Matters of public importance

Women’s health

The SPEAKER (16:01): I have accepted a statement from the member for Northcote proposing the following matter of public importance for discussion:

That this house recognises that the Allan Labor government is prioritising women’s health by giving it the focus and funding it deserves.

Kat THEOPHANOUS (Northcote) (16:01):

I am delighted to rise to lead the debate on this incredibly important matter of public importance, which asks that the house recognise that the Allan Labor government is prioritising women’s health by giving it the focus and funding it deserves.

As the Parliamentary Secretary for Women’s Health it has been my absolute honour to work alongside our utterly determined Minister for Health and under the outstanding leadership of Victoria’s Premier on a policy area that means so much to me and to so many others.

Indeed it does feel as though women’s health is at a turning point as women’s and girls’ voices right across our state have themselves elevated the public discourse and demanded change.

It is an extraordinary thing to think that we are now in a time when our Premier can share her personal story of endometriosis. Just consider how unheard of that would have been a decade or two ago and consider the power of that voice being heard by others and the ability for stories like this to bring women’s health out of the shadows.

Since we embarked on this work we have been uncovering layer after layer of a complex picture. It is a picture that depicts centuries of stigma and bias which have compounded an embedded disadvantage for women in our society and in societies right across the world. Just as we see these inequalities play out in economic and social spheres, we see them replicated in health outcomes for women.

Part of it is bound up in the vexed relationship societies have had with women’s bodies for the longest time, seeing them as mysterious, even dangerous, and our ability to create life as a threat, and that danger element then translating into attempts over history to subdue and control women and their bodies.

Think about the history of so-called hysteria, a proclaimed disease basically outlining the symptoms of normal female sexuality, yet women were forced into asylums and in some cases had to undergo surgical hysterectomies.

These sorts of horrors are thankfully behind us, but the hang-ups, the stigma and the gaps in medical knowledge about women’s bodies unfortunately remain.

That destructive and damaging experience of being dismissed, gaslighted and misunderstood has echoed across forum after forum after forum that I have attended as part of our Victorian inquiry into women’s pain, an inquiry that has now received over 12,000 survey and submission responses from women and girls across our state – an extraordinary response to a survey – and I thank each and every one of these Victorians for lending their voice to our work to improve women’s health care.

From Geelong to Monbulk to Glen Waverley to Northcote, rooms of women and girls have reverberated with the grief and pain and frustration that has been felt for too long. It is visceral: story after story of women sharing their experiences of chronic pain, about persistent migraines, about debilitating endometriosis, about birth trauma, about pain during the menstrual cycle, about arthritis or about conditions like fibromyalgia, and story after story of women having to strategise before they go to their GP lest they be dismissed or told they are simply depressed or viewed with suspicion as though they are just there for the drugs, as though being there for the drugs is a bad thing when you are in pain.

I hear women feeling under pressure to push through to meet work and caring responsibilities; women struggling through shifts in excruciating pain, unable to take time off to navigate the system and not willing to when their experience has given them little hope that that system will respond.

I hear about the shame and the loneliness and the isolation – of low energy levels, of not wanting to leave home and of friendships that slip away, relationships that deteriorate, opportunities that pass by. As much as there is solidarity in the sharing of those experiences and the commonality of them, there is also anger and determination and, ultimately, hope – hope that in this golden moment, with our collective voices drawing public attention, with the ambition of our government and with dedicated funding, we can and will change things for the better.

It is that hope that each of us as parliamentarians is accountable to, an accountability that the Premier, the minister and I take very seriously. It is why we will use every moment that we have to drive and embed reforms in women’s health and why our Labor government is giving it the focus and funding that it deserves, because what this goes to is the quality of life for generations of women and girls.

The Allan Labor government has invested $153 million as a first step to transform the way women’s health is treated in our state. This investment means that over the coming years we will open 20 women’s health clinics so that women can have access to comprehensive, affordable care.

The first tranche of five clinic locations was announced in April this year: at the Northern Hospital, Epping; the Royal Women’s Hospital; the Frankston Hospital; Barwon Health, Geelong; and the Ballarat Base Hospital. These multidisciplinary clinics will allow women that safe, affirming space to see specialists like gynaecologists, urologists, specialist nurses and allied health professionals. They will cover a whole gamut of conditions, like endometriosis and pelvic pain, polycystic ovary syndrome, perimenopause and menopause.

One of the things that we know for sure is that health inequality is compounded by intersectional factors, and in a context where non-Indigenous women live on average eight years longer than Indigenous women, it is extremely important that First Nations voices form a core part of our statewide efforts, which is why in addition to the 20 women’s health clinics we are also working with Aboriginal health organisations to deliver a dedicated Aboriginal women’s health clinic and have the guiding expertise of Jill Gallagher, who is also on our women’s health advisory council.

To make sure our investment in health equity reaches right across the state, we are also establishing an additional mobile clinic to help us serve regional and rural areas, because we want to ensure that no matter where they live, Victorian women have access to quality care.

