Transcript Of Interview AMA Federal Councillor And Obstetrician, Dr Andrew Pesce, With Mike Carlton, Radio 2UE, 9 November 2004

09/11/2004

MIKE CARLTON: Dr Andrew Pesce is from the Australian Medical Association, and he is their spokesman on obstetrics and gynaecology. Good morning.

ANDREW PESCE: Good morning Mike.

CARLTON: Is it possible to say how many abortions are carried out in Australia each year?

PESCE: On the Medicare statistics, I don't think it is. The Medicare statistics relate to the number of surgical procedures performed on women who have an operation on, I guess to put it completely, a pregnant uterus. So it's an item number that relates to surgical procedures performed on women who are pregnant to empty the uterus.

CARLTON: Right.

PESCE: Now, there are two item numbers that you can use to claim for such procedures, and one is for what's called an incomplete miscarriage, which is where a woman has already partially lost the pregnancy, and then there's a sort of a fairly simple and straightforward procedure just to basically clean out the remainder of the tissue that's inside the uterus. And then there's another item number, which is for anything else, OK? And that would include terminations of pregnancy, just for sort of maternal choice. It would include terminations of pregnancy for medical reasons, such as the woman's health is at risk. It could be also because she's done a test and found that there's a severe abnormality with the baby and it's incompatible with life, or it's so severe that she wants to organise a termination. And it could also include procedures for women who have turned up for their first visit to the obstetrician, really happy that they were pregnant, had an ultrasound and found out that the baby is no longer alive, or there's an empty sac, or, you know, in various ways there are non-viable intra-uterine pregnancies.

So there are all of these possibilities of treatment which are being put down under the item number, and therefore it is impossible on the current item number to interpret how many of those are for what Tony Abbott and other people would say are terminations of pregnancy, and how many are for non-viable pregnancies which are being surgically treated.

CARLTON: Right. So let me just sum that up if I can, and put it into, I hope, simple language. Correct me if I'm wrong. Under this Medicare treatment, as a specific number for a specific procedure, some of those would be abortions, but a great many of them, and perhaps the majority, would be to deal with simple miscarriages--

PESCE: Yes, I believe--

CARLTON: --and the like.

PESCE: Yes, I believe that the majority are for what you would consider a miscarriage, yes.

CARLTON: What sort of majority do you think?

PESCE: Look, I would only be speculating, all right? All I can say is in my personal practice over 90 per cent would be for non-viable pregnancies.

CARLTON: So the number of abortions might be only 10 per cent, and the number of non-viable pregnancies and miscarriages and so on could be 90 per cent?

PESCE: It's possible, yes.

CARLTON: Right. So this figure being thrown around of 100,000 abortions in Australia each year, is simply not - in no way accurate?

PESCE: Well, it might be accurate, but it's not accurate if you're basing it on the Medicare statistics.

CARLTON: Yes. How many private abortions would there be perhaps, that don't attract, you know, that wouldn't get into the Medicare figures?

PESCE: I think that there wouldn't be too many, because there are basically - there are three ways a woman could have a surgical abortion in this country. One would be to go to an abortion clinic, and I suspect that they would claim their Medicare funding under the item number, and that should probably show up. They could turn up at a private doctor's surgery, and have it organised privately in the private system, and that certainly would turn up, because that's the only way that the payment can be made--

CARLTON: To the doctor, yes.

PESCE: --and they could go to a public hospital, and if the public hospital had a clinic which, you know, ran and helped treat these women, they could get admitted as public patients in a public hospital, and that wouldn't show up on this, because the public hospital doesn't make a claim on the basis of an item number, it just works on its funding through its consolidated budget.

So it's really quite, you know, it's very, very difficult to know how many women would seek a termination through the public system, and how many do it through the private system or the termination clinics, and so it really is very, very difficult to know.

CARLTON: Right. But the figure being thrown around of 100,000 abortions in Australia each year is in your view, what, is it dishonest, is it wrong, or what?

PESCE: No, I don't think it's dishonest, I just think that it's dishonest to say that you can use the item number and come to a conclusion about the number of abortions being performed. I honestly don't know, I mean there are various ways you can look at this, and all I can say is if someone really wanted to know, in general medical terms, if someone wanted to know what the prevalence or incidence or frequency of a medical condition was in this country, they wouldn't go to the Medicare item numbers for operations that might be treating it, to get scientifically-based information on the frequency of a condition. They would have to go to the trouble, and possible expense, of collecting that data separately. And so this is probably the only easily available data, I mean I can get it up on my computer today, but it's just not accurate.

CARLTON: Right, OK. So are we then being misled?

PESCE: I think this is a demonstration, and it works both ways, it would be inaccurate to say that just because I said on your program that less than 10 per cent of these are terminations in my practice, that that applies nationally and therefore we can say there's only 10,000 a year. I think that would be as equally misleading as to say that we can be confident there are 100,000 a year from these figures.

I suspect that, you know, there are lots of terminations performed, and for the people who think termination is bad, there are too many, and the people who agree with it, they'll say, "It's just right". So you know, I mean the problem is that instead of addressing, I suppose, the public interest moral and ethical question of do we as a society agree with the fundamental right to choose, of a woman, as you said in the opening of your program, well that's quite a reasonable public interest and ethical question to ask, and I, as a medical practitioner, only have as much input into that as any person. I happen to have a bit more personal experience, because I treat these women, but my moral opinion is no more value than yours or anyone else's in the street.

But the trouble is that because of the difficult nature of this issue, people use statistics and sort of parallel arguments about the frequency and all of this to argue for, say, well the Federal Government can't ban abortion, because it's a State issue, it's State legislation, which covers when it's lawful to terminate a pregnancy or not. But what they can do is withdraw funding for Medicare item numbers, which fund terminations of pregnancy.

CARLTON: And that's what they're trying to do. Thanks for your time.

PESCE: And I don't know whether that's the case, but I think that's sort of what it gets around to.

CARLTON: Yes. Thanks very much.

PESCE: Right, bye.

CARLTON: Thank you kindly. Dr Andrew Pesce from the AMA, and what I still believe to be the essentially dishonest and unscrupulous attack on a woman's right to choose. They can't - no Federal Parliament can ban abortion, it is a State matter, but this campaign from the hard right wants to withdraw Federal funding from this medical procedure, abortion or not apparently, even if it's just a simple miscarriage. It is a disgraceful campaign.