Press Conference: Sexual Health & Family Planning ACT

SENATOR THE HON KATY GALLAGHER, MINISTER FOR WOMEN: It's great to be here as part of this very significant and historic announcement for women's health, the package that the Albanese Labor Government has prioritised. It's about more choices for women, it's about cheaper access to healthcare and better access to healthcare. That's what this package is about. I'm thrilled to be here with a lot of people who have worked on that package, but this is all about making sure we're addressing areas where it's been unfair or unaffordable for women to make sure that they are able to access contraception, that they're able to access menopause support, health assessments, that GPs are reward and supported to be providing that care. And also to make sure that women who are on the lowest incomes are able to access care through pharmacies. This really is a game-changer for women around the country. It will help millions of women, both from an affordability point of view but also an access point of view. And this is what Labor governments do when we invest in healthcare and make sure that women get a fair crack, not only at access to healthcare, to services, but also access to the best treatment and medications available.

THE HON MARK BUTLER MP, MINISTER FOR HEALTH AND AGED CARE: Thanks, Katy. You simply can't be serious about strengthening Medicare without a serious focus on women's health. And today is a great day for women's health. Women consume about 60 per cent of all health services in this country and they face a range of significant costs simply by virtue of being women, particularly around contraception and during perimenopause and menopause. Through a range of pieces of work, particularly Senate inquiries that Senator Marielle Smith has led and Ged Kearney's work through the Advisory Council, it's been very clear to us that women simply haven't been getting the level of support they deserve through our healthcare system for too long. Today's landmark package reverses decades of neglect and finally delivers Australia's women more choice, better care and lower costs.

THE HON GED KEARNEY MP, ASSISTANT MINISTER FOR HEALTH AND AGED CARE: Thanks, Mark. Good morning everyone, I'm Ged Kearney, the Assistant Minister for Health and Aged Care. And today is truly a landmark day for women's healthcare. The policy announced today is indeed life changing. I'd like to thank Ministers Butler and Gallagher for their absolute trust in this package and their investment in it and Senator Smith for all the amazing work she did with the inquiries, and the Women's Health Advisory Council who's been with us this whole way, and to all the women advocates who have raised their voice in a chorus, telling us that the health system wasn't good enough. But today we have a package that will transform menopause care. It will mean fewer unplanned pregnancies. It will mean women with pelvic pain and endometriosis will be heard and believed and get earlier diagnosis and treatment. And it means some women who suffer the agonising pain of UTIs will get treatment more quickly. This is life changing. For every menopausal or perimenopausal woman who has had flooding periods, night sweats or brain fog, for women who haven't been able to afford their choice of contraception, for women who've had agonising pelvic pain and been told that it's all in your head or just suck it up, that women should be in pain, and for women who have had to agonise through the awful pain of a urinary tract infection because they couldn't get timely treatment - this package is for you. The Albanese Labor Government has heard you, we believe you and we are acting for you. Thank you.

MARIELLE SMITH, SENATOR FOR SOUTH AUSTRALIA: Thanks, Ged. I'm Marielle Smith, Senator for South Australia and Deputy Chair of the two inquiries. Menopause is not an optional part of ageing and good quality healthcare shouldn't be optional either. And when it comes to women's health, we've had far too many stories of women's pain being ignored or worse, dismissed. And through our two inquiries, we heard from more than 600 women and organisations who came with us and shared their pain, they shared their intimate symptoms, they shared their experience of being ignored and let down. Our Government listened. We have heard them. And we're rewarding their bravery with this investment, which will make a huge difference to their lives. Good public policy is all about good outcomes and I want to thank the women who submitted to our inquiries. This change is for you. Your bravery has meant something.

ALI PEPPER, MOUNTAINEER: I'm Ali Pepper. Thank you, Ministers, for this incredible announcement that will change the lives of so many women across Australia. When menopause hit me, it was like an avalanche. Severe night sweats, insomnia, aching joints, depression, and brain fog. As a high-altitude mountaineer, I honestly thought I'd never climb again. Overcoming menopause felt harder than Everest. It took months to find a GP that was trained in menopause care. But when I finally did, I was prescribed an estrogen gel combined with a progesterone tablet. Everything changed. Within a month, my severe symptoms disappeared. Within a year, my body felt better than it had for years. I was able to take on my biggest challenge yet, climbing all 14 of the world's 18,000-metre peaks without oxygen. Since starting MHT, I have summited seven of those giants. Five of them without oxygen, becoming Australia's most accomplished female mountaineer. But my story is not unique. Menopause affects every woman and for too long many have struggled in silence, unable to access the best treatments because of cost. That changes today. With this announcement, more Australian women will have access to modern, body-identical hormone therapy treatments that are not only effective, but aligned with the latest medical research. This isn't about just managing the symptoms, it's about restoring health, vitality and the ability to keep doing what want. To every woman going through menopause, know this: with the right treatment and a strong wellness plan, the best years of your life are still ahead of you. Thank you.

