Wednesday, 31 August 2022

IVF services

Ms CROZIER (Southern Metropolitan) (10:44): I am very pleased to be able to rise and speak to my motion, because it goes to the heart of what so many women and families require to be able to start families. I move:

That this house notes:

(1) the decision by the Andrews government to suspend time-sensitive IVF services earlier this year, which caused unnecessary distress and confusion to women and their partners;

(2) that Victorians considering IVF should not be unfairly prohibited from accessing this procedure to assist having a baby simply due to their financial status;

and calls on the Andrews government to immediately match the Victorian Liberal and Nationals commitment of providing rebates to assist women and their partners in support of IVF testing and treatments.

As I said, this is an important motion to give women and their families that security. Earlier this year we saw the government suspend IVF services. That was going to absolutely have a devastating effect on so many women and their families in being able to have babies. This was an illogical suspension during the code brown.

Members interjecting.

The ACTING PRESIDENT (Mr Gepp): Members, there are a number of conversations going on. Ms Crozier is trying to introduce the motion to the house, so please, if we could just have a bit more quiet.

Ms CROZIER: I appreciate that, Acting President, because it is an important motion, as I said, in relation to IVF services and the ability for women and their families to access these important services and to be able to have families.

At the start of the year the government implemented a code brown. Victoria was the only state or territory in the country to implement such a measure. That suspended surgery and IVF services. Not only was it incredibly damaging to so many Victorians who wanted to be able to get their elective surgery, there were surgeons, anaesthetists and nurses sitting at home doing nothing while their patients were not able to be treated or cared for. This code brown was extended for weeks.

If you think back to what happened in January, when we were told we were opening up, the government failed to even get the basics right. They failed to get rapid antigen tests in place. We were calling for those to be made available in Victoria. The federal government at the time said home testing would be available from 1 November, yet this government, the Andrews government, only ordered RATs for Victorians on Christmas Eve—on Christmas Eve, can you believe it? Of course over Christmas, the new year and all of that time through the festive season—when Victorians quite rightly, after coming out of the world’s longest lockdown, wanted to be with family and friends—the omicron variant got to Victoria and took off, but we were warned about that. The government said there would be cases. We were warned about that, we knew that, and as a result of the government’s inactions over the two years prior to that there was a very, very big impact on Victoria’s health services.

The illogical decision to suspend IVF services, as I was saying, in January of this year must be reversed. There were heartbreaking stories of so many women who said, ‘Time can’t wait. I can’t wait until April, until the government lifts this ban, to be able to have this time-critical treatment’. It was a very, very bad decision by the government; it was illogical. They were saying that health professionals would be taken from these facilities and used in our hospitals and healthcare system—well, they were not. They are specialists in their areas and could not be moved into hospitals to do that work.

The government at the time also argued that staff at private hospitals that were closed down would be put into the public system. That did not happen either. We found that out at the Pandemic Declaration Accountability and Oversight Committee when the committee was told, ‘No, that didn’t actually happen’. Private staff did not go across. As we know, there were issues around why that did not occur, but the government told Victorians that that would happen. It did not happen, and as a result IVF services and treatments in these specialist clinics where these specialist health workers work could not be transferred to busy general hospitals at that time. It was unnecessary, and it was, as I said, a completely illogical decision made by the government.

At the time it was really clear that Daniel Andrews and his government were dictating to Victorian families what they could do, and it was, as I said, very time critical and time sensitive that these women be able to get their treatment so that they could have and start a family. When I asked the chief health officer in that pandemic committee that I have referenced previously, he said—

Mr Atkinson: Has it met?

Ms CROZIER: Well, Mr Atkinson interjects, ‘Has it met?’. No, it has not met for months, and the last time the pandemic committee heard from the chief health officer was on 31 January, when I was asking these questions to him. He has not been back before the committee. He needs to be back before the committee in my view, and it is absolutely shameful that the Andrews government, within an hour before the committee is to meet, cancels and does not form a quorum. They say they are not available. Three times, Mr Atkinson, that has occurred. That is contempt of the committee process.

We have just gone through something with the Privileges Committee inquiring into the breach of committee deliberations and report contents, where Ms Patten was found to have undertaken matters that have been held in contempt of the very issue that Mr Atkinson spoke of—the integrity of the committee process. We are still under a pandemic declaration and yet that committee has not met. It is an absolute disgrace. It is a disgrace by this government, and the Premier should, frankly, hang his head in shame that he is directing his MPs not to attend this committee.

Ms Shing interjected.

Ms CROZIER: Well, somebody is. Why are they not turning up, Ms Shing? They continually do not come.

Mr Erdogan: On a point of order, Acting President—

Ms CROZIER: Well, Mr Erdogan, you are on the committee. Why don’t you attend the committee meetings? Three times.

Mr Erdogan: On a point of order, Acting President, it is just a false allegation.

The ACTING PRESIDENT (Mr Gepp): There is no point of order, but I will remind everybody in the house that if you do wish to level any allegations against any other member then you are able to do it by way of substantive motion rather than in debate.

