Wednesday, 18 October 2023

Motions

Parenting support services

Debate resumed.

Emma KEALY (Lowan) (14:47): I rise today to speak on what is widely known in the house as the IVF motion. But this is of course much broader than that, and it has matters which relate to how we are best supporting parents and young people in their early years and particularly around some of the issues that come to be when you are looking at making that decision – and it is an enormous decision which so many of us in this place do know about – to start a family and how you go about that journey.

I have just remarked to the member for Dandenong across the chamber that I think the last time we were in a similar circumstance we shared our stories over the table, and we both had wet cheeks by the end of the contribution, so I am actually quite pleased that we are able to share this moment again. Of course since then we have both had children; we have both welcomed little ones into the world. And we are very fortunate in being able to do so, because I think it is perhaps one of the most important jobs that any of us will ever have beyond being a member of Parliament. Being a parent is so important, and if I can take the liberty of giving us both a pat on the back for the work that we do in balancing a family and also representing our local people. For all the parents we have got in the chamber, whether you are a mum, whether you are a dad or whether you are an important role model for younger people in your life, thank you for all you do. You do a fabulous, fabulous job.

When it comes to starting a family, it is a decision that I find quite ironic – that it is so hard for some people to be able to start a family, yet when particularly women are, I guess, entering into that world of relationships and really when they are thinking about children it is probably taking every single effort not to have a child. Then it gets to the point where perhaps you have made the decision that you want to bring a young life into the world. Maybe it is something that you find out that was not necessarily planned, but you make that decision around, well, what happens next. I think particularly for women when they make that decision that they want to have a child and they do not fall pregnant and then they do not fall pregnant the next month and the next month and the next month – and it can be a very short time frame where I guess there is this perception for so many women when they are taught sex ed at school that if you have unprotected sex you will fall pregnant straightaway if you are within a certain window, so it is very, very challenging for women to find out that hey, my body does not work like this. I was told when I was at school that if I did this, this is what would happen. This would be the outcome. I would be pregnant straightaway. There is an enormous inbuilt sense of failure for women who are unable to follow that pathway that we are taught about at school.

That can of course have enormous flow-on effects, not just for the woman or the family in terms of their ability to actually have a child and grow a family in their own right but also about their mental health, about their sense of worth in the community and about confronting those really challenging issues: ‘This is something I actually planned my whole life around. This life that I was going to live was going to look this way, and now I don’t know what happens next’. The feeling then when you have got friends who have babies or you have got other family members, sisters or brothers or other siblings around you – it can just remind you that you are without, and that is very, very difficult.

Of course also with IVF making the decision to go down that pathway is enormously expensive. Having a family, creating a family and nurturing a family should never be a decision which is based on your bank account. I think we all agree on that. I do not think you will find any challenge from anybody in this chamber or probably any Parliament in Australia, to be quite honest. It is everybody’s right to be able to have a family. It should not be out of reach simply because you do not have the finances to be able to endeavour to engage in a health program like IVF. This is something there were a number of commitments about before the election. The government had their own commitments, which they are bringing forward. The Liberals and Nationals took their own commitments, which were quite similar in many respects, around supporting women to be able to access IVF without financial impediments and without the amount that is in their bank account being a limiter on whether they could enter into IVF or not. There were particular other elements that the Liberals and Nationals brought forward around including some of that paid fertility treatment leave for nurses, teachers and other public sector workers. I think it is very important to make sure that when time is taken away from work you are able to get some flexibility from your employer or able to access leave for that so you still have an income. It is very important that we see that ongoing support.

The other aspect which is slightly different to the pathway that the government have gone down is that when women have a relationship already with an existing IVF provider, they have a relationship, and it is often a very deep relationship because it is not just around that health procedure that takes place, it is actually about working through, as I said, the mental health aspects and the trust. It is invasive as well, so it is something where it is important that women can, wherever possible, stick with the same provider, the same clinic and the people that they have developed that relationship and trust with. I think it is very, very important to ensure that this is not just seen as a public or private entity and we actually ensure that women are given choice about their provider. They can stay with their current provider if they have been on IVF for some period of time and that relationship is able to continue into the longer term.