CAROLINE MULCAHY, CHAIR OF FAMILY PLANNING ALLIANCE AUSTRALIA: Hello. I'm Caroline Mulcahy and I'm the Chair of the Family Planning Alliance Australia. The Family Planning Alliance is a group of sexual and reproductive health centres, and there is one in each state and territory. As the Minister has said, this funding is an unprecedented funding game changer for women and for reproductive health care in Australia. We hear from women every day about the challenges they face, the barriers in accessing affordable sexual and reproductive health care. This investment offers healthcare practitioners the essential education and training they need to care for women and girls across their reproductive lifecycle. It also offers women so much more choice and control when considering what contraception best suits them, and also treatments for heavy periods, pelvic pain, endometriosis, menopause and much more. We are absolutely thrilled that the ministers and the Albanese Government have listened to women and girls across Australia, and I'd like to thank Minister Kearney and Senator Waters for holding the two Senator inquiries into accessible and affordable reproductive health care and also perimenopause and menopause. It's actually the first time I think women have actually had these concerns and their reproductive and sexual challenges recognised and acknowledged by a government. So, thank you. Removing barriers and providing accurate information, appropriate medical counselling and easy access to contraceptive services increases choice, accessibility and affordability, and I say again, this is a game changer for women and girls in Australia.

JESS MCGOWAN, COMMUNITY LEAD: My name is Jess McGowan. I am one of the two endo community leads for the ACT. This is a great day for those with endo and pelvic pain. I was diagnosed with endo 20 years ago. Since then, I've experienced not being able to access services countless times, whether that be because of cost-of-living or lack of services, and almost everyone with endo that I've met has had those same barriers at one point. Being dismissed by medical professionals and experiencing long delays in diagnosis and treatment will hopefully be a thing of the past one day, but having these dedicated clinics is a huge step in the right direction. We've already seen a positive outcome for endo sufferers who've accessed these clinics. Takes an entire community to come together to achieve things like this. So, this is a very, very welcome investment. And I look forward to what is to come and to continue working with all levels of government to assist people with endo and pelvic pain moving forward. Most of all, thank you for hearing us.

JOURNALIST: Minister Kearney, a question - just given you're wearing the IUD necklace today, a question about IUDs. Obviously, the cost has been a huge barrier for some time, but a lot of women also say that there's a fear factor because there are so many stories of women experiencing injury, excruciating pain. In what way will this package today address that side of the equation?

KEARNEY: That's true. There is a lot of misinformation and disinformation out there on the internet about hormonal IUDs. Part of this package will be establishing Centres of Excellence where we will be able to train health professionals in how to have that conversation with women about their choice of contraception, how to insert them, how to remove them properly, and it will develop a community of practice that will be able to disseminate information that is true, that is real. And the best thing a woman can do to find out about the IUDs or contraception that is best for her, is to talk to her health professional.

JOURNALIST: But in terms of the pain, we all know women who say that they fainted or you know, saw stars - that is a real element and a fear factor around getting the IUD. Will there be any measures to deal with pain relief?

KEARNEY: I think part of the training aspect of this package is going to be vitally important. A lot of health professionals tell me that a lot of the pain is due to imperfect insertion and technique and if we can get that right, that will go a long way to controlling that pain. But also, we are reviewing guidelines, or there has been a review of the guidelines by RANZCOG, around pain management and advice to patients for when they do actually present for an IUD insertion.

JOURNALIST: Just picking up what you said before, the best thing a woman can do is have a chat with their health professional - I mean, some of the response to this package today has been great, this money is welcome, but also it's still very hard to find a bulk-billing doctor in a lot of places for adults and for working women who maybe don't have as much time or choice in where they go.

KEARNEY: That's the beautiful thing about this package. It's addressing just that access issue. The bulk-billing rebate is 150 per cent more for a GP, plus there will be a 40 per cent bulk-billing incentive on top of the rebate for the doctor. So, we're fairly confident that that will mean GPs will be able to bulk-bill women who wish to have an IUD. The Royal Australian College of General Practitioners has come out this morning and welcomed this package, so we're very helpful that that is the outcome and that's our intent.

