Page 3854 - Week 10 - Wednesday, 19 September 2018

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Detail stage

Bill, by leave, taken as a whole.

MS FITZHARRIS (Yerrabi—Minister for Health and Wellbeing, Minister for Higher Education, Minister for Medical and Health Research, Minister for Transport and Minister for Vocational Education and Skills) (6.33), by leave: I move amendments Nos 1 to 35 circulated in my name together and table a supplementary explanatory statement to the amendments [see schedule 1 at page 3860].

MS LE COUTEUR (Murrumbidgee) (6.34): I would like to thank the minister for supporting the clear intention and importance of this work and for undertaking due diligence in preparing these amendments to the bill.

First, I commend the addition to the clause about conscientious objection, which provides a further safeguard that medical practitioners must not refuse, on the basis of conscientious objection alone, to provide medical assistance or treatment required because of an abortion. I further accept the amendments to the terminology and clarification that the legislation covers prescribing, supplying and administering an abortifacient. In my early consultation on the bill, the terms “termination of pregnancy” and “abortion” were used interchangeably by different stakeholders. The decision to use “termination of pregnancy” was made on the basis of modernising the legislative language, as is the case in Victoria, Tasmania, South Australia and the Northern Territory. However, if this is purely a matter of semantics, I am happy with whatever the Assembly is minded to do.

Similarly, whilst I made every effort, in drafting my legislation, to preserve the effect and intention of the exclusion zones around the approved abortion facilities, and to ensure that, if needed, they could be applied to other health facilities as needed in the future, I accept Minister Fitzharris’s amendments that clarify this.

I would like to draw attention to two amendments with which I must confess some disappointment. The first is removing nurse practitioners from the legislation. Regarding nurse practitioners, from my first investigations into rectifying access to medical abortion in the ACT, I wanted the legislation to be forward looking. That is why I sought to include nurse practitioners. The proposal was supported by the ACT chapter of the Australian College of Nurse Practitioners and key women’s health advocates, as a way to increase both access and affordability. I do recognise, as Minister Fitzharris pointed out, that this is not currently in the scope of practice for nurse practitioners in the ACT. Indeed, their prescribing rights are restricted under the PBS. Minister Fitzharris said that she was recognising reality, which she was, but I guess my response is that I am trying to change reality here, hopefully for the better.

Of course, even leaving these barriers aside, there is scope for nurse or nurse practitioner supported models of care for people seeking an abortion. Nurse practitioners and nurses can work with a GP to conduct patient intake and assessment, and then liaise with the GP for necessary referrals and prescriptions. This can assist with the timely provision of access to medical abortions, which are time critical as

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