A public hospital in regional New South Wales is restoring abortion services after an ABC investigation revealed the executive had banned staff from providing terminations to patients for non-medical reasons.
A leaked document obtained by the ABC revealed that staff at Orange Health Service in Central West NSW could no longer provide abortions for patients with "no identified pregnancy complications".
Multiple sources from within and outside the hospital told the ABC that both medical and surgical terminations — a legal form of health care — were previously provided regardless of circumstance.
New South Wales Health Minister Ryan Park issued a brief statement on social media this afternoon advising that the level of abortion services previously available at the hospital would be restored.
In a further statement to the ABC, the Health Minister said:
"I am committed to improving safe and transparent pathways to abortion care.
"The 2023 NSW Budget allocated an additional $3.5 million over four years to support this. NSW Health is currently undertaking next steps to enhance safe access to abortion care in NSW.
"Additionally, Western NSW Local Health District is undertaking a review of access to abortion services across its public facilities."
A outlined the service referral pathways for patients seeking termination of pregnancy.
It specified that women with fetal anomalies or maternal medical conditions could be treated within the hospital. Those who present with "no identified pregnancy complication" must be sent elsewhere.
Decriminalisation was meant to ensure that abortions could be legally provided to any patient regardless of their circumstances or reasoning. The only exception under NSW law is for the sole purpose of sex selection.
Healthcare workers who spoke to the ABC had been directly involved in providing terminations before the change in policy.
"Surgical terminations were absolutely being provided here. It didn't matter if there was a complication or not," one hospital staffer told the ABC.
"We would find a way to provide it, if it was needed."
According to the new policy document, staff were required to refer all patients wanting terminations for non-medical reasons to GPs, or "seek advice" from Family Planning NSW or the closest service provider.
The nearest Family Planning clinic is almost two hours away, does not provide surgical terminations and does not open on weekends.
In a statement to the ABC this afternoon, the Western NSW Local Health District, which oversees the Orange Hospital, stated that:
"The Western NSW LHD executive has assessed immediate matters at Orange Hospital, and the level of abortion services which has historically been provided at the facility will be restored and available to the community.
"In line with the next steps NSW Health is taking to enhance access to safe abortion care, Western NSW LHD is also undertaking a separate assessment and review of access to services across public facilities in Western NSW."
The Western NSW LHD confirmed that both medical and surgical terminations would be available for patients with or without early pregnancy complications, and that services would be restored as soon as possible.
The LHD also confirmed the service would be restored with existing staffing and resources.
Hospital executive 'tightening the screws' on abortion access
The new referral pathway document was emailed to staff after an ABC investigation on regional abortion access revealed concerns that terminations for non-medical reasons were being obstructed due to conscientious objection from "high in the health bureaucracy".
Under NSW law, health practitioners who have a conscientious objection can refuse to provide abortions as long as they disclose their position as soon as possible and refer the patient to another practitioner who can provide the service.
But the conscientious objection clause does not apply to hospital executives or the Local Health Districts (LHDs) that oversee them. It only applies to the individuals working within them.
The ABC can now reveal that earlier this year, Orange Hospital's executive issued a verbal directive to the obstetrics and gynaecology team to stop providing terminations for non-medical reasons.
One insider said that since then, the executive had been "slowly tightening the screws" to further restrict the service.
Staff had privately expressed their frustration, with makeshift signs displayed outside the hospital last week with the slogans "abortion is healthcare" and "abortion access is a community responsibility".
Speaking to the ABC this week, on the condition of anonymity to protect their jobs, several staff members lamented the new guidelines.
"It's just an opportunity for the hospital executive to say, 'If you provide a termination for non-medical reasons, we can reprimand you'," a frustrated clinician said.
"Usually, when you treat a patient, it's a therapeutic relationship — just patient and doctor. That's a privileged relationship. To have the executive muscling their way into the midst of it, damages that trust."
Family Planning Australia chief executive Sue Shilbury told the ABC the decision to reinstate services at Orange Hospital was a "terrific result" for women seeking reproductive health care.
"We're also really happy to work with the Western NSW LHD to help women better access service delivery at the primary setting, but there is a time when the public hospitals need to step in to meet that need," she said.
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