JOURNALIST: Question for Caroline, if that's okay. Obviously, Australia has the lowest uptake of IUDs in the world, is that correct? What are people telling you and how will this help, do you think, I guess to mitigate unplanned pregnancies?

MULACHY: Part of this package includes a public campaign and so, the Family Planning Alliance does national campaigns. We did one recently on UTIs. And what we'd like to see is a national campaign which encourages women to go talk to their health practitioner, particularly family planning practitioners that have been trained in reproductive and sexual health, to increase the uptake. Australia - it's about one in ten women in Australia. But if you compare that to Sweden, for instance, which has the highest intake, one in three - we'd love to use that as our benchmark and we'd like to see more women and young women particularly coming to us to have IUDs inserted.

JOURNALIST: Can I ask on the PBS listings? You know, good news that there's two new ones. I think you flagged that there might be some more oral contraceptives down the track, how long is that likely to take and is there any kind of process so that you know, if new drugs come onto the market, some sort of automatic consideration so it doesn't take another three decades?

BUTLER: On that, the core driver of this package is to give Australia's women more choice over their health care. So yes, we're making long-acting contraceptives, IUDs and implants cheaper and easier to access. We're training more GPs and nurse practitioners to do those services. We're very confident that the very big increase in the rebate will mean that close to 100 per cent of those consults will be bulk-billed as well by GPs, and hopefully, I'll say, by obstetricians and gynaecologists. But we want to give Australia's women the choice to decide whether or not an implant or an IUD is the right contraceptive for them, or whether they want to continue with an oral contraceptive pill. There hasn't been a new pill added to the PBS for more than three decades, in spite of the fact that several of them have been registered on the TGA's register. And that's why I wrote to the Pharmaceutical Benefits Advisory Committee late last year and to the sponsors, urging them to do everything they could to bring those cutting edge, next-generation contraceptive pills onto the PBS. This is Yas and Yasmin in particular, that are used by tens and tens of thousands of Australian women who have to pay private fees because they're not on the PBS. So, for those tens of thousands of Australian women who use those two drugs, they'll be saving somewhere between $250 and $350 a year just because we've been able to get them on the PBS. We're also really hopeful of a third cutting-edge drug, Slinda, another oral contraceptive pill, which we also asked the PBAC to consider late last year. We're hopeful that that will be added to the PBS as well, but there are still negotiations going on about that. I mean, our ambition has been to get as many choices onto the PBS as possible and frankly, the PBS has been moving too slowly for Australia's women. In December, we listed the first new drug for endometriosis in over three decades for the end, Visanne. There had been nothing new for the one in nine Australian women who suffer from endometriosis for 30 years since last century. Today, we're adding three new menopausal hormone treatments of the type Allie uses onto the PBS, that will save women hundreds of dollars a year as well. So, it's about choice. And we're going to do everything we can to try and expedite new, cutting-edge medicines for Australia's women onto the PBS.

JOURNALIST: This is something that's been endorsed by the Coalition. Michaelia Cash says it builds on work the Coalition did. Can I just ask, how much of the $50 million for endometriosis that the Morrison Government committed has been - how much of the 22 clinics were funded with that money? And do you welcome the fact that this has bipartisan support?

BUTLER: Well, of course we prefer bipartisan support, but I'm not quite sure what Michaelia Cash is talking about in terms of their contributions to women's health. Peter Dutton tried to abolish bulk-billing for every single Australian woman and man besides. He tried to cut $50 billion from Australia's public hospitals, which are disproportionately used by Australian women. And yes, they did - in the dying days of their government - put some money towards endometriosis clinics, but they didn't open a single one. We've opened 22 since we came to government and today we're funding another 11, so that every primary health network catchment has access to one of these specialist clinics. You know, what else Michaelia Cash refers to that they did for women's health, I'm at a loss, because they didn't list a single drug for endometriosis, a single new oral contraceptive, a single new menopausal hormone treatment. Yes, I prefer their support than their opposition. But frankly, the idea that they made a contribution to women's health does not reflect history.

JOURNALIST: Minister, the Coalition today is also really zeroing in on bulk-billing rates. It says in the last financial year, 40 million Australians didn't go to the doctor because they couldn't find a bulk-billing doctor. Today, we have a report by Cleanbill, which has surveyed different federal electorates and found that adult patients in electorates including your home state of South Australia weren't doing any bulk billing. What is Labor's answer to this?

