Women’s Health
WEL Policy Demands
- Sustain and strengthen women’s health services across NSW by doubling funding for Women’s Health Centres under the NSW Women’s Health Program.
- A state wide network of publicly funded reproductive health hubs supported through affiliated GP practices, public hospitals, pharmacies, women’s health centres and Family Planning clinics, with priority establishment of hubs in CALD communities and remote, regional and rural NSW.
- NSW Government to support Aboriginal designed, managed and delivered Aboriginal women’s health services and provide an Aboriginal ‘voice’ on public health services for Aboriginal people and in Aboriginal communities.
- Prioritise implementation of recommendations 16, 26, and 27 of the report from the Legislative Council Inquiry ‘Health outcomes and access to health and hospital services in rural, regional and remote NSW’. These recommend: urgent increase in nurse and midwifery staffing numbers in rural, regional and remote NSW (16); implementation of the midwife continuity of care model with a priority in rural, regional and remote NSW (26) and the urgent review of maternity services in order to develop plans for midwifery, GP Obstetrics, specialist Obstetrics and newborn services (27).
- Remove the wage cap in wage and salary negotiations for nurses, midwives and public sector health workers and introduce Nurse to Patient ratios.
Background
Under the Women’s Health Program there are 20 Women's Health Centres serving metropolitan, regional and rural NSW. They provide healthcare to more than 50,000 women experiencing disadvantage who would otherwise be unable to access it.
Services provided include counselling, cancer screening and reproductive healthcare such as advice on contraception options, abortion and prenatal and antenatal care. The Women’s Health Program grant provided by NSW Health - currently $10.56 million per annum - has not seen a real increase since 1986, despite major economic and social changes, and structural adjustments in the health sector over this period.
As a result, the funding structure and resourcing for the Women’s Health Program currently reflects the expectations for a 1980’s era community based health service. The Women’s Health sector as a whole is no longer sustainable under current arrangements and has now reached a crisis point. Over the next two years some Centres may have to close because services cannot be funded in the face of escalating demand. Doubling current funding would enable sustainability of services and realise significant benefits for women and disadvantaged communities across NSW.
The NSW Legislative Council 2022 report of the Inquiry into ‘Health outcomes and access to health and hospital services in rural, regional and remote New South Wales’ paints a devastating picture of place based inequities in the NSW health system, including severe staff shortages and services shortfalls in areas of women’s health – particularly maternity health services.
The Inquiry heard many witnesses testifying to staff shortages and high levels of staff turnover and resignations in rural and regional health services. WEL believes that the 3% public sector wage cap has contributed to these staff shortages in the health care sector, where women care workers predominate. We support campaigns by the health sector unions to abolish the cap and the campaign by the Nurses and Midwives Association to institute Nurse to Patient ratios.
Reproductive Health
On average, people living in rural, regional and remote areas of NSW experience poorer reproductive and sexual health outcomes than people living elsewhere in NSW, including higher teenage fertility rates, higher rates of maternal death, and higher rates of some sexually transmissible infections (STIs). Easy access to reproductive and sexual health services and continuing supplies of contraceptive pills and emergency contraception, condoms and other contraceptive devices can also be limited.
The September 2019 decriminalization of abortion in NSW was a significant milestone for women’s rights. Yet many NSW women continue to have restricted access to contraceptive advice and choices and limited or no access to abortion in public health facilities. Women in rural and regional NSW, low income women and those in marginalized culturally and linguistically diverse communities are particularly disadvantaged.
In their submission to the Senate Inquiry into ‘Universal Access to Reproductive Healthcare’ the Sphere Coalition (Centre of Research Excellence in Sexual and Reproductive Health for Women) outline five priority actions for achieving universal access. WEL supports these priorities which underpin our demand for a state wide network of reproductive health hubs.
They include free contraception, training primary care practitioners in contraceptive service provision, regional planning for contraception and abortion services through publicly funded community and public health services, expansion of the health workforce through training, and incentives to expand the scope of practice of health practitioners and coordinated public health campaigns to improve health literacy on rights and options for accessing effective contraception and abortion. https://afmw.org.au/inquiry-into-universal-access-to-reproductive-healthcare-sphere/
Access to health services for many women from CALD communities is limited by language constraints, reproductive and sexual health literacy levels, socioeconomic status, confidentiality concerns and unfamiliarity with the health system. CALD women in NSW are often unable to find information easily on the location and costs of reproductive and sexual health services. Limited information in languages other than English make it difficult to navigate the health system.
Aboriginal Health
There is strong evidence that health services designed and run by Aboriginal communities which draw on cultural knowledge and practices are the best foundation for improving Aboriginal women’s health outcomes (see for example, Wiyi Yani U Thangani (Women’s Voices) Chapter 4, Australian Human Rights Commission 2020).
