Assistant Minister For Health And Aged Care, Speech 15 March

Department of Health

*Check against delivery*

Thank you all for being here for the 2024 Women's Health Summit.

Before I begin, I want to acknowledge the traditional owners of the lands on which we meet - the Ngunnawal and Ngambri peoples, and pay my respects to Elders past and present.

I extend that respect to other First Nations people joining today.

I would also acknowledge the Hon. Mary-Anne Thomas, Victorian Minister for Health; Ms Kat Theophanous, Victorian Parliamentary Secretary for Women's Health; Rachel Stephen-Smith, ACT Minister for Health; Jonty Bush, Queensland State Member for Cooper; Senator Larissa Waters; Deputy Chief of Mission for the United States in Australia, Ms Erika Olson; my fellow National Women's Health Advisory Council Members and Special Advisers; and everyone else here today that is joining to share their story or learn from the stories of others.

Today's summit is an important one - a one-day event to further the objectives of the National Women's Health Advisory Council, which I am proud to chair.

Leaders, experts, and advocates identifying and addressing emerging issues that will shape future Council initiatives.

Now, I have been travelling around the country listening to women about their experiences in the health system. And I have learned that every single woman has a story.

From the Kimberley to Melbourne's outer suburbs.

From women in the NT to inner city Adelaide.

Every woman has a story about gender bias. About being dismissed or having their symptoms minimised. About an experience of medical misogyny.

There are heartbreaking tales of continued pain, of ongoing suffering on women's long journeys to diagnosis.

As a mother myself, the stories women have told me about care failures around birth trauma are confronting and visceral.

It's outrageous to hear again and again. We have logged thousands of these stories.

At the most difficult times in their lives, so many women have had to fight to get the care and support they deserved.

Not because they were without symptoms, or pain, or struggle. But because they were women.

Today is important. Today we are bringing into this shared, direct conversation the people who can act within the health care system to improve care for everybody.

Everyone present today is here because we grasp the importance of this mission - and have the expertise, experience and influence to champion a healthcare transformation.

The Albanese Labor Government is here to make women's health a priority because we are driven to empower Australian women in every aspect of their lives.

Last week, the Minister for Women released the Gender Equality Strategy with the groundbreaking announcement that we will pay superannuation on Government Paid Parental Leave.

This is but the latest in a suite of policy reforms to which our government is committed because we know where women have been struggling. Where women have experienced poverty and marginalisation. Where women's health, their care, their opportunity has not been prioritised.

And we know the whole community suffers when they do. Women deserve better because everyone deserves better.

The cliché, alas, is true: research repeatedly shows us our current health care culture presupposes the "default patient" is a 50 year old white male.

This default worsens with various intersections that further compromise women's health. If you have a disability. If you belong to the LGBTIQ+ community. If you are a First Nations Australian or a migrant woman. Also, if you live in a remote or rural area. All making it so much harder for you to access timely and specialised care that meets your specific needs.

It is already disgraceful that 67% of women responding to the survey reported experiences of discrimination and bias. So it is beyond disgraceful that more than 80% of respondents with a disability and more than 80% of LGBTIQA+ survey respondents had this experience.

My career before politics was as a nurse. I have been at the coalface of care, I have seen the best of our system, I have seen its limitations but I have honestly been overwhelmed by the intimate, personal and terrifying stories shared with me by women who that system has failed.

We owe it to them. We owe it to everyone woman to take meaningful, material action.

So, thank you. Sincerely, thank you for joining us and joining me on this crucial mission to improve health outcomes for women in Australia.

National Women's Health Summit

Today's program centres around four focus areas examined by the Council's subcommittees - access, care and outcomes; empowerment; safety; and research.

We'll hear an overview from each subcommittee lead of key themes emerging from their work. They've focused on different issues, but there are common themes.

The need to better understand barriers to better health care for women.

The unique experiences of priority populations, facing additional disadvantage.

Workforce and training, including increasing workforce awareness of gender bias in health care and research.

