lindsay and Bowman. I believe these amendments are basically red herrings to the real issue. The creation of disallowable instruments will simply mean that any member can raise the issue again anytime, and this parliament will end up having this debate again, again and again. No, I will be supporting the bill and will not be supporting these amendments.
I have been criticised by some for saying that men should butt out of the debate and allow the decision to terminate a pregnancy to be left to the woman to decide. I certainly listened to my wife and daughter. It is women who have to deal with the issues of disruption to their career and the provision of care for a child and to bear the social stigma that can accompany single parenthood. We have come a long way since the wearing of the scarlet letter, and well-meaning men may express their affirmation, but it is certainly not them that have to deal with the consequences of finding they are pregnant. Yes, I am a Christian, but I am also conscious of the real issues facing many young women in Australia each day. The provisions of the bill will ensure that important issues affecting women and their reproductive health are decided by a panel of experts, based on the best scientific information, and not by the minister of the day, who in many cases would have no real expertise in the area. I commend the bill to the House.
At the outset I must state my respect for all my colleagues in this place and the honourable and forthright way in which this debate on the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005 has been conducted. The issue of abortion, which has some relevance in this debate, is an emotive one. I am conscious of the strong and deep convictions of many here in this place, many people across Australia and of course many in my own electorate of Hasluck. Those convictions, I feel, have been well represented in this debate in the Australian parliament. I have received many phone calls, emails and written submissions on this issue. I do very much appreciate the effort those who have contacted me have made to share their views and their experiences in order that I can make an appropriate and informed decision.
I must confess that my position has wavered many times over the course of recent weeks, before I have been able to stand in this House to speak on this private member’s bill. In coming to my final position on this issue, I took great comfort from a submission from UnitingJustice Australia, an agency of the Uniting Church. I quote from their letter:
It is our view that the current campaign against RU486 confuses medical, moral and political issues. As the Uniting Church understands it, the issue is whether or not this particular drug is safe to be released for use in a country where abortion is legally available. This is a decision that should be made by the Therapeutic Goods Administration using sound medical evidence and advice.
It is our belief that RU486 should not be made an exception from this independent process purely due to its application as an abortifacient. Termination of a pregnancy is legal in Australia, however fraught politically or morally.
I also quote from a Uniting Church media release:
The decision to have an abortion is not just a moral issue but a social one. While the current debate attempts to pass moral judgment on the act itself, it ignores the many emotional, physical, financial and social issues that often create a situation where a woman is forced to consider an abortion.
I rise to speak in favour of the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005, and I do so after carefully listening to the debate, both here and in the other place, to my constituents and to my family. Prior to my election I said that I would represent the constituents of Hasluck without fear or favour. Unfortunately, on this occasion, I know that a number of my constituents will feel that I have let them down. However, I feel that in leaving the decision on the use of RU486 in the hands of the executive we are confusing the method of abortion with the legality or availability of abortion.
Abortion, by and large, is legal, under varying circumstances and conditions, in all states and territories of Australia. This is, and always has been, a matter for state parliaments. Through Medicare rebates, the Commonwealth government funds surgical abortions in this country, rightly or wrongly. In light of these facts, I do not see how we can justify special conditions for the approval of abortifacients. These drugs are classified as restricted goods under the Therapeutic Goods Act 1989. Abortifacient drugs are the only type of drug classed as a restricted good. Evaluation, listing, registration or importation of restricted goods requires written approval from the minister for health. That approval must then be put before each house of parliament within five sitting days. Every other drug merely applies for approval to the Therapeutic Goods Administration, which evaluates the drug and regulates its use. The minister is not involved in this process for non-restricted goods.
The TGA is a respected organisation, recognised internationally for its standards and competence. It is the equipped authority to make decisions on the safety and appropriate use of therapeutic goods and for monitoring and reviewing the long-term effects of those same goods. The TGA does not operate in isolation, as the Australian Drug Evaluation Committee carries out an oversight role on the activities of the TGA. This group of independent experts is appointed by the health minister and includes highly qualified medical practitioners, pharmacologists, toxicologists, manufacturing chemists and others. Through the minister, this committee ensures an effective level of public accountability. The Drug Evaluation Committee is part of the regulatory framework and risk management approach approved by parliament. The TGA has so far evaluated more than 50,000 therapeutic goods. It has earned the trust of the Australian parliament and the Australian people. Surely it can be trusted to impartially assess products such as RU486.