When we are talking about IVF and pregnancy, there are many, many quirks around it. I do note the minister’s comments in her opening statement. She did cover off on so many aspects of the challenges and the warm stories as well. I think one of the things that is very, very difficult for anybody is to know somebody experiencing, or to go through yourself, the loss of a pregnancy. It is something that women who go through IVF have to face so regularly that for some it can become just a transactional thing of oh, this has failed again, and there is nearly a sense of disbelief when they are finally pregnant that it will carry along to a full-term pregnancy.

We all know, and it upsets everybody in the Nationals team still, that we have a very close friend who lost her baby last year. That was an incredibly difficult time for each and every one of us but particularly for the former member for Euroa and her family around the circumstances of that occurring. Our thoughts are always with Steph. We certainly wish she was still around; she is a superstar, but we know that she is doing very well also. But we feel like we lost part of our family last year, and I think that is an experience any person can go through. Particularly for the woman who is going through that pregnancy loss, it is an exceptionally difficult thing.

I do note the minister’s comments in her opening remarks in this debate around the Pink Elephants, who will be presenting in Parliament tomorrow. Of course there are many early pregnancy and miscarriage support groups right around the state. Some are more prominent than others, some are local community groups that get together. This is a very important network of services because while you can be close to somebody who has experience of loss of pregnancy, whether it is through termination, whether it is through spontaneous miscarriage, whether it is in the early stages of IVF and an implant not taking root they are all steps where people need support. Often to share those experiences can make an enormous difference in being able to connect to someone who has an empathetic ear and that sense of connection. That is very, very important because we are all going through our own individual journeys and while there are a lot of battles in this place, I think that on this we can at least all agree that when people can share their stories in an open and respectful way, it does lead to a greater outcome for every single individual who is going through that scenario.

While it is sometimes difficult, in this place we can sometimes share our stories in a very personal way. It is something that is important because it might resonate with one individual out in the community who then feels like they can either reach out and get support, to know that they are not alone and to know that there is a pathway forward and perhaps a different journey ahead of them. It might not be what you expected, but in some way it may end up being the right journey and pathway for you. There were people I met who were going through IVF who were unable to continue with their programs during the COVID lockdowns. It was something that was investigated as part of the Pandemic Declaration Accountability and Oversight Committee in the last term of Parliament. It is covered off in the Review of the Pandemic (Visitors to Hospitals and Care Facilities) Orders, which was tabled in this place in July 2022. There were many decisions made over the COVID lockdowns, and there is now the opportunity to look back and think what was right, what was wrong, what worked and what did not. There is no doubt it would have always been difficult to find that line. For me, one of the most outrageous decisions and one which was not founded in health advice or health recommendations was the cessation of not just elective surgery but also IVF treatments for a period of time in early January 2022.

This was part of the code browns that were called at that point in time. I was a member of the committee, and it found that it was an overreach and an unnecessary action that took place under the guise of releasing health workforce into the public hospital system. But, we heard through evidence, that that did not ever eventuate. The outcome was that we had families, women, who were going through IVF treatment who had to suspend that treatment and interrupt cycles in the midst of the COVID pandemic. The committee heard that advice was not sought from the chief health officer at that time as to what the implications would be in terms of the mental health impacts and the financial and physiological impacts on women who had their IVF treatments interrupted. There was no input from the chief health officer on that rationale of balancing the staff. While this was an attempt to release staff, would any health staff actually be released into the public health sector? Unfortunately the answer was no, and that is something else we heard through evidence. While they were attempts through that code brown to release staff, not one staff member was released during that time.

