Cairns Hospital sends abortion patients to Sydney

Cairns Hospital sent 23 women to Sydney for surgical abortions last year after a standoff with staff doctors.

RU486 abortion pills can not be used after week nine of gestation.

A regional public hospital in Queensland sent 23 women to Sydney for surgical abortions last year after staff doctors refused to perform the procedure.

The standoff at Cairns Hospital has helped swamp already limited private abortion services statewide, increasing the numbers sent south for terminations that cannot be performed in Queensland. This involves hundreds of women, case workers say. The crisis in Queensland mirrors a collapse of private abortion services in Tasmania that has forced many women to travel to the mainland.

In Cairns, the problem can be traced to the retirement in 2016 of private practitioner Michael ­Carrette, who had performed about 500 surgical abortions a year, meeting most of the demand for a vast catchment reaching to the far-flung indigenous communities of Cape York Peninsula.

But unlike the situation in Tasmania, where clinic operator Paul Hyland claims to have been driven out of business by the relatively low cost of terminations using the abortion pill RU486, doctors in Queensland say the issue is a state law that makes them liable to criminal prosecution for performing an abortion.

Cairns-based professor of gynaecology and obstetrics Caroline de Costa, a key figure in the campaign to introduce RU486 to Australia, said when no workable replacement for Dr Carrette could be found, approaches were made to the Cairns and Hinterland Health and Hospital Service to take over.

“There was a strong suggestion that it should be done by gynaecologists at the Cairns Hospital, of which there are now seven,” she said. “But they have demurred … claimed conscientious objection, they can’t fit them on the lists and there’s just endless excuses. It’s clear that it’s never going happen.”

This has resulted in a collapse of referrals of women for surgical terminations from the state-funded Cairns Sexual Health Service, down from about 200 in 2016 when Dr Carrette was operating to 56 last year. None was performed in Cairns. Instead, 33 women were sent to Townsville, four to Brisbane and six to Southport on the Gold Coast to undergo the procedure. The remaining 23 were flown to Sydney, according to Queensland Health.

Separately, the NGO Children by Choice in 2016-17 provided financial assistance to 293 Queensland women having elective abortions, some of this to fund travel.

Counsellor Michelle Reynolds said women often had to go alone interstate. This was particularly hard on indigenous women who might have never before left Cape York or been on a plane.

“There is absolutely no person in Cairns to do a surgical procedure,” she said.

While the take-up of so-called medical abortion using the combination of RU486 (mifepristone) and misoprostol had helped, the pills could not be used after week nine of gestation, creating another obstacle for women in remote areas who could not access reliable ultrasound screening.

By the time they were assessed in Cairns and underwent the required counselling, there might be no option but a surgical procedure.

“It is really adding to the distress and pressure these women are experiencing — especially in the case of young indigenous women who may have never been away from their community (and) have limited means or support networks,” Ms Reynolds said.

A spokesman for Queensland Health confirmed that “individual doctors” had the right to refuse to perform termination procedures in the public system. Queensland and NSW are the only states that maintain criminal sanctions again abortion, but doctors can get around this through the law of precedent laid down by judicial findings.

Acting state Health Minister Shannon Fentiman said abortion law reform in Queensland was long overdue and the recently re-elected Labor government was awaiting advice from the Queensland Law Reform Commission on legislation to decriminalise abortion.

In a statement, Queensland Health said: “Since the retirement of Cairns’ sole provider, the Cairns and Hinterland Hospital and Health Service has referred women for surgical terminations to private providers in Townsville, Brisbane, Southport or Sydney. The HHS is investigating alternatives to this situation.”