This should not be a debate about abortion. The question really is: what is the best and most effective way of assessing the safety of drugs in Australia? The medical experts at the TGA are surely the most experienced and qualified to do so. I do not say this to reflect negatively on the Minister for Health and Ageing, who is an excellent minister and an honourable man. My opinion is that any health minister, whoever they may be, should not be the gatekeeper for the approval of any drug or product. This should not be a political decision. The decision to approve or not approve a drug should be made by qualified medical professionals. Ultimately, we, as members of the Australian parliament, will be held accountable by the people of Australia.
The oft-repeated argument that faceless bureaucrats should not be making this decision is weakened by the fact that the decision to approve every other drug is made by those so-called faceless bureaucrats. If we are so concerned about this process, why have there been no calls to bring the approval of other classes of drugs within the purview of the minister? There is no shame in parliament legislating for an independent body of experts, with general oversight by government, to make decisions regarding particular matters. This has happened in Western democracies for hundreds of years and it is an effective way of ensuring that complex matters are given the due consideration they deserve rather than being reduced to sometimes trite simplifications of political debate.
Our Australian society is divided in its opinion on abortion. There is no clear consensus on this issue. While I am sympathetic to those with alternative views, I must err on the side of personal choice. I believe that parliament must also respect the individual’s right to personal choice. I personally believe that there are far too many abortions in Australia. It is a sad and traumatic event for any woman who makes the decision to take this action. I do not believe that anyone takes this decision lightly. I am sure that everyone in this place—indeed, everyone in this country—would prefer to see fewer or no abortions performed.
The reality is that we live in an imperfect world; abortions are legal. However, this debate is not about increasing the incidence of abortion but ensuring that Australian women, in consultation with their medical practitioner, are able to choose the best method. Given the very unfortunate circumstances where individuals need to make such a choice, is it not appropriate that, with medical advice, we ensure that a full range of medical procedures and choices are available? Rather than, as I see it, artificially limiting people’s options to deal with their situations, we should be providing greater resources to help people make better decisions and to help them be aware of the consequences of their actions.
In this regard, young people are particularly vulnerable. The abortion rate is highest in women aged between 20 and 24. By putting in place better information and education programs, we can inform young people more effectively about contraception and sexuality, provide them with better life skills and teach them about parenting. When our young people have full and frank access to this information and the support of their parents and communities, we will see a reduction in abortion rates. A blanket ban on RU486 does not reduce the abortion rate; it just reduces the options available to Australian women. Indeed, it has been shown in respected and thorough research in many of the countries where RU486 is used that the introduction of RU486 has not triggered an increase in the rates of abortion.
At the end of the day, we should subject RU486 to the same scrutiny as any other drug—that is, the rigorous independent expert evaluation of the Therapeutic Goods Administration. If RU486 is approved for use by the TGA, access to this drug will be subject to the normal safeguards provided by consultation and counselling with a doctor. It will also mean that patients can make a fully informed choice, knowing in detail the effects of the drug. I am in no position to make a decision about the safety or otherwise of RU486; I humbly suggest that very few members of this parliament are. That is why I support this bill to move approval of RU486 to the Therapeutic Goods Administration.
At the end of this very extensive debate, I rise to voice my opposition to the Therapeutic Goods Amendment (Repeal of Ministerial responsibility for approval of RU486) Bill 2005. I do so because the system of regulation proposed by this bill is, in my belief, fundamentally inadequate. At present, as honourable members know, final approval for drugs such as RU486 rests with the Minister for Health and Ageing. It is argued by the proponents of this bill that this arrangement—that is, final approval resting with the Minister for Health and Ageing—lacks in transparency and accountability. They seek to resolve this lack of transparency and accountability by replacing the decision made by the Minister for Health and Ageing with a decision made by the Therapeutic Goods Administration, the TGA. If, as many proponents claim, this issue is not about abortion but about the best process of decision making, this bill is flawed for the very same reasons that the proponents claim the current system is—that is, it contains no more transparency and accountability than the current arrangements.
Having spent much of my professional life advising governments—I should say, both Liberal and Labor—and health care institutions on appropriate approaches to the regulation of biotechnology and reproductive technology, it appears to me that both the current arrangements and those proposed in the bill are inadequate. Much has been said about the appropriateness or otherwise of the Minister for Health and Ageing alone having the decision, but little attention has been given to the alternative proposal. There are a number of reasons why I believe that the TGA alone should not have these powers.