There are other aspects when we look back over the COVID pandemic where there were critical decisions made without founding advice and without supporting evidence even at the time, and this is without the 20/20 vision of hindsight, where there were significant impacts on young families in particular and our kids. This motion mentions expanding Victoria’s early parenting centre network. Over COVID some of the services that are being outlined and are being delivered by Victoria’s early parenting centre network were delivered by maternal and child health nurses. They are absolutely brilliant people. They were all woman in my experience. Jen and Jennifer were my two maternal and child health nurses. They supported me over COVID, but it was a very, very difficult time. I had my darling little girl Ella in one of the first lockdowns. For me it was a very difficult experience. I had been at home in lockdown. We had had no cases of COVID at all on our side of the state. I had been homeschooling my little boy Harvey, who was in grade 2 at the time, every day, so he had been sitting at home with Mum, watching her get bigger and bigger and bigger. At that young age, about six, seven years old, he was not quite sure what was happening, but he knew that something big was happening.

When my waters broke on the Sunday night I called up my dad. He came round to look after Harvs as Chris and I went into hospital, and Harvey did not know where Mum was in the morning. Even though Poppy was there, he had no idea where I was. I feel like he missed out on a really important opportunity to bond with me, to have a greater understanding of what was happening in his family life, because he was not allowed to come into hospital to see his mum. He was not allowed to come into hospital to see his sister. He could not work out what was happening, and he was very, very concerned about all of us. Given there were no cases around, as I said, at the time – and there would not be for a year to come – I do always wonder what difference that would have made to him. In some ways even though it was completely out of my control – they were not my hospital orders; they were the government’s hospital orders – I still feel a level of guilt that there was not something I could have done to better support my child.

I also think it would have made a difference to me in my mental health journey, as has been shared in this place before, given my wonderful maternal and child health nurses Jen and Jennifer were not able to do the drop-ins that they usually would do as part of their maternal and child health checks. It is very normal for maternal and child health nurses to come to your home to make sure you are coping okay, you have got supports around you and it is a safe environment. That is particularly important in identifying women who are at risk of family violence and other aspects at this time: ‘Is there food in the fridge? Is the baby going to be safe? Is there somewhere for them to sleep? Is there a dog in the area?’ It is all of those questions, which seem quite basic but were totally missed over that COVID period. We need to make sure that we are checking in on all of those mums and all of those kids now, and I am not sure that has ever been caught up on.

But Jen and Jennifer for me were fantastic. It was at a time when eventually I was diagnosed with postnatal anxiety more than depression, and if it had not been for Jen and Jennifer I would not have been able to get any support at all. They were amazing. But there was just nothing available, and there are still very, very limited resources out there for women who are going through postnatal anxiety or depression. It is really hard to get access. In fact if I had not had access to the parliamentary mental health support team as a member of Parliament, I would not have been able to get anything – not a thing – and that is what parents are still facing right across the state of Victoria. They cannot access mental health support when they need it.

There are not enough mental health workers in this state. While there are some scholarship programs that have now been put in place, there is not an increase in the number of places that are available to make sure we are training an expanded workforce. Now we come out and all of us say we want to get the right care that people need in the place they need it at the time they need it, but that is not happening in Victoria. It has not happened in my time in Parliament, and I cannot see it being addressed any time in the near future unless we expand the mental health workforce.

I am enormously appreciative of PANDA. PANDA have amazing online resources. They have provided for the gap in support and care that people need from the get-go, and I thoroughly recommend them for any new parent. Whether you are a dad or a mum, it does not make any difference. Maybe you are another supporter in someone’s life. Reach out. Go to PANDA if nothing else. Go to your GP. Talk to your maternal and child health nurses. They are the ones who will connect you in, and while resources are limited, do not think that it is not worth reaching out simply because you do not think there will be anyone out there. Please put yourself first, put your baby first, put your relationship first and reach out for that support.

As I said, over the COVID pandemic things got very tough for a lot of different reasons around mental health, and that was also for younger kids who simply could not deal with being cut off from their family and friends, from their school and routines and from the things that they like to do to enjoy themselves or connect with the community. That is things like playing sport, going to art classes, playing guitar, being in the local stage production, just being able to go down to the playground or kick a footy with mates. That could not happen. While that had an impact then, which is summarised, as I said, in the report I mentioned earlier from the Pandemic Declaration Accountability and Oversight Committee, we are still seeing the impact of that today. The journey of life can begin with IVF, it can begin in lots of different ways, but we need to make sure we have got in place a system to nurture children and make sure they are the very best they can be.

