REPRODUCTIVE HEALTH CARE REFORM BILL 2019

I speak on the Reproductive Health Care Reform Bill 2019 and note the Premier has authorised a free vote for Liberal Party members of Parliament. For this reason, I believe it is important I outline to the House, but most importantly to my party and the people of New South Wales, my views on this matter and how I will vote. It is incumbent that we all explain our position. We are leaders and we write the laws of our State. I know that some will not agree with my position, but that is not a reason to avoid speaking or expressing my opinion. It is fair to say this is a challenging issue and the bill has exposed deep division in our community. As I have said before, abortion is a matter of great importance; a very personal and sensitive matter. For some it is deeply personal. For others it is a matter of women's rights. For others still, it is about human rights more broadly.

But the fact remains that lawful terminations are allowed currently in New South Wales. This was established in 1971 following a decision by Judge Levine. In New South Wales a termination is defined as lawful if it is conducted by a registered medical practitioner with the consent of the woman and if that medical practitioner believes the procedure is necessary to preserve the woman from serious danger to life, or physical or mental health. The NSW Ministry of Health policy stipulates this and it has developed a framework for terminations. Strict protections have been implemented by the Ministry of Health outlining the need for the termination, the consent of the woman and the responsibility of the health organisation conducting the procedure. Furthermore, the policy outlines the process for a termination under 13 weeks, between 13 and 20 weeks and greater than 20 weeks, including the need to offer counselling and consultation with relevant specialists and, in some cases, multidisciplinary teams of experts in areas of fetal medicine, psychiatry or neonatology.

What is being proposed? The bill is not about decriminalising abortion. If that was the case, we would have before us a bill that codified the existing law in line with community expectations. I cannot support the Reproductive Health Care Reform Bill in its current form. I will outline in my speech the concerns I have and the amendments I intend to move in Committee. Before I do that, I place on the record my frustration around the process for examining the bill. I am concerned the social issues committee was not afforded enough time to consider the complexity of the bill. It was given a week to receive submissions, conduct an inquiry and prepare a report. Despite the short time frame, it received over 14,000 submissions. However, due to the short time frame, the vast majority could not be read. I apologise to those who took the time to write and to those who hoped to appear before the committee as a witness. I say to them, I will endeavour to ensure this does not happen again. As a member of the community, they have every right to express their view and to ensure we as legislators are not only considering their views but are passing legislation in line with their expectations.

In addition to the submissions, I have been inundated with emails, phone calls and messages, over 90 per cent of which have asked me to oppose the bill. Abortion is a very serious matter and any legislation must be considered in a measured and respectful way. No matter where we stand, that is something we should all agree on. When we look at other States and the length of time they had to review their legislation, consult the public and consider amendments, we can see our process has been manifestly inadequate. Tasmania, Victoria and Queensland all held parliamentary inquiries and released consultation papers for up to six to 12 months before reporting the bill to the House for debate. In fact Victoria examined several models before a final bill was introduced. What is evident is that every jurisdiction has taken the time to consider abortion reform before passing legislation. The termination of pregnancy is very serious and personal. We owe it to the people of New South Wales to have extensive consultation and consideration, regardless of one's stance on the bill, to ensure we are providing good legislation for our State with appropriate safeguards.

When I was working as a theatre nurse, I recall a lady in her late forties who was having a dilation and curette. At the time I did not think much of the procedure; maybe I chose to ignore the procedure and focus on the medicine. Maybe I knew above all my job was to provide a duty of care to my patient and not judge. Either way, I could not help but feel for this lady, a mother of eight, who would not survive another pregnancy. Less than a month later I was called over to the maternity wing of the hospital to assist with a caesarean, which was expected to be standard surgery. Devastatingly, we delivered a stillborn baby. We all felt for the mother and family—staff and patients alike. Over the years, I have not thought again about these two cases, nor asked why one medical procedure emotionally affects so many and another is just that—a procedure.

I do not seek to raise the ethical question of when life begins, except to say that having seen the remains of a 10-week-old fetus and a dead 29-week-old baby, it is hard to not do so. From a personal perspective, I have been unfortunate to have had a number of miscarriages. The last was medically difficult and did not come without risk. I understand the loss of a child and feel for a woman who has lost a child, whether it is by choice or by nature. It is difficult for the mother and those around—the father and family. Having seen the ultrasounds of a baby's development, I find it difficult to accept the threshold for "abortion on demand" to be 22 weeks, as determined by the bill. I believe many in the community share this view and it is worth noting that other jurisdictions have lower thresholds.

A survey conducted by Galaxy Research revealed 74 per cent oppose late-term abortions past 23 weeks, with only 6 per cent supporting terminations of up to 23 weeks and only 5 per cent supporting terminations up to birth. A stillborn delivered at 20 weeks or more is registered as a birth and yet, under the bill, an aborted baby at the same gestation will not be acknowledged. Some argue that late-term abortions are rare and will occur only where there is a pressing medical need. If this is the case, then it should be clearly enshrined in the legislation. I accept the vast majority of medical professionals do the right thing and will continue to do so. However, we must protect the community from the ones who may choose to do the wrong thing; that is our responsibility as legislators.