Ms CROZIER: Thank you, Acting President. I will just make that point again. The committee has not met. The last three meetings have not been undertaken, because Labor Party committee members have cancelled within the hour. That is a fact. The last three meetings have been cancelled. The chief health officer was last before the committee on 31 January. I asked him about the suspension of IVF services, to which he said it was not his decision, he did not give the advice, it was made by the department secretary. So we did get that clarification.

But as I said, it is and it was such a bad decision by government. It was a knee-jerk decision by government, where these time-critical procedures could not be undertaken and where families were denied an ability to be able to have that critical treatment. There were so many heartbreaking stories. Melanie, who was 45, said her chances of having a child were slim and she was pinning her final hopes on IVF. She was one of many women. She went on social media with her heartbreaking story about her desire to have a child that was slipping away before her because the IVF treatments were being suspended. It was heartbreaking.

I know others went interstate. I had contact from fathers—in fact one texted me not so long ago and thanked me for the support that I gave to his daughter and her partner, who went to Sydney, and thankfully they are having a child. That was a wonderful outcome for them. But the heartbreak and the anxiety, the stress that had occurred during this time was truly unforgivable. And it was Melanie who went on her social media; she pleaded with the government to lift the ban. There were thousands of signatures, and of course the government did finally lift that ban. So you can understand that it was a political decision. It actually was not on health advice in the first place. It is another reason why we need a royal commission and another reason why we need to understand exactly what went on, why the decisions were made and how they were made. Decisions like this caused so much heartbreak, were unnecessary and should never happen again.

If I can go to the second part of my motion—that Victorians considering IVF should not be unfairly prohibited from accessing this procedure—this is a very important one. This is an election commitment that we have made because we think access equity is really important. There are women right around the state who have great difficulty accessing IVF, whether it is from a health aspect, a physical aspect because of where they live or a financial impediment. All of these issues must be taken into consideration for many women and their families to be able to have IVF procedures, and that is why we announced that we would provide rebates for fertility services to enable Victorian families to get the necessary support, so that they are not prohibited from having a family just based on their financial circumstances.

Even with the support of Medicare rebates, some families will be out of pocket up to $5000, so we are looking to ease that burden on so many women and their families. We will, and that is why we have said that we will make fertility services more affordable by providing a rebate of up to $2000 to undertake an initial IVF procedure using a private fertility clinic. These private clinics are already up and running. They have already got the technology and the specialist personnel in place to enable this to occur, so they will have a more timely and efficient way of getting women and their families through this process. That is why we are saying we would provide this in these clinics. We will provide a rebate of up to $2000 to undertake a subsequent IVF procedure if the initial procedure is not successful and a rebate of up to $500 for pre-IVF fertility testing, a very important aspect of any IVF treatment. This is incredibly stressful. As I said, it is to help ease that financial burden and to give peace of mind to some of these women and their families. There will be up to five days of paid fertility treatment leave for nurses, teachers and other Victorian public service workers. We think it is an important element to support women and their families in these areas, to recognise that if they have a desire to have a family, we will support them in doing that.

I am very pleased to be part of a team within The Nationals and Liberals to support this initiative. This is driven by what I have heard from so many women, and that is why we are doing it. We think it is important. That is why I am calling on the government to match this initiative that we are putting forward. I think the government, with their initiatives, are years away. They are not going to give women that immediate treatment. They are years away in terms of setting up any public clinics. It is just not going to happen overnight. It is highly technical, and there is a high degree of expertise that is required here, whether it is the equipment, whether it is the specialists that are involved or whether it is the specialist nurses and counsellors that are all involved with this very important part of health.

It is a significant part of health. It is a very important part of our health system. IVF has been tremendous for so many families. Of course it was Victoria that led the way all those years ago, and what a remarkable story it has been ever since. I would urge the government to immediately match the Liberal and Nationals commitment in this regard. I think that is the right thing to do for the thousands and thousands of women who every year have to go through these extremely difficult—very difficult at times—procedures. As I have said, there is a real burden both physically and financially, and this is why this is an important motion to be debating today. I would hope that the government would support it, and I look forward to them doing so.

Ms WATT (Northern Metropolitan) (11:00): I rise to speak on this motion regarding IVF, and in doing so I would like to note that the Andrews Labor government are delivering on our commitment to establish publicly funded IVF so that more Victorians can achieve their dreams of becoming parents, because we believe that everyone should get the chance to start their family no matter how much they earn. The government does not support this motion because it calls on us to support an inferior policy. We call on Ms Crozier, the Liberals and The Nationals to match the Andrews Labor government’s initiative to deliver public IVF services. Unfortunately the policy Ms Crozier calls on the house to support today is one that falls short of adequately addressing the financial barriers for so many parents.

Assisted reproductive treatment can be a long, emotional and expensive journey for people dreaming of starting a family. It can come with amazing joy for some but incredible heartbreak for others. IVF can help people who want to become parents achieve their dreams, but too often it is financially out of reach. We know that people struggling with fertility issues can be left thousands of dollars out of pocket following each cycle of treatment, and for some Victorians this means that IVF is simply out of touch and out of reach. This is why the 2021–22 Victorian budget delivered $70 million to establish public fertility care services, including Victoria’s first public egg and sperm bank. This investment will work to ease the financial pressure on many hopeful families during what is already a demanding experience for so many. This funding includes $20 million to equip public hospital facilities to deliver these services. Fully implemented, the service will provide up to 2700 free treatment cycles and a range of other fertility care services to up to 4000 Victorians per year.