I went to two schools last week. I went to the fabulous Halls Gap Primary School and I went out to Kaniva College in the west of the state. Speaking to the teachers in both of those centres, they were very much concerned about the impact of the COVID lockdowns on their students and the limited support that was still available to them as teachers to better support those kids. While I know that there is a feeling that I am cutting back over something that happened years ago now and we are trying to park it in our past, the impact and implications are still having an effect today and it cannot be forgotten.

We had an enormous surge in calls to Kids Helpline – a phenomenal surge. We saw in 2021 that close to 123,000 attempts were made to connect to Kids Helpline counsellors by people in Victoria alone. That was a 20 per cent increase from the pre-COVID time, but they simply do not have the funding to be able to deliver support to all of those kids calling in. Kids Helpline have done a phenomenal job in providing that support for our kids, and they still have similar demands. It has eased somewhat, but it is certainly not back to levels that we saw before COVID. I would urge the government to look at expanding their financial support to Kids Helpline, to Lifeline and also to other helplines. They are always put forward in government media releases, but they need to get that additional funding in place to make sure that they can meet the demand, because it is still there today.

I would like to go back again to the early parenting centre network, which is specifically itemised in today’s motion. While it is a step forward that we have early parenting centres where professionals are able to provide advice and support to parents around sleep and settling, child behaviour and parent and child health and wellbeing – I guess in some areas this is something that maternal and child health nurses are somewhat providing, but not in the same way – I do note that these early parenting centres are all based in either Melbourne or large regional cities. My electorate of Lowan represents about 20 per cent of the state, and as many of my National Party representatives know, when you are in a country area a long way away from Melbourne, a long way from Ballarat, Bendigo and Geelong, you have the most limited access to services. While I understand that the government can only do it in certain seats, we need to make sure that people who live in country Victoria do not miss out on the supports that are available to people in the city just because they choose to live in the country.

There are kids, like the kid of a very good friend of mine, who simply do not settle, and it can have an enormous impact on the relationship between the child and the parent. We all know how tired you can get being a mum, especially as a new mum or when kids go through that eight-month stage when the teeth kick in. That was a terrible time for my two kiddos. Whatever it is, it can be a really difficult time, and when your baby will not sleep and you cannot sleep and nobody can catch up, it is just annihilating. That can also exacerbate other issues that happen, particularly postnatal depression. I have got a very, very close friend who has done a lot of work with PANDA, an organisation I mentioned before. She had significant postnatal depression, and if she had not had the support of and access to a sleep centre – she came to Melbourne for those services – she questions what the future would have been for her and her child. She felt she was at risk and she was thinking things that she did not want to be thinking about, about harming her child. These are the supports that we need available to every single Victorian woman.

Having those services available in Melbourne is great, but without financial support for women to be able to access those services from the country or to travel to that area, or even the recognition that they are travelling away from their support network – they are travelling away from perhaps their mum who is there every day otherwise, or they have got one support person who they can trust and rely on in town, and you are taking them out of that environment – we need to have flexible ways that we can provide supports to people who do not live in Melbourne, Ballarat, Bendigo or Geelong. It is really important that we do make sure that we have got services for every Victorian, not just those people who live in metropolitan centres.

Because we are talking in this motion around the critical early years of children’s lives, I also want to speak about some of the other aspects of this. Unfortunately there are other downsides when it comes to government decisions about their priorities and about where things are going wrong and not being addressed. We know that government tends to gloss over some of the key issues because it looks bad. It is probably one of those things we all get accused of. The government only talks about the good stuff that they can sell in their media releases to get a positive story and a smiling picture in the news, but we do not necessarily get the truth. And that is the job of opposition, to make sure we hold government to account. So within this motion, while absolutely we have got things to do –

A member interjected.