The bill stipulates that after 22 weeks the medical practitioner must consult with another practitioner and both must believe the abortion should be performed. There is no threshold or clearly articulated assessment or checklist for late-term abortions. The bill leaves the power with the second medical practitioner, who is not required to assess the individually personally. Furthermore, evidence shows that an unborn baby can feel pain and yet there is no provision in the bill that a child being terminated is to be anesthetised.

For abortions performed after 22 weeks that are unlawful, doctors face no criminal sanctions, even if they break the proposed law. If a doctor believes, for whatever reason, that the abortion should be performed, but fails to consult a second doctor, they will not face any criminal sanction, with professional reprimand being the only possible penalty. I believe this needs to be explored in the committee debate. There are several cases of premature babies being born at 22 weeks and surviving. The youngest recorded was 20 weeks and five days. In the Legislative Assembly, an amendment was voted down that would have provided a baby born alive after an abortion with the same neonatal care that would be given to any other infant of the same gestation and in the same medical condition. Since Victoria reformed its abortion laws in 2008, more than 300 babies have been born alive after abortions. Denying life-saving treatment for a baby born alive after a termination is, to say the least, inhumane. Secondly, if a child born alive after an abortion survives, who is responsible for the child—the mother or the biological father, or is it a ward of the State or up for adoption?

I also believe we need to clarify in the bill the prohibition of trading in human tissue, which is currently prohibited in New South Wales by the Human Tissue Act 1983. However, section 32 of that Act provides that a person must not sell or supply tissue from any such person's body or from the body of any other person. Because this provision refers to tissue "from the body of any other person" there is a question or doubt as to whether that reference includes the body of a fetus. This doubt arises unfortunately because an unborn child in New South Wales is not recognised as a person.

Under the bill as it stands, there is no protection against prenatal sex discrimination. Sex selective abortion is a well-documented issue worldwide and has resulted in as many as 23 million missing females. The inquiry received evidence that girls are being aborted in New South Wales and Victoria because some communities value boys over girls.

Furthermore, the bill fails to ensure that appropriate support or counselling from specialists will be provided to a woman contemplating having an abortion. Proposed section 7 of the bill merely notes that before performing an abortion, a medical practitioner must determine whether it would be beneficial to discuss counselling with the woman seeking the abortion and, if so, to then provide her with information about counselling. This hardly provides a safeguard for the informed consent of a woman seeking a termination. It is subjective and based entirely on the medical practitioner's judgement. Whether it is in the abortion provider's financial interests to encourage an abortion—or whether there is any conflict of interest, for that matter—they as medical practitioners hold the power to determine whether it is beneficial to provide counselling to that woman.

It is argued that a women has a right to choose to terminate a pregnancy, but she is not given the right to choose to see a counsellor. That decision is made for her. A mandatory offer of counselling should be provided to the woman, with that counselling being conducted by an independent body to eradicate any conflict of interest. A termination of pregnancy is a significant decision with the potential to physically and psychologically impact the woman. Overwhelmingly, but not surprisingly, a report conducted by Galaxy Research revealed that 90 per cent of people surveyed believe that women should have the right to independent counselling.

Under clause 9, Registered health practitioner with conscientious objection, the bill requires the medical professional to refer the client to another health practitioner or health service provider who does not have a similar objection. Does that mean that a public list will be made available of medical practitioners who will or will not perform an abortion? If so, will they and their practice be protected from potential violence? The bill will compel doctors and health professionals, regardless of their beliefs, to facilitate an abortion. It neglects our doctors and health professionals who may hold religious or ethical values that run contrary to pregnancy terminations and will force them to facilitate an abortion through the process of referral.

As if that is not difficult enough for our doctors, the bill also indicates that the failure to refer following a conscientious objection is grounds for complaints and disciplinary procedures under the Health Practitioner Regulation National Law and the Health Care Complaints Act. Respect for conscientious objection is a fundamental principle in Australia. Medical practitioners should expect that their rights will be respected, as would any other citizen in our democratic country. We are giving ourselves a conscience vote but refuse to allow our doctors and health professionals to have the same right.

I find it extraordinary that there is no mention of a woman in this bill, despite all of us referring in this debate to women who are pregnant. As the law stands, only those who are legally female can be pregnant. This should be about them. The use of "person" rather than "woman" in the bill is based on a radical gender ideology that is out of touch with biological realities. Under the Births, Deaths and Marriages Registration Act 1995, a person born female could only apply to change the sex on her birth certificate to male if she first underwent a sex affirmation procedure, defined as "a surgical procedure involving the alteration of a person's reproductive organs". While some members may wish this requirement to be abolished and any person to be entitled to change their registered sex at will, that is not currently the law in New South Wales. It is not appropriate to anticipate any such change. Those who attempt to do so by stealth are attempting to smuggle this terminology into the bill, which purports to be about women's reproductive health care.

Finally, I refer to concerns raised about access to reproductive health services in rural and remote areas. More needs to be done to support women and families, but it is not right to say that because there are challenges with accessing services, we should allow late‑term abortions. That is a simplistic view of a complex issue. Members in this House and in the other place have raised serious concerns about the bill and I welcome the opportunity for our Chamber to reflect over the coming weeks on the amendments being proposed. If this bill is to pass this House, it is imperative that it is in line with community expectations and protects women and unborn children.

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