Labor won’t make public hospitals perform abortions, despite fresh push for access

The federal government won’t force state hospitals to perform surgical abortions, formally ruling out a policy it took to the 2019 election, but is facing a fresh push from health groups and left-leaning Labor women to make terminations more accessible.

The Royal Australian College of General Practitioners is ramping up its calls for universal access to abortions in both public hospitals and through doctors, who they say should be able to supply the medical abortion pill to women following a fully funded consultation.

Family Planning NSW also wants the government to guarantee Medicare coverage of telehealth appointments for medical abortions – a measure due to expire at the end of the year – after an analysis of its data showed women used the service in greater numbers while it was free.

Women outside major cities are travelling 200 kilometres to get abortions. Credit: Stock

A renewed focus on reproductive healthcare has come after a senate inquiry into the issue recommended in a May report that public hospitals either offer surgical abortions or steer patients to affordable providers, and that the abortion pill be easier to prescribe.

Abortion services are a patchwork across the country, with rules that differ between states and territories, while many GPs and public hospitals refuse to provide terminations for conscience reasons or because they fear an influx of abortions could cripple already overstretched resources.

The inquiry heard women outside cities often travelled 200 kilometres to get an abortion, leading one in 10 to pay for overnight stays, while 4 per cent had to go interstate.

However, Health Minister Mark Butler has categorically ruled out revisiting Labor’s 2019 policy of making public hospital systems provide abortion services to qualify for federal funding, ahead of a push from left-leaning Labor women’s ranks to put the issue back on the agenda at the party’s national conference next month.

“That was a policy at an election some time ago. It’s not our policy now. It’s not the policy we took to the last election,” he said at a press conference last week.

Labor had previously distanced itself from the idea, which some thought hurt its election prospects in faith communities, and went into the 2022 election with a softer promise of “equitable access”.

Butler said that was still his government’s position. “Part of that is geographical, part of it is also socio-economic,” he said.

“We got an exhaustive response from the community and a really thorough report from the Senate committee, and we’re working our way through that.”

The progressive Labor women’s group Emily’s List is pushing for fully funded abortions, the government to cover travel costs of regional women, and wants nurses and midwives to be able to prescribe the medical abortion pill.

Currently, the pill can be taken before nine weeks’ gestation but must be prescribed by a registered doctor. The Therapeutic Goods Administration is considering an application from pharmaceutical company MS Health that would enable other health practitioners to prescribe the medication and remove registration requirements.

RACGP president Dr Nicole Higgins said both medical and surgical abortions should be accessible to all patients regardless of their postcode or income. She said the ACT and Northern Territory were leading the country in giving free access, and that the states should follow suit.

“This is a discussion that needs to be had at national cabinet about how that is funded,” she said, adding that medical abortions were cheaper than surgical ones but could still cost between $250 and $600.

“It takes time to counsel a woman, not only about the decision to have a termination, but about the process, complications and the risks, and contraception moving forward. [We need] a higher rebate for that consultation that is not just time-based,” she said.

Family Planning NSW medical director Dr Clare Boerma said ensuring free telehealth abortion consults was also essential. A new study investigating access trends at the organisation found telehealth use for medical abortions has increased during periods where Medicare rebates have been available for sexual and reproductive healthcare.

The research, published this week, also showed telehealth was more likely to be taken up by patients in rural and remote areas, where it can be more difficult to access abortion services. However, the rebates are due to expire at the end of the year.

“Our clinic data shows that when access to Medicare-rebated telehealth is restricted, so is equitable access to medical abortion,” Boerma said.

She also wanted to support more GPs to provide medical abortion services, since only about 10 per cent were registered.

Assistant Health Minister Ged Kearney said that “deserts of care” when it came to family and reproductive healthcare were worrying.

“We are very serious about addressing this issue. We really welcome the [senate inquiry] report – we are working through it right now,” she said.

“We remain committed to ensuring that all Australians have equitable access to healthcare. We want to see all health practitioners operating to their full scope of practice. This is particularly important when it comes to addressing the structural barriers facing women accessing maternal and reproductive healthcare, so that more women in Australia can access the care that they need.”

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