First, the TGA’s purview is limited to technical questions of quality, safety and efficacy. It does not consider other criteria. It is not empowered to take into account any ethical or other consideration that may pertain to this issue. Secondly, the TGA’s technical consideration is limited. For example, there is no requirement that doctors or pharmacists report any adverse reaction to the drugs. Yet we know that the use of this drug, in combination perhaps with other drugs, has caused a number of maternal deaths. Indeed, a major investigation into this issue is currently under way in the United States of America. It would be a pity if, out of all of this, the only winners were the drug companies and members of the legal profession.
Thirdly, the work of the TGA is largely funded through the industry that it regulates. Indeed, part of the reason advanced in favour of this bill is that, with the costs of making an application being so high, the CEO of a drug company would not make one, if the decision were to be subject to parliamentary scrutiny. I find this disturbing—not for the reason which was advanced by my friend the member for Moore, but because it may give rise in the community to a perception that the TGA will be a rubber stamp for applications. That would be regrettable, as far as the reputation of the TGA is concerned. This bill proposes that a group of medical experts will decide, on narrow grounds, what pharmaceutical companies in Australia wish to market. As Justice Michael Kirby once observed, the regulation of new technologies is not a matter to be resolved behind closed doors by committees, however expert and sincere they are.
For these reasons, in my view this bill contains a very inadequate system of regulation. Indeed, I find it quite strange that parliamentarians who day in, day out defend the concept of ministerial responsibility and parliamentary scrutiny in other areas would wish to abandon them in this instance. To the contrary, the amendments foreshadowed by both the members for Lindsay and Bowman provide more checks and balances and a higher level of accountability and transparency than the current bill. I prefer the amendment moved by the member for Lindsay, because it involves not only the expert advice of the TGA but also the minister and the parliament. For those who say that this argument should be based on a level of accountability and transparency then obviously both sets of amendments provide more accountability and more transparency than is provided in the bill before the parliament. Accordingly, I will support the amendments.
May I make a few comments about the issue of abortion. I find it disingenuous to say that this debate is not about abortion. That is purely a technical argument. The whole purpose of RU486 is to induce an abortion. If the subject matter were aspirin, we would not have been having this debate in the parliament over the last few days. Indeed, many speakers both here and in the Senate have explicitly stated their stance on the bill and related their stance on the bill in relation to their view about abortion generally.
Two things appear clear to me about abortion in Australia. The first is that there is no desire generally in the community to change the current legal approach to abortion. Contrary to what many have said, abortion is illegal in most Australian states unless certain circumstances are established, which usually relate to a threat to the health and wellbeing of the mother. However, in practice we know we have abortion on demand.
Secondly, there is a growing unease about the high number of abortions. Many Australians are concerned that there are 80,000 to 100,000 abortions performed in this country each and every year. Many believe that we have trivialised a profound issue and many also worry that this bill will compound that view. I believe that this level of abortion in Australia is a blight upon our nation. Many speakers both here and in the Senate have voiced concerns about the high abortion rate. Anecdotal evidence is supported and reinforced by surveys. A national poll conducted by the Sexton Marketing Group found, for example, that 87 per cent of people wanted the number of abortions in Australia reduced and 78 per cent wanted mandatory counselling before the procedure was undertaken.
I note that this bill proposes absolutely nothing that would reduce the incidence of abortion in Australia, something which I think overwhelmingly Australians would like to see. Indeed, the comment by Serena Williams, a young Melbourne woman reflecting on the unwanted loss of a pregnancy, in the Herald Sun last Sunday succinctly summarised the concerns of many people. She said:
I cannot understand why we are fighting so hard to promote less counselling, less help and debilitating bleeding at home without medical supervision, which is what would happen with RU486.
Given the level of concern in the community about the prevalence of abortion, I urge my colleagues in the government to consider what support and counselling can be provided for people facing this choice—and, by counselling, I do not mean services provided by abortion clinics. The reality today is that we have abortion with very little or no support for the women and the men facing these significant decisions. I urge the government—indeed, I urge this parliament—to address the issue. I believe a program that provided counselling and some time for people to consider all their choices would be widely supported in the Australian community.
We need more discussion, not less, about the causes for such a high incidence of abortion. For far too long we have danced around the subject—like the elephant sitting in the middle of the living room that we all know exists but whose existence we do not want to acknowledge. I hope this debate will not be the last word on the subject in this parliament but the beginning of a mature reflection on a matter of concern to so many Australians.
That the amendment (Miss Jackie Kelly’s) be agreed to.
by leave—I present a copy of the bill that is in my name so that it can become part of the House records. I would like to thank David Elder of the Clerk’s office for his assistance to my office in the preparation of this bill.
Original question put:
That this bill be now read a second time.
Bill read a second time.