At the same time as setting up the clinics, we are also expanding locations for our sexual and reproductive health hubs from 11 to 20. The final six of these were announced this month, with new locations to open in Kyneton, Melton, Wyndham Vale, Broadmeadows, Ararat and Horsham. These hubs provide access to contraception, medical abortion and referrals for surgical abortion as well as sexual health, testing and treatment.

They have been immensely successful, and at Peninsula Health, where there is one, the team, led by Dr Nisha Khot, are also pioneering the use of the green whistle for patients undergoing IUD procedures. The green whistle is common in emergency settings and in sporting events. It is an analgesic that is inhaled, and giving it to women means more women being made comfortable during IUD insertion. It encourages the uptake of this incredibly effective, long-acting, reversible contraception.

There is a lot more that we are doing as part of our women’s health reforms. I have got 6 minutes left, so please excuse me for flying through this a little bit, but I do want to put a few things on the record. We are doubling the number of laparoscopies and related surgeries, which are part of the diagnostic toolkit for identifying endometriosis.

New health and wellbeing support groups are being funded specifically for women, because no-one should have to go through the challenges of chronic disease or menopause alone. Indeed this is something that came out really strongly in the women’s health breakfast that I hosted with the Premier in Northcote last week. Women described feeling like they had no-one they could talk to, like they were letting their families and friends down when they were unwell, and the impact that that then had on their mental health. As women we yearn for those secure and supportive spaces to openly discuss our health journeys, access support, connect with our communities and seek guidance. It is often remarked that modernity has meant the loss of our villages, and for women this loss is profound.

There is so much power in sharing knowledge and experience amongst one another. As an example, in my local electorate I am lucky enough to have Women’s Health in the North just down from my office, and as part of their women’s health and wellbeing package they are now able to deliver a face-to-face support group for people with experiences of abortion, something that has had a huge amount of stigma surrounding it. Women are now able to come together and talk about that.

A strong health workforce is vital to delivering a better healthcare system for women. Just this week our government launched the third round of applications for free nursing and midwifery courses, part of a package that will deliver scholarships to more than 10,000 students.

We are also providing more than 175 scholarships specifically to upskill women’s health specialists in areas like IUD insertion, sexual and reproductive health, pelvic physio training, menopause and PCOS. The scholarships include funding to promote cultural safety and remove existing barriers for First Nations women, women from migrant and refugee backgrounds and LGBTIQA+ communities. It is a key part of ensuring our new clinics have highly skilled practitioners giving women and girls the care they deserve.

However, even with trained specialists there are still significant gaps in our understanding of women’s health issues and effective life-saving treatments, and that is a symptom of generations of women’s exclusion from medical research.

As uncomfortable as it is, the male body and male experiences are still overwhelmingly cast as the default in everything from discovery research to clinical trials, to drug development, to anatomical models, to diagnostic tools and to treatment in emergency.

This exclusion has serious consequences for women’s health, borne out starkly in the statistics and anecdotally in the thousands of women now lending their voices to the push for medical equality. We know that chronic pain affects a higher proportion of girls and women than men around the world, yet women are less likely to receive treatment.

We know that even when treatment is received, women are more likely than men to experience adverse reactions to many medications because they are not trialled on them. That means they are more likely to stop their treatment. That means more women in pain for longer. To address the gender gap in medical research and grow our knowledge about conditions that impact women we are supporting the establishment of a women’s health research institute here in Victoria.

This is an exciting part of the reform package and our work towards health equity and a true enabler to enhancing our understanding of women’s bodies.

This Labor government has a proven track record when it comes to improving outcomes for women and girls. Whether that is opening Victoria’s first clinic focusing on women’s heart health or our statewide sexual and reproductive health line 1800 My Options, whether it is legislating safe access zones around abortion clinics or our groundbreaking family violence reforms, whether it is supporting key initiatives like free kinder or the expansion of our early parenting centres or building more female-friendly facilities at sports clubs across the state, we are a party that sees women, that hears women and that delivers policy to make women’s lives safer, healthier and more equal.

Earlier this year I had the pleasure of attending the Victorian Pelvic Pain Symposium, the first of its kind. It brought together experts, academics, researchers and lived experience advocates to share expertise, innovation and networks, all with a focus on delivering better patient-centred care for women living with pelvic pain. It was incredibly elevating and edifying to have so many experts in the room with a passion and determination for change.

As we continue to invest in women’s health, we are not just changing policies, we are changing lives. We are breaking down barriers, we are addressing inequalities and we are ensuring that every woman and girl in Victoria has access to the care and support she deserves.

This is just the beginning of our transformative journey towards a more inclusive and responsive healthcare system. I want to thank everyone who has contributed to this vital work, in particular the thousands who submitted to the inquiry.

I thank the minister and the Premier for their leadership along with our hardworking advisers and public servants. I look forward to continuing to work together to build a healthcare system that is as dynamic as the women it serves.