Public fertility care services will mean more people, including those in our regional and rural communities, LGBTIQ+ communities and single people, will have the opportunity to start a family. This initiative is consistent with the recommendations from the landmark independent review of assisted reproductive treatment by Michael Gorton AM, which found the establishment of public fertility services was critical to making the system fairer and was strongly supported by many stakeholders, including private providers. Specifically, the final report recommended the establishment of public assisted reproductive treatment services and a public sperm and egg bank. These recommendations have been carefully considered in the development of the model for public fertility care services in Victoria by the Andrews Labor government. By contrast, the opposition’s commitment only provides a partial rebate, meaning patients might still have to pay up to $10 000 up-front to access IVF, and this really is an impossible barrier for too many Victorians. This policy is woefully inadequate, which is why our commitment to supporting Victorians accessing IVF goes so much further.

Our commitment to public IVF will provide average savings of up to $10 000 to eligible Victorians for a broad range of services in addition to IVF, including fertility management and ovulation induction, donor services and surrogacy support and fertility preservation where medical treatment may compromise fertility, and we are delivering on this commitment as we speak. Access to public fertility care services will commence later this year under a phased implementation approach following the announcement of service providers. It really is unfortunate that Ms Crozier does not support this policy and does not support fully public services that will change lives and ensure that bank balance is no barrier to becoming a parent. While the Andrews Labor government gets on with the job of building our public health system, this is what I am entirely proud of.

The best predictor of how a Liberal government will behave in the future is what they have done in the past, and Victorians know that their record is one of cuts, privatisation and contempt for public health care and healthcare workers. Since we were elected in 2014 the Andrews Labor government have worked tirelessly to invest in our health system at unprecedented levels. We are creating stronger nurse-to-patient ratios, building world-class hospitals right across our state and legislating free dental care in schools, and we commissioned Australia’s first royal commission into mental health.

The global coronavirus pandemic has also shown the world just how valuable and important health workers are. I will take a quick moment to acknowledge and thank everyone who has worked around the clock to keep our community safe and well during these past couple of years and who continues to do so as our community recovers from the global coronavirus pandemic.

The Andrews Labor government has a proud record of supporting better access and choice for Victorians who want to start a family. Earlier this month landmark reforms came into effect to make it easier for more Victorians to access assisted reproductive treatment. Victoria has been a world leader in developing assisted reproductive treatments. These reforms are about making them more accessible for all Victorians by removing barriers for people starting or expanding their family. The new laws mean prospective parents can meet with any counsellor who meets the prescribed requirements, not just those based at a registered ART clinic, to complete the counselling required before artificial insemination. This removes unfair barriers for rural and regional Victorians and gives prospective parents freedom to choose the counsellor they wish to have on their journey of starting or expanding their family. The latest reforms also provide more certainty for those opting for donor conception, giving them more say over how their embryo is managed.

These final changes are part of the rollout of ART law amendments, which began in September 2019 following the review of ART by Michael Gorton AM—as I mentioned earlier, a key 2018 election commitment. They are part of a major push to ensure more Victorians have better access to safer, higher quality discrimination-free treatment, supported by guiding principles that are inclusive for all Victorians. In June this year a change came into effect that allowed nurses and other trained health professionals to perform artificial insemination under doctor direction and supervision in registered ART clinics, providing more Victorians with easier access to lower cost treatment options. The change also gives women more choice about who performs the procedure, which may benefit Victorians with specific preferences due to cultural, religious or other personal reasons. Amendments earlier this year also expanded the family arrangements where a surviving partner can use the egg or sperm of their deceased partner in a surrogacy arrangement, giving more surviving partners a greater chance of still being able to have a child.

Prior to these changes the government had already implemented several other recommendations from the Gorton review, including removing barriers for separated women to access services and reforming how surrogate mothers are reimbursed. We expanded the costs that can be reimbursed to a surrogate mother and removed the requirement for women who are separated but not divorced to seek the approval of their former partner to access assisted reproductive treatment with their own eggs and donor sperm. In addition, the government has removed the requirement to undergo police checks before accessing treatment. These amendments are an important part of ensuring Victoria’s assisted reproductive treatment laws are fair and up to date and reflect the expectations of our modern community. Our public IVF commitment builds on the record of reform to expand access.

When it comes to health we know that those opposite have only ever undermined the response to the pandemic. IVF is an immensely challenging journey for anybody going through it, let alone in the midst of a global pandemic. We are deeply sorry for the distress caused by disruptions to services during the pandemic. Following the advice of the chief health officer, IVF procedures were briefly suspended as part of necessary changes to protect our hospitals. These services commenced as soon as possible to help support Victorians who were wanting to start or grow their family. While the IVF restrictions were in place services were still available to those who needed to complete a treatment cycle that was underway or those that required further IVF procedures due to health treatment that would render their eggs non-viable.