BUTLER: Yeah, well my first answer would be to have a look at the official data around bulk billing rather than the headline-grabbing phone poll by a private company. You know, we publish, for the first time ever, since we came to government, we publish the most transparent data around bulk billing for general practice visits. And it shows that 77 per cent of all general practice consults are bulk billed. Now that's not as high as we'd like, we want to do more in bulk billing. But I've said before, I've quoted before, the College of General Practitioners said that when we came to government, bulk billing was in free fall and at a tipping point. That's their language. And it reflected six years of a Medicare rebate freeze that Peter Dutton kicked off. I mean, if you freeze the income of doctors while their costs are continuing to rise, yes there's pressure on bulk billing. That's what Peter Dutton wanted. When he said in 2014 there were too many free Medicare services, and he tried to abolish bulk billing altogether, that was the end goal that he wanted. And frankly, he achieved it. Bulk billing was in freefall. Now, the tripling of the bulk billing incentive that we put in the 2023 budget with the strong support of the Finance Minister stopped that free fall and has seen bulk billing turn around in every single state and territory. Now, it's not turned around as much as we would like. We've said over the last several weeks we would like to do more around bulk billing. In this area, as Assistant Minister Kearney has said, we have carefully calibrated the Medicare rebate that was put in place for consults around the insertions and removal of implants and IUDs to ensure that we're confident that we'll get close to a hundred per cent bulk billing there. We've looked at what the private fees that are being charged by some GPs and OBGYNs are, and we've set that Medicare rebate and the bulk billing incentive to ensure that women, when they're exercising choice, can be confident that a long consult with their GP, or in some cases with their OBGYN, they won't be shelling out hundreds of dollars in gap fees that they are now.

JOURNALIST: Sexual healthcare is obviously a huge part of this. And recently Queensland decided to halt hormone therapies for people under 18. I guess, what's your reaction to that, especially with the rallies around Australia today and yesterday?

BUTLER: Well the week before last, I announced the National Health Medical Research Council was responding to my request to conduct a review to develop new clinical guidelines for the care of gender diverse and trans children and teenagers. The NHMRC has a statutory charter set out in federal legislation to develop and issue clinical guidelines. They've got decades of experience in this area. They are undoubtedly the right body to do that, which is why that announcement has been broadly welcomed right across the board in an area that is very contested. And as the NHMRC said, in a clinical sense, is evolving. So, we want to see an end to the politics around this. We want to make sure that we're providing the best possible clinical care and wrap around support to some really vulnerable young people who are at the wrong end of pretty much every metric, when it comes to health and mental health in particular. So, my request is to people, let the clinical guidelines be developed. That will include a report next year on the use of puberty blockers for under 18s. Let those guidelines be developed in the same way the NHMRC has developed guidelines for decades now. And going forward, ensure we provide the best possible care to these young people and their families.

JOURNALIST: You picked up on something Michaelia Cash said before, but I wanted to ask about something else she said, she called the PM drowsy and disinterested. You're pretty close with Mr Albanese. Has he given up?

BUTLER: Well, what a surprise you'd get a cheap sledge from someone like Michaelia Cash. That's her stock and trade. I mean, our Prime Minister is focused every single day on the national interest and making sure we get through what has been a very difficult period after the COVID emergency, with cost-of-living pressures facing all Australian households. That's why we've been focused so squarely on delivering responsible cost of living relief to Australia's households including in these areas - strengthening Medicare and cheaper medicines.

JOURNALIST: On last week, Peter Dutton told Peta Credlin, "I just don't believe in discriminating against anyone, not on the basis of anything. And for young girls not being able to achieve their Olympic dream or to be displaced from a team because someone has a physiological advantage over them, I just don't think that's in the spirit of sport." What is Labor's position on trans participation in professional sport?

BUTLER: Well, I'll have a go, Katy might want to add to this. But this is not an issue in Australia. We have very clear legal provisions in the Sex Discrimination Act. Section 42 says that sporting codes are able to put in place measures to ensure that particular sporting competitions are reserved for in this case, the case you're referring to, biological women. And they can do that where, I think the wording is, strength, stamina and physique are a relevant factor in that sport. So, perhaps not chess championships, but certainly in physical sports where strength, stamina, and physique is an issue. There are really clear provisions that allow sporting codes, with the guidance of the Australian Sports Commission, to make those arrangements. And I don't think you can point to a single sporting code that has said it does not have the tools at its disposal to deal with these issues that are subject of some community discussion. So, look this might be a, you know, a political contest or a matter of political contest in the United States or some other countries, but let's not bring politics to an area that's got very clear legal protections and provisions. A clear history of sporting codes being able to manage this issue for their own purposes. And, you know, no need for the sort of culture war that I suspect Peta Credlin and Peter Dutton are trying to stoke.