The development of national standards or frameworks, and discussion of the recommendations from the Senate Inquiry into Universal Access to Reproductive Healthcare report.

Full disclosure, our aim is for today's Summit to be history-making, marking the start of real action to overcome gender bias and end medical misogyny in the health system.

Today is our opportunity to empower women with transformative patient advocacy and supported decision-making in their healthcare.

It's our opportunity to improve access - to health care, health services and health outcomes - for all Australian women.

And it's our privilege to come together - here, now, today - to ensure equity in the health system.

Addressing gender bias in health is certainly something I am very passionate about - as a nurse, as a woman, a mother, grandmother, and now as Assistant Minister for Health and Aged Care.

But you don't need to hear from me to know how real this issue is.

#EndGenderBias Survey Summary Report

Today I am launching the Government's #EndGenderBias Survey Summary Report.

More than 2800 responses were received to Australia's first ever #EndGenderBias survey - from women with real life stories as well as from healthcare professionals and groups.

The stories of pain, and trauma, and embarrassment, and discrimination, from women and girls who have been subjected to gender bias and medical misogyny are what make our work today imperative.

Together, they form a disturbing picture. A shocking picture. An unacceptable picture.

Our survey found that two thirds of respondents reported they experienced gender bias or discrimination in the health system. The most common setting women reported experiencing gender bias in was general practice - most often in diagnosis and treatment, and then in follow-up care.

Consistent themes included feeling dismissed, or disbelieved. Being stereotyped as 'hysterical', a 'drama queen' or a 'slut'. Again and again, women's symptoms were quickly attributed to other causes such as menstruation, lifestyle factors or even an assumption they were 'faking it' and this was especially when symptoms related to pain.

The following are direct quotes from women in the survey:

"Within the first few moments of meeting me, [the doctor] had decided I was a 'waste of time', a hysterical woman with a non-urgent problem who was being dramatic."

Another woman wrote: "Doctor after doctor denied me the right to try [menstrual suppression]. They fed me all kinds of unfounded misinformation and disinformation - 'It'll shrink your ovaries, 'it'll give you cancer', 'it will shrivel your uterus' … 'kill (your) libido'."

And another: "The gynaecologist refused to explain the [sterilisation] procedure to me and noted that "I would need to meet your mother and your partner".

Then, from a First Nations woman with disability: "I was bullied into accepting another IUD during this surgery [for endometriosis]. I was told that the surgery would not be scheduled if I do not consent to an IUD."

And an LGBTIQ+ woman with disability said: "I was to have a melanoma removed from my face. I began to cry. The surgeon … said to me in a sarcastic tone, why would it matter anyway you aren't trying to get a guy? He believed that since I am a lesbian my face can be mutilated with no consequence."

It's horrific, disgusting, unconscionable and it undermines the hard work and professional standards of all the many wonderful doctors, nurses and other health professionals in Australia who do deliver compassionate and sensitive care to their patients.

These incidents of bias and misogyny create a mistrust of the entire system that is dangerous to vulnerable Australians.

Our #EndGenderBias survey did return some reassuringly positive experiences of health care. And it's a stark comparison, because these stories show there are transformative outcomes when women are listened to. When women are simply believed.

A woman who'd survived violence told us: "When you find a good doctor who listens and is willing to help, it makes so much difference. It brought so much optimism back into my life."

Women wanted and reported positive experiences where health care professionals invested time in discussing options, carefully explaining procedures and asking questions that were sensitive to the women's experience.

They wanted health care professionals to be honest about what they didn't know, to be open to learning about their individual circumstances and to acknowledge and explicitly address power imbalances.

We know these behaviours are foundational to culturally-safe care and trauma-informed care but they're difficult to achieve in contexts of short consultations, fragmented care, and rushed health care professionals.

Women finding that individual health professional who listened and who took their concerns seriously was often a turning point in women's treatment, care and recovery.

The sad reality we saw repeated was how long it took women to find such a care provider.