Health, especially women’s health, is an issue close to my heart. As I have said, prior to entering this place I served on the boards of many community health organisations. I am proud to be a member of the Andrews Labor government, who always put health workers first—as seen recently by our announcement of free degrees to become a nurse or midwife. This great announcement means more than 10 000 students will now have the practical support they need to continue caring for Victorians. I will leave my remarks there. Thank you very much for the opportunity to speak on a topic I feel so passionately about.

Mr ATKINSON (Eastern Metropolitan) (11:10): This is a particularly important motion. I note the contributions of both Ms Crozier in support of the motion and Ms Watt in putting on the record some of the government’s programs and commitments in terms of IVF treatment. I acknowledge that the government has undertaken a number of reforms, and certainly both sides of this house have supported the development of services that support women who are looking to have families who have difficulty with pregnancy. IVF is a particularly important program. It is a service that has evolved, and in Victoria we have been in the vanguard of providing these services and ensuring women have access to these services. Certainly some of the government’s promises and its budget commitment do suggest an expanded program that should enable more women to access IVF services and the related services of counselling and so forth that are so important in progressing their opportunity for starting families.

As Ms Watt said, IVF has delivered extraordinary joy to many families because of successful outcomes in terms of IVF treatment. But there has also been trauma for other people who, despite IVF, have not been able to have families, and certainly there is a significant financial commitment that has been required for those women or women and their partners to pursue IVF as an option where pregnancy has had some complex issues associated with particular individuals. The motion that is before us today certainly addresses some of those financial obstacles.

I note Ms Watt’s comments about the public system, and I think it is terrific that there is an expansion of opportunities in the public health system for IVF treatment. But I am a little concerned about whether or not this represents a government attitude that denies the opportunities for people who are seeking to have IVF treatments through the private system—that there really is a skewing of government policy towards public and a dismissing of the important contribution that the private sector makes.

I do go back to the lockdown period, when I was seeing a specialist about an aspect of surgery that I needed. On a number of occasions that surgery was delayed because of the edicts of the government in terms of whether or not the private sector clinics or surgeries could operate and whether or not specialists were able to operate, despite the fact that those specialists were not redeployed to support COVID-19 health measures. Their ancillary staff, including anaesthetists and nursing staff, were not redeployed towards that COVID effort. From the elective surgery performed in private hospitals, those private hospital surgeons were not redeployed. Those private hospitals, in terms of their bed count, were not redeployed to COVID measures. They were simply stood down in that period, and you have got to wonder why that was necessary. Certainly whilst Ms Watt says that the cancellation of IVF, which I regarded as particularly cruel at the time, was on the advice of the chief health officer, Ms Crozier says today that, in terms of the committee that has been looking at that lockdown process and the laws that are in place—the oversight, if you like, of lockdown measures—the chief health officer says that he did not provide that advice on IVF.

IVF is already a journey for many women and their partners and their families that is a difficult journey. It is a psychological journey as much as a physical journey, and the disruption that was caused, the heartache that was caused, at that time when IVF services were suspended when they did not need to be suspended—when the treatment was not COVID-dependent, when there was no risk in terms of COVID, when in fact the people involved in those services were not being redeployed to the COVID response effort—was outrageous. It only lasted a very short time, because I dare say that the government was very much on the receiving end of a lot of criticism, both from within its own ranks as well as obviously from within the medical ranks and those women and other people who were upset about this disruption to that service. At that time, as I said, the private health sector could have done a lot more, continuing with elective surgeries. Certainly it was able to cope with the IVF processes and ensure that people who were already on the program were not disrupted.

For those who are looking to come into the program it is not a matter of them just turning up on a particular day to start the program; there is already a lot of work, a lot of thought and a lot of angst that has gone into even starting the program. And to have it delayed—in some cases, that missed opportunity—might well have meant that they were not able to have children at all going forward, such is the nature of IVF treatment; it is so time critical.

This motion is important. This motion certainly addresses supporting financially some people who need that support in the private sector as well as in terms of public treatment. Yes, the extension of services in public health is welcomed, although one must be concerned about workforce planning in terms of these sorts of services and so many other services across public health. It is all very well to be announcing new facilities or announcing service extensions and so forth, as this government has been doing in recent times, but it is without actually having in place the workforce planning. We heard at the weekend of some initiatives that have been taken—and of course the opposition has also matched those—in terms of nursing services, but workforce planning is absolutely critical.

With IVF treatments, yes, we hear what the government plans to do in public sector health provision. Where is the workforce planning to support that? Not just the budget allocation, but where is the workforce planning that will ensure that there is a continuation of those services and there is not the disruption so that people who go on IVF treatment programs are actually able to go on those with confidence that they will receive those services and, importantly, that those public health areas of support are not at a cost to the private health sector? It plays such an important role as a companion in health service delivery here in Victoria and ought to not be relegated according to some ideological plan but should in fact be encouraged to be a full partner in the provision of these services. Where it is appropriate the government should be supporting those programs, as is called for and as is provided in this particular motion. I support the motion and urge the house to support it.