Emma KEALY: And yes, I hear from over the table, here we go. There are really important events that are not being addressed, and we are not seeing transparency in the state of Victoria around them. We know that the 2021–22 Sentinel Events Annual Report indicated there was a significant increase in the number of sentinel events in healthcare services in Victoria over a 12-month period in 2021–22. In fact, there were 240 sentinel events in 2021–22, an increase of 43 per cent on the previous year. Of those 240, 38 were children. We still do not know from the government how many of those sentinel events resulted in the deaths of children. We do not know how many. It is so important that every government is transparent in the information they provide and does not just talk about the good news story and the happy snaps. We also need to understand what is going on, why it happened and what the government is doing to fix it, because it is very, very concerning that we have got 38 children who had a sentinel event, which is either a death or a significant injury which caused a substantial difference in that child’s capability going forward. This is a significant number – 38 in Victorian hospitals in one year alone. The government must come clean with that. They must make sure that they are being accountable to the services that are being provided to children across our state.

I do believe one of these instances was around the case of a young man that I have spoken to on a number of occasions, Jesse. He went through a hysterectomy as part of a gender reassignment surgery at the Women’s hospital. Jesse recounts a terrible situation where he had not had a pregnancy test beforehand, and his hysterectomy also aborted a fetus that was months old. This is incredibly difficult for someone to wake up to. There were other complications as part of the surgery. There were other challenges in Jesse’s journey as well in being misgendered on a number of occasions and still getting letters asking for donations in his former name and being addressed as ‘Miss’. There are key issues around some of that, and we need to ensure that at every opportunity we are doing what we can to shed light on these issues. I believe that Jesse’s fetus – Wolf is what Jesse called him – is one of the 38 children who were noted in that sentinel events report.

We have also seen a critical lack of support in terms of Aboriginal children in Victoria removed from their families and placed in the out-of-home care system. If we are looking at the best possible support for all Victorian children, we must focus our energy on reversing this trend of more and more Aboriginal children being taken out of their homes and put in out-of-home care. I note that again we have seen a horrific increase in that number. In 2008–09 it was 37.7 children out of every 1000, a total of 734 young Aboriginal kids taken out of their home. In 2020–21 it went up to 134.9 kids per thousand head of population. It was a significant increase, and in that year, 2020–21, it was 2592 Aboriginal children taken out of their home and put in out-of-home care.

While I acknowledge this motion today is around the government talking up the good work they have done, there are significant issues that must be addressed, and we cannot see that they are being addressed. Whether it is about fairness and equity for children who are born in rural and regional areas of the state or whether it is about equity and services and fairness in access to services for parents and families who live in rural and regional areas of the state – whatever it is – we need to make sure that all Victorians are cared for. We are not seeing that from the Allan Labor government, as we did not see it from the Andrews Labor government. We are not seeing anything made different at this time, apart from the fact that the Allan Labor government cannot manage projects and cannot manage money. Certainly we are seeing are glossing-over of some of the significant issues that are facing this state.

We need to make sure that IVF services are accessible to all. We need to make sure there is fairness and equity in how those health services are delivered. But most importantly we need to see an expanded array of services available to people who live in rural and regional Victoria, because they contribute so much to our state. They are too often forgotten and overlooked, but they should be front and centre of every single decision made in this place. Just because they are not part of the population of greater Melbourne does not mean that they are lesser, and it does not mean that they are not as important. We know things will need to be done differently, but unless government stops overlooking them and starts looking at how it can reach every corner of the state, we will not see a difference in health outcomes, educational outcomes or closing the gap in our wealth outcomes for people who live in rural and regional Victoria.

Gabrielle WILLIAMS (Dandenong – Minister for Government Services, Minister for Consumer Affairs, Minister for Public and Active Transport) (15:17): I move:

That the debate be now adjourned.

Motion agreed to and debate adjourned.

Ordered that debate be adjourned until later this day.