Note to the PM: Politics doesn’t belong in medicine

The final sitting weeks of 2005 have come and gone, but despite widespread anticipation that the prime minister was to allow a vote on the removal of the effective ban on the abortion pill RU486 before the Christmas break, supporters of women’s reproductive choice have been left empty-handed. At some point next year - in the manner, and at the time of the prime minister’s choosing it now appears - MPs will be granted a conscience vote on the issue.

But a conscience vote sends all the wrong messages to parliamentarians and to the electorate about the nature of the vote on RU486. It asserts that the vote is about the moral or legal legitimacy of abortion. Yet this could not be further from the truth. In reality, this is a vote about the integrity of Australia’s framework for ensuring the quality, safety and efficacy of the medicines we ingest and give to our children. It is a vote about whether or not the Therapeutic Goods Administration (TGA), or the health minister, ought to be making critical decision about which pharmaceuticals are made available to Australian patients, and in what circumstances.

To understand why, a short history of the offending amendments is necessary. Passed in 1996 with the agreement of both major parties, the amendments were designed by their author - anti-choice Senator Harradine - to forever deny Australian women access to RU486 and any other pharmaceutical capable of inducing a non-surgical abortion. Having made the specious claim that the rigorous quality, safety and efficacy analysis the TGA does for all pharmaceuticals entering Australia was inadequate for these drugs - and these drugs alone - the Harradine amendments require the federal health minister to approve in writing the importation, trial, registration or listing of such drugs, and to table that approval in parliament. In exchange for this warped dream-come-true, Senator Harradine horse-traded his vote to privatise Telstra.

Of course, the drover’s dog could work out that the Harradine amendments virtually guaranteed that no company would attempt to market the drug in Australia. Registering drugs with the TGA is time-consuming and expensive. No manufacturer with any sense would bankroll it knowing that even if they successfully demonstrate that the drug was both safe and effective the health minister could still - without even needing to explain why - refuse to permit Australian patients access to it.

The contempt both political parties showed for Australian women and patients in passing the Harradine amendments - and continue to demonstrate by refusing to join hands to remove them - is breathtaking. RU486 is used in the treatment of life-threatening conditions like Cushings Syndrome, inoperable brain tumours, HIV-AIDS, ovarian and some breast cancers. Yet, by and large, Australians with such life-threatening conditions miss out or are forced to cope with intolerable delays.

The hypocrisy of anti-choice players in this drama also deserves mention. Mifepristone enables women to abort very early in pregnancy - indeed, the moment they know they are pregnant while six weeks is the earliest a woman can have a surgical abortion. However, despite opponents of choice expressing particular concern about the “tragedy” of “late” abortions, they have worked tirelessly since 1998 to effectively ban Mifepristone, and to keep it banned.

In a strange way, the anti-choice health minister’s unprofessional behaviour in commissioning the chief medical officer to provide what Liberal colleague Mal Washer called “lightweight” answers to “stupid questions” about the drug’s safety has exposed the way the Harradine amendments twist the proper, impartial, evidence-based processes that parliament - through the TGA - put in place to ensure Australians gained timely access to good pharmaceuticals and were protected from the bad. Tony Abbotts’s behaviour, in other words, has clearly demonstrated why properly resourced experts on the basis of the evidence, not a single individual with an axe to grind, should rule on what drugs should be made available to Australian patients.

The right thing for the government, and the opposition, to do would be to admit the terrible mistake they made close to a decade ago in backing the Harradine amendments, and make amends to those injured by their expedient mistake by voting together - along party lines - to remove them from the TGA.

There wasn’t any conscience vote to enact the amendments. Balance and justice suggest there shouldn’t be one to remove them either.