Analysing the state’s surgical abortion situation after 11-month delay

abortion ruth forrest

After 11 months delay, Tasmanian women are set to be able to access a surgical abortion service.

Hampton Park Womens Health Care, which is based in Melbourne, will begin operating the service from November 28.

However, some say the fortnightly service is still not good enough for women living outside of Hobart, and are critical of the fact it took almost a year for the state government to finalise a provider.

The last private provider in the state closed on December 31, and after initially promising a new service by October, the government has missed their self-imposed deadline by a month.

New provider

What we know so far. 

  • Will be run fortnightly, with possibility for increased sessions depending on demand.
  • Taking referrals from Monday, with first clinic due for November 28.
  • Will cost $475 per surgery.
  • Will be run by Melbourne-based provider Hampton Park Womens Health Care.
  • Women can refer by phone through Department of Health website.
  • Patient Travel Assistance Scheme will be available for intrastate travel to the service.
  • Solution to previous provider closing, based on a report from the Department of Health and Human Services secretary Michael Pervan.

What is surgical abortion?

There are two legal ways to terminate a pregnancy.

A medical abortion is available up to nine weeks, and involves taking a pill called RU486. This option has been available within Tasmania all year, through family planning services, termination by mail services such as the Tabbot Foundation, and some general practitioners. GPs have to undergo specialist training to prescribe RU486, and in between 40 and 50 GPs have signed up to do so in Tasmania. There is “at least one in every region,” according to Royal Australian College of General Practitioners chair Jenny Presser.

When the pregnancy is between nine and 16 weeks women needing to terminate a pregnancy require a surgical abortion. This was legalised in Tasmania in 2013, but has been unavailable in practice since December. Some private obstetricians have continued to offer surgical terminations, but this is beyond the price point for most women and is not widely advertised, outside of contacting specialist advice services such as Women’s Health Tasmania. The majority of women further along than nine weeks have travelled interstate to access surgical abortions since December.

After 16 weeks, abortion is only legal in Tasmania with the written consent of two doctors confirming there is a risk to the health of the mother. This is the only time abortion will be undertaken at public hospitals in the current system.

What happened this year?

abortion timeline

The government previously said there would be private provider operating in Hobart by October, which did not occur. On Friday November 16, Health Department secretary Michael Pervan confirmed the new service would begin operations this month, with referrals taken from Monday and the first session due for November 28.

Initially, the state government said the name of the provider would be kept secret and that women would need to be referred by GPs. However, on November 9 Dr Pervan reversed this and said women would be able to contact the service directly via a phone number on the Health Department website.

What’s the situation for the north?

There has been criticism that a fortnightly service in the capital does not qualify as a truly accessible option for regional and rural women.

For example, women in Launceston will have to find time to travel to Hobart and back. They will have to either find overnight accommodation, or organise a support person, as they cannot drive after being under anesthetic. As nearly 60 per cent of women who have abortions are already mothers, this also frequently involves organising childcare.

University of Tasmania researcher into reproductive services, and Women’s Health Tasmania board member, Meredith Nash, said that a provider in Hobart was only marginally more acceptable than no provider at all.

“Just getting the one service is the first step, but regional and rural women are really disadvantaged when it comes to reproductive care,” she said.

“They should be able to access care within a reasonable distance. It’s part of the solution to have this new clinic open, but not the whole solution.”

The government said women would be able to apply for compensation costs incurred in travelling to Hobart when the new provider opens.

“The department will also provide increased funding to Prescribed Health Services, and Pregnancy Counselling and Support Tasmania, to ensure longstanding arrangements to support women continue,” a spokesperson said.

Why has it taken so long?

abortion will hodgman

The government says it has taken over 10 months to finalise negotiations between the provider and an appropriate surgical facility.

However, Women’s Legal Service chief executive Susan Fahey said she believes the nearly year-long wait was as much about ideology as it is about practical barriers.

“This is either incompetence or ideology, and the [Health] Minister can be very competent when he wants to be,” Ms Fahey said.

All members of the Hodgman government voted against legalising abortion in the conscience vote that occurred in 2013, and Health Minister Michael Ferguson is well-known as being personally anti-abortion for religious reasons.

MLC Ruth Forrest also holds the view that the delay in a surgical abortion facility can be explained by a personal opposition to abortion on behalf of the government and the Health Minister.

“I believe that the Minister’s personal philosophical beliefs are getting in the way of a good service,” she said.

“I’m so sick of it, it’s just wrong.”

Dr Nash said it was tempting to draw the conclusion that the delay was not wholly due to bureaucracy.

“The silence [has been] strange here, and it’s easy to assume the worst,” she said.

“My optimistic view is that there are inspections at the site or other practical matters that are holding this up. But if that’s the case, then why can’t they just publish that? It’s easy to think that it’s something more dire, like trying to limit access.”

Premier Will Hodgman said accusations of ideological bias were inaccurate.

“I’d have liked to restore that service sooner,” he said.

“We’re guided by medical advice. The Department of Health and Human Services secretary released a report to Parliament about what is a suitable service, and what’s driving government is to deliver that.”

“The advice provided by the Department of Health supported the establishment of a private provider, we are following that advice,” a government spokesperson added.

abortion susan fahey

What is the opposition’s view?

If elected, Labor has promised to make terminations on request available through public hospitals.

They attempted to pass a motion enabling abortions in public hospitals in July, but failed by one vote.

“Services would have been available months ago, and terminations could have been established within the public system by now,” opposition health spokeswoman Sarah Lovell said.

That proposal is also backed by the Greens, and Independent MLC Ruth Forrest.

“This service does not provide back-up and follow-up care if needed – it’s once a fortnight – women from outside of Hobart cannot access it easily, and it just perpetuates disadvantage for women outside the city,” Ms Forrest said.

“Not everyone needs to get their appendix out, but you still need to know that you can get it through a public hospital if you need it.”

 

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