Dr KIEU (South Eastern Metropolitan) (11:20): I rise to speak to the motion put forward by Ms Crozier on IVF testing and treatment. I cannot see any perceived or potential conflict of interests, but I would nevertheless like to disclose that my daughter is an IVF specialist, so I know and I have heard a little bit about IVF treatment. This is a type of assisted reproductive treatment that can be very long and drawn out and be an emotional as well as a very costly journey for many people who take part in that.

The success rate is quite varied depending on age and also on personal circumstances—health and so on. It could be as low as 6 per cent for one treatment for people over 40, or it could be as high as 65 per cent for people under 30 after many treatments. But people, whether it is for a family reason or because they are separated but not divorced or for a career decision or for some other reason, may want to choose to have IVF treatment in order to have a child. Also, the government is supporting people in other parts of Victoria, in regional and rural areas, as well as those in the cohort of the LGBTIQ+ community and single people. IVF can help people to become parents, to achieve their dreams, but more often than not financially it is too prohibitive for them to attempt that.

In Ms Crozier’s motion there are two main elements. One is about the suspension of IVF services during the COVID time, and the other element is about the opposition’s policy to support IVF treatment. As I just mentioned, IVF treatment is a very challenging journey for anyone to go through, and the global pandemic—this global one-in-100-year pandemic—was unprecedented; we had no rule book for how to deal with that. So what we did was rely on expert advice, rely on the advice from the chief health officer. We took the advice and had a suspension, and we are deeply sorry for the distress caused by the disruption to these services—IVF treatment and some other elective surgery treatment—during the pandemic. But that was necessary. That was the advice from the experts. That was the advice from the chief health officer. As soon as it was possible, those services were started up again to help support Victorians who wanted to start or to grow their family.

It also has to be pointed out that while the restrictions were in place the services were still available for people who needed to complete a treatment cycle which had been underway and also for those who had other health reasons. The government still supported them to go through IVF treatment, because otherwise a delay would have rendered their eggs non-viable. There were exceptions, and as soon as we got advice from the chief health officer the restrictions were lifted as soon as practically possible.

On the policy proposed by those opposite, it needs to be pointed out that the policy is inferior and inadequate. It falls short of addressing the financial barriers that people need to overcome in seeking fertility treatment. As my colleague has pointed out, the government does not support this motion. The Andrews Labor government are delivering on our commitment to establish publicly funded IVF so that more Victorians can achieve their dream of becoming parents or growing their families further. This is based on the recommendations of the landmark independent review of assisted reproductive treatment by Michael Gorton. The government’s initiatives are consistent with the recommendations coming out of that review. The review found that the establishment of public fertility services was critical to making the system fairer, and this was strongly supported by many stakeholders, not just the public hospitals but also private providers. The funding that the government has committed amounts to $20 million to equip public hospital facilities to deliver these services. This is part of the 2021–22 Victorian budget amount of $70 million to establish public fertility care services, including Victoria’s first public egg and sperm bank.

By contrast, the opposition’s commitment only provides a partial rebate, meaning patients must still be able to and may have to pay up to $10 000 up-front to access IVF, which is an impossible barrier for too many Victorians. Our commitment from the Labor government to public IVF will provide, on the other hand, an average saving of up to $10 000 to eligible Victorians for a broad range of services in addition to IVF, including fertility management and ovulation induction, donor services and surrogacy support, and fertility preservation where medical treatment may compromise fertility. Access to public fertility care services will commence later this year under a phased implementation approach following the announcement of service providers.

Victoria has been a world leader in developing assisted reproductive treatments, and our reforms are about making them more accessible and fairer for all Victorians by removing barriers to people starting or expanding their families. Compare that to the inferior policy of the opposition, and we cannot support the policy of the opposition.

Ms TAYLOR (Southern Metropolitan) (11:29): I think where there is some unity is on the fact, the real fact, that IVF can be financially out of reach for many people. That is where on this side and the other side we have some synergy, but that is about where the synergy begins and ends on IVF policy. I think there has been some fairly bizarre discussion about ideology here today, and what our government really is all about is ensuring equitable access. So let us put aside these strange ideological arguments. This is about making sure that Victorians seeking reproductive services and, I should say, assisted reproductive treatment have equity of access, because we know that obviously—I say obviously based on people themselves I have known who have gone through IVF, but I think it is broadly known—it can be quite a heart-wrenching process. It does not necessarily deliver the outcome that one wants at the end. On the other hand there can be an extraordinary and almost miraculous result, particularly when some couples or even single people have tried for many years to achieve the birth of a child or to advance their fertility, so to speak.

We should now look at what the heart of this discussion is really about rather than pontificating over the pandemic and the various vicissitudes of that, which did have nothing less than the potential outcome of death. We saw that around the globe, so I think these kinds of manipulative arguments going back in time to the peak period when there were thousands of cases and we know that millions of people have died from COVID-19 are not really helpful. I think it is quite manipulative and can prey on people emotionally in a way that really is not very constructive or supportive of best possible outcomes. Rather, I think it is actually useful for the chamber to compare—because that is what is being asked today—what our government is doing in terms of delivering equitable access to IVF or fairer access to IVF, which is probably a better word, versus what the opposition is proposing. Hence we do not support the opposition’s motion, because it calls on us to support an inferior policy. Why would we support it? We call on Ms Crozier, the Liberals and The Nationals to match the Andrews Labor government’s initiative to deliver public IVF services.