The negative experiences recounted in the #EndGenderBias survey far outnumbered the positive experiences. Encountering gender bias in health care has a profound impact on women's lives. The survey reported:

"Feelings of abandonment, shame, blame and self-doubt, as well as significant financial burdens, lost educational opportunities and compromised career trajectories".

There were devastating stories of delayed diagnosis and treatment leading to disease progression, fewer treatment options and worse health outcomes. And 'Near misses' where dismissed health concerns turned out to be immediately life-threatening.

Most devastating of all, were the stories of women just giving up.

Does anyone really think our "default" 50-year-old white male patient has had similar experiences to those recounted by the survey respondents? Friends, I absolutely do.

Women's stories of bias and misogyny make difficult, upsetting and confronting listening. But we must hear them because they oblige action. We are long overdue for a national conversation about gender bias in the health system - because the stories we've heard today sit against a backdrop of chilling, gendered health statistics.

Like how women are more likely than men to have one or more chronic conditions. And that women's risk of heart, stroke and vascular diseases is consistently under-recognised. That women experience pain more often. And that nearly two-thirds of people with dementia are women.

This while women continue to earn less money at work, have less income in retirement, have more care commitments to other people and bear a heavier cost of living burden. The reality of material conditions causes women to delay or put off treatment and medication.

Our government has made health a key priority area of our recently launched Gender Equality Strategy. We know that addressing gender stereotypes and gendered attitudes in the broader community, results in less gender bias in the health system.

But we've also already started to address this bias in the health system.

As you know we launched the National Women's Health Advisory Council - many of the members are here today.

We made a $58.3 million investment in last year's budget to support women with endometriosis and pelvic pain. In addition to a suite of measures that is truly making a difference right around the country, this investment included the establishment of 22 specialised clinics which are now all up and running.

We welcomed the TGA's decision to remove a number of restrictions on health professionals who prescribe and dispense MS-2 Step. It was a practical decision that recognises the importance of health practitioners that women see regularly - their GP, their nurse practitioner and their community pharmacist. It means better and more accessible reproductive healthcare.

We expanded the self-collection screening options for cervical cancer testing. This has been particularly positive for people who have never screened or are overdue. In the past year, 1 in 3 first-time screeners and 40 per cent of overdue screeners took up the self-collection option. It's also been embraced by First Nations women.

And it's a part of our broader strategy that has put Australia on track to become the first country in the world to eliminate cervical cancer. How amazing is that!

We're also making sure that gender bias in research is addressed. When we won government we tasked the National Health and Medical Research Council with a target to award an equal number of Investigator Grants to women and men.

And now? The NHMRC has achieved gender equity in the scheme. Medical research has traditionally been dominated by men, so this is such fabulous news.

And we're also making sure that future research actually considers diverse identities - not just the default 50-year-old white male. Last year, I launched consultation on the draft Statement on Sex, Gender, Variations of Sex Characteristics and Sexual Orientation in Health and Medical Research.

So much has been done already but there is so much more to do. So, let's do it here, together, today.

I'd also like to give a shout out to the state governments that are a part of building the movement for a women's health revolution.

Like Minister Mary-Ann Thomas from Victoria who recently announced an inquiry into women's pain, and also a network of sexual and reproductive health hubs across Victoria.

Minister Shannon Fentiman from Queensland who recently announced a blockbuster $250 million women's health package, which also includes nurse led walk-in women's health clinics.

And Minister Rachel-Stephen Smith who has made history by making abortions free in the ACT.

I wish everyone well in the day's deliberations and I thank you for being here, for the work you already do and for the work you will do beyond this Summit.

But I'd also like you to join me in thanking the women who shared their personal stories with us and to acknowledge not only their courage in speaking out for themselves, but their selflessness and generosity in speaking up for the benefit of all the women who'll come after them.

May their experiences stay in mind throughout our conversations today, and may we all find equal courage to build the fair, responsive health system that every one of them deserved.

Thank you.

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