JOURNALIST: Can I just ask about the Werribee by election yesterday. Labor has taken a big hit to its primary vote there. Are you worried, Victoria has historically been a very strong state for the Labor Party, a very strong state. Are you worried that the state brand might hurt the federal chances at the upcoming federal election?

GALLAGHER: Well, I think everyone knows, that the federal election will be a real choice. And that will be, you know, our focus will be selling what we have done and what we will do, and that will be in stark contrast to Peter Dutton and what he will do. So, you know, I think in terms elections, by elections, you often see swings against incumbent governments. But the federal election, I think the Australian voting community understand that, you know, do you want to see more investment in Medicare, more investment into aged care, more investment into your services that Government delivers. Or do you want to see cuts and nuclear reactors dotted around the country? I mean, that will be the choice. I think it will be a very clear choice for voters. And we will focus on that, we've got a busy few months ahead of us.

JOURNALIST: We have a Victorian here. Is the Labor brand in trouble in Victoria?

KEARNEY: I just endorse everything Minister Gallagher just said. You know, we've got to get on absolutely from day one, making sure that people know there's a very stark difference at a federal level between the two options next election.

JOURNALIST: Just another one for Senator Gallagher. You're the Minister for Finance and for Women, this is obviously a cost of living measure as much as anything else, and for half of Australian voters. Are you hoping this will be a vote winner?

GALLAGHER: Well, it's good policy. That's the work behind it that Ged, and Marielle, and Alicia and all of the speakers you've heard from today. This is about responding to unmet need and areas of concern by women. And so, it's good policy, in terms of having good policy that is good in meeting people's needs, and women's needs, that have been so under-met for a long time. I mean the challenge for us has been, I think in the past, no one's found the money to put into this. So it's been easy to sidestep and not address. What we've managed to do, with Ged's work and the work she's done across the community, and the work that Mark has done, is find that important investment - over $500 million - to make sure we are addressing those needs of women. So, it's about women's health. It's not about politics. It's about meeting unmet need, addressing those areas where women have been concerned and raising issues. And as Ged said, we've listened and responded. And for me, you know, as someone who, I think I came here first in 1986 or 1987 to Canberra Family Planning and watched it through my life, it's amazing to be able to stand here today with all these amazing people, and know that we're making a real difference for women right around the country. You know, this is actually why we do the jobs we do, because it will make such a difference. And particularly cost of living, help with those bills that we know women have that men don't have. To be able to make progress there is just amazing.

JOURNALIST: Just quickly on the Senate agenda, in particular Production Tax Credits Bill tomorrow morning. Have you landed a deal with The Greens on that one?

GALLAGHER: We're pretty optimistic about production tax credits. So, we've got a bit to go on that Bill. But we would definitely be looking to get that through this week. You know, obviously the Senate is a contested space. We've got Peter Dutton opposing them - opposing actually incentivising the production of critical minerals in this country - so when Peter Dutton opposes things, which he usually does in the Senate, we have to go and secure additional votes. But we are, you know, I'm pretty positive about that Bill.

JOURNALIST: On proposed electoral laws, how confident are you that that package, maybe a bit tinkered with, might pass by the end of the week?

GALLAGHER: Well, we're continuing to talk to people in the Senate and working with the Opposition on that. But also the cross bench. Again, it's something that we want to get done, we want to take big money out of political campaigning. We think that's the right thing to do. We want to be more transparent about where money's coming from and more timely with that information. So, we'll press on with that. It's not over until it's over. And again, Minister Farrell is leading that work. So, it's on the notice paper. We've got a lot of bills we'd like to get done. We've got the, Keeping NBN in Public Ownership, we've got some money bills in the Senate that we want to get done so we can fund amazing things like this. And, yeah, it'll be a busy week.

JOURNLAIST: There's reports the crossbench want the spending cap doubled, is that something that's being looked at?

GALLAGHER: There's a range of amendments that I think the crossbench are putting forward. And there's some, I think I've heard there are some that want particular parts of the bill split out and not progressed. This has been years and years in the making, this Bill. It's been subject to a number of committee inquiries. We're pretty confident we've got the balance right. Again, getting big money out of politics and being more transparent in a timely way about where donations are coming from. But, negotiations will continue. It is a bill we would like passed this week, and we're going to need, you know, the help of other senators to get that done.