Our Andrews Labor government is delivering on our commitment to establish publicly funded IVF. Why? Let us bench these silly ideological arguments. We are doing this so more Victorians can achieve their dream of becoming parents. That seems to be a pretty fair and reasonable goal to achieve and to support, and hence this is why our government is backing it in. Why? It is because we believe that everyone should get the chance to start their family no matter how much they earn. Okay? That is really at the heart of this discussion today. The opposition have opened that door. They want to compare what they are offering with what we are offering, so let us do that and let us get to the heart of this issue.

We know that people struggling with fertility issues can be left thousands of dollars out of pocket each cycle of treatment. For some Victorians this means IVF is just completely out of reach, which would be devastating in itself. Hence this is why in the 2021–22 Victorian budget our government delivered $70 million to establish public fertility care services, including Victoria’s first public egg and sperm bank. This investment will work to ease the financial pressure on many hopeful families during what is already a very demanding experience for many people. This funding includes $20 million to equip public hospital facilities to deliver the services. Fully implemented, the service will provide up to 2700 free treatment cycles and a range of other fertility care services to up to 4000 Victorians per year. What does this actually mean? Public fertility care services will mean more people, including those in our regional and rural communities and LGBTIQ+ and single people, will have the opportunity to start a family. So you can see there is that heavy emphasis on fairness embedded in this policy.

A further point that is very relevant to this discussion is that this initiative is consistent with recommendations from the landmark independent review of assisted reproductive treatment by Michael Gorton AM, which found the establishment of public fertility services was critical to making the system fairer and was strongly supported by many stakeholders, including private providers. I think it was a bit disingenuous to go down this kind of ‘Oh, one side is anti or pro private’ or whatever. That is not what this is about. If we focus on the purpose—that is, fairness in terms of delivery of the opportunity to seek assisted reproductive services—and we take on board the perspectives of the stakeholders—that is, those who are involved in delivering these services at the coalface, so to speak—then we can move away from what I see as disingenuous, ideological and political discussions and focus more on what is being delivered for Victorians who want to be parents, or a parent in the case of a single person.

Specifically the final report recommended the establishment of public assisted reproductive treatment services and a public sperm and egg bank. These recommendations have been carefully considered in the development of the model of public fertility care services in Victoria by our Andrews Labor government. Again, a comparison because the door has been opened—let us look at what those opposite are putting forward. The opposition’s commitment only provides a partial rebate, meaning patients must still be able to pay up to $10 000 up-front to access IVF, which we all know can be an impossible barrier for too many Victorians. Ten thousand dollars is a lot of money, and I do not think I have to reiterate that point too much. I think it is very clear to everyone here that up-front that could be a significant impost on many Victorians. Hence that policy is not adequate, and that is why our commitment to supporting Victorians accessing IVF goes much further.

The opposition opened that door; they said, ‘Right, we’re putting it up there’. We are going to test what is on offer versus what they are offering. And I am not sure, if I were in their shoes, that I would have done that, because what they have done is actually expose a very stark contrast between what our Andrews Labor government is offering and what the opposition are offering—when I say opposition, I mean the Liberal and National parties respectively. But they opened that door.

Our commitment to public IVF will provide average savings of up to $10 000 to eligible Victorians for a broad range of services in addition to IVF, including fertility management and ovulation induction; donor services and surrogacy support; and fertility preservation where medical treatment may compromise fertility. Most importantly, we are delivering on this commitment as we speak. Access to public fertility care services will commence later this year under a phased implementation approach, following the announcement of service providers.

I think, based on what has been shared by my colleagues in the chamber today and me here just now, members can see why we are not going to support the motion put forward by those opposite, because we clearly have a policy and we are implementing mechanisms as we speak to support Victorians with assisted reproductive treatment.

Ms LOVELL (Northern Victoria) (11:39): I rise to speak on Ms Crozier’s motion 781 today, which speaks of the Andrews government’s extremely insensitive disruption to and suspension of IVF services during the pandemic and also speaks of the costs associated with and the difficulties for women who cannot access IVF due to their financial status.

Firstly, I would like to touch on point (1), which is about the suspension of IVF services by the Andrews government during the pandemic. To not be able to conceive must be the most devastating thing for a couple who are wanting to start a family. No-one could possibly imagine the heartache that they go through when they cannot conceive a child that they so desperately want. IVF has given so many couples the opportunity to become parents. Mr Bourman is sitting in the chamber with us today; we know what it has meant to him. I have also seen many of my friends who have gone through that same journey as Mr Bourman, and I have seen how difficult that journey can be for them—the disappointment time and time again when they go back for procedures that do not result in a pregnancy and the emotional and the financial cost that it imposes on them.

But for couples who were in the middle of their treatment during the pandemic to find that the services had been suspended must have been an extremely traumatic time for them. Many other families, as we know, were able to conceive during the pandemic—and we had a little bit of a bump in our birthrate because of that. But for those who were unable to conceive naturally, to have these services denied to them—it was truly just an incredible decision by this government to stop those services. I just cannot fathom why the government would be so insensitive.

But as I said, I have seen many of my friends go through this journey and suffer through that time. I also know the financial impact that has had on them. One of my friends has a young daughter who has been through this journey and had a couple of pregnancies from IVF that did not result in going to full term. I saw the emotional turmoil it caused that couple. Fortunately their third pregnancy resulted in the most beautiful little girl I have ever seen. I love her dearly and consider her to be part of my extended family. But I also know the financial impost that that had on that young couple. They were so desperate to conceive that they actually accessed part of their super in order to fund the IVF treatment as it kept dragging on for them. The cost of that was beyond them if they were not able to access their super. We should think about how sad that is—that young couples are having to forgo their future by accessing their super to start a family, something that should not be costing them anything.

That is why the Liberal Party have come up with a significant commitment, an election commitment, to assist those families who are accessing IVF to help them to cover those out-of-pocket expenses—because what we know is that even after the Medicare rebate, families are usually left with around $5000 in out-of-pocket expenses, and this can be a significant barrier for those seeking to start a family. This is why we should be helping these young couples. Especially now with the cost-of-living pressures that are rising, too many families are being left in this unacceptable position of choosing to start a family, choosing to support their household budgets or choosing to access their superannuation savings in order to fund IVF.

I pay tribute to Ms Crozier for developing our policy, which has come up with a rebate of up to $2000 to undertake the initial IVF procedure using a private fertility clinic and a further rebate of up to $2000 to undertake a subsequent IVF procedure if the initial one is not successful. There is also a rebate of $500 for pre-IVF fertility testing and up to five days of paid fertility treatment leave for nurses, teachers and other Victorian public service workers. Critically, these rebates will be available to women undergoing IVF treatments in a clinic of their choice without the need for them to relocate to a different facility or to interrupt their treatment. This is an important commitment that would provide critical and practical support to thousands of Victorian families. Our Liberal plan would make it easier for families who are wanting to start having children. The cost of living should never, ever be a barrier to starting a family.

Mr BOURMAN (Eastern Victoria) (11:45): I rise to give some, as they say in this place, lived experience to this entire motion. Basically there are two parts to this motion. One is about the decision to suspend IVF, and the other is about the Liberal and Nationals commitment to providing rebates. I am going to do it in reverse order: I am going to talk about the rebates first.

The rebates are a good idea. Fortunately for us we were in a position to be able to absorb the cost. Fortunately for us we were able to have Nicole take time off work and to be able to afford to do what gave us some very low lows but also the ultimate high, our little daughter, Becky. Not everyone is in that position, and I have got to say my experiences in the over 2½ years we have had Becky have made me think that anyone that desperately wants to have a child should be able to. There are rebates for this and that, and I feel that as much as possible rebates on IVF—I do not want to get into the war between the two majors here—are something that the government should take up. It is the best thing I have ever done—far better than coming here, far better than my other services to the state. Becoming a dad and having the honour of having a little person mature—if you can call 2½ years old mature—with our help, is something that everyone that can possibly have it should have.

Let us move to the first part. I am going to give a very unpopular opinion here, and I have discussed what I am going to say with my wife. We all know about our first round of IVF. We all know about what everyone thought was our last round of IVF, number 11. What we did not really publicise is that after Becky we kept on going during the pandemic. We were directly affected by these suspensions, and Nicole at that time was reaching the hard end of any egg collection. I think at 46 it stops—no ifs, no buts, no whatevers. We were running right down to the wire, and then they suspended it. At the time we had a big chat about this, and we both came to the realisation that there was a global pandemic on. Could the government have handled the initial stages better? Yes. But the decision to suspend IVF services from our point of view was fairly logical until they could get a handle on it. We were directly affected. We had five extra cycles after Becky. We were directly affected by this. But I have got to say, we have got to look at this in the context of what was going on. There is a lot in IVF that does not require attendance at a facility. There are a lot of injections. There are a lot of things that you need to do that you can do in the privacy of your own home.

That is my sole problem with this thing. I think the monetary part is right on the mark, but I just do not think it is fair to blame the government for the initial problems with the pandemic. I do not think any government, regardless of the flavour, would have done much different, because at that stage no-one knew how this was really spreading; no-one knew how this was going to go. And I am not saying this from a position of ‘I don’t know how it went’. This decision on this directly affected us. Did we lose by it? Maybe. I do not know. But it was the thing to do at the time.

I have got to pay tribute to Nicole. There were 16 rounds of IVF. There was one stillborn. There was one—I do not like calling her a ‘rainbow baby’, because she was far more than that. But after that came the rest of it.

As I said, my opinion on this may or may not be popular. I do not really care. It is what it is. I have heard the term ‘lived experience’ in this place many times. That is our lived experience.

Ms SHING (Eastern Victoria—Minister for Water, Minister for Regional Development, Minister for Equality) (11:50): We have heard a wideranging set of contributions today from members not just about the course of their own experiences with IVF and assisted reproductive technology and the procedures that go along with that but also in the context of the way in which services were provided during the course of the pandemic and the impact of that period from 6 January to 20 January when procedures were suspended, except for those people who were already in the middle of them.

Mr Bourman has just made a really valuable point, and it is one which I think goes to the heart of this issue. IVF is not one procedure. It is a mountain of paperwork. It is numerous appointments, a number of which during the pandemic and during lockdowns were able to continue through telehealth and in a virtual setting, including as it related to counselling and including as it related to education on what medical processes were involved and the impacts and side effects of those processes—everything from the way in which daily injections and other medical routines need to be established and maintained to maximise the success of either egg harvesting or implants to making sure that when and as IVF processes are undertaken in that procedural sense they are given the maximum chance of success and of a healthy pregnancy that results in the very long awaited children for couples who are seeking to have a family with that additional support.

IVF is by no means an easy or straightforward journey for the vast majority of people who access it. We have seen this evolve in the way that governments have contemplated access to services and the way in which we have refined and changed the definitions of ‘fertility’. I know many, many people who are rainbow families who have had to access IVF and had a really difficult set of circumstances that cast aspersions on their fitness to be parents—the requirement of police checks, the idea of needing to be determined to be socially infertile because of being same-sex attracted. I note the way in which the system at large needs to continue to evolve to remain respectful and to become more receptive and responsive to the changing circumstances within which IVF occurs.

The circumstances in which IVF occurred between 6 January and 20 January, when they were suspended, caused an enormous amount of distress, and I am not going to stand here and say that that was not the case. Of course the experience of couples, particularly those who were up against the clock, as a number of speakers have referenced here today, caused very real distress and caused very real worry and anxiety.

Worry and anxiety and distress are part of the IVF process. It is about counting down the days, it is about daily injections, it is about wondering whether egg harvesting will be successful or whether an embryo will take. It is a constant emotional journey, which is why counselling is such a big part of the access to services. It is also why there have been necessary changes made, following the introduction of legislation under the former health minister, Martin Foley, in 2021, and the review of ART by Michael Gorton AM. A number of other speakers have gone to that point today, talking about the importance of public fertility services. As Mr Bourman indicates, rebates may well help, but one of the things that I think is worth focusing on is the allocation of $70 million within the 2021–22 budget to establish those public fertility care services, including Victoria’s first public egg and sperm bank.

This is a framework which addresses systemic inequity in accessing assisted reproductive technology. This, along with changes to the way in which donor participation can occur to move between 10 people through to 10 families, enables people to access greater opportunities to build upon the history of IVF where early rounds are not successful or indeed where further children are desired. These are practical differences which in fact make a difference around what the model for public fertility services looks like and how that needs to improve over time.

So when we compare that against the opposition’s partial rebate it is really important to note that patients still need to be able to pay under that plan up to $10 000 to access IVF. As speakers from the opposite benches have indicated, this is a really significant barrier. Ms Lovell has in fact talked about the cost of living and the impact on accessing fertility services. Well, under their plan there will still be a need to find money, to find many thousands of dollars, in order to access that IVF up front.

Our commitment in fact goes further than what is proposed by those opposite. But in addition to that, what we have done already in government is in operation. These are not promises. These are not commitments to make changes in the future. This is what is already part of the 2021–22 budget. Easing that financial pressure is part of the thinking on tackling the cost of living and also as a result reducing the emotional burden of people already undergoing a really significant medical and psychological journey. We should not ever forget, as I hope that those opposite will not, in the public conversations around IVF that this is about people. It is about watching the calendar, it is about watching the days count down to those key milestones around age, as Mr Bourman has indicated. But I also want to note that between 6 and 20 January, when those services were suspended, it is important to note that those who were already on the path toward procedures taking place were able to continue that work and also that in the context of a global pandemic uncertainty requires a default to public health advice, which was the necessary response to and the appropriate response to the chief health officer’s directions in that regard. Within the public framework, as it operated under the emergency declaration, those determinations and the directions were the guidance that set the government’s decision-making at that time. On that basis, and noting that we are perhaps up against the clock before question time begins, I will take my seat. My apologies, Ms Crozier.

Ms CROZIER (Southern Metropolitan) (11:58): That is fine. I do not need much time to sum up. I want to just acknowledge those speakers that have spoken on this motion. It is an important motion giving support to women and families right across Victoria in acknowledging the difficulty that so many people have. I know that Mr Bourman spoke of his personal experience and the joy that he and his wife have had with their baby, Becky, but many have not, and many through the suspension earlier this year who are not in his position and who do not have that joy were devastated because of the untimely nature of what was happening to them. I know that my office received so many emails from so many women stating that they were so concerned about what was happening. I was pleased the government saw that what they had done was incorrect and reversed the ban, but it should not have gotten to that. They should not have made that decision in the first place. It should not have gotten to that. It was a very bad oversight in relation to the directions that were given at the time. I think my time is running out, but I want to say that I urge all to support this motion.

Motion agreed to.

Business interrupted pursuant to sessional orders.