90: Australia's Menopause Inquiry and the Push for Health Equity with Senator Marielle Smith

Welcome to Dear Menopause podcast, where we discuss the menopause transition to help make everyday life a little easier for women. Today, I have with me Senator Marielle Smith. Senator, welcome Dear Menopause . Thanks, Sonya, it's great to be on here. It's absolutely wonderful to have you Now. We have quite an important topic to talk about. Today we're going to be deep diving into the Senate inquiry into menopause here in Australia that is taking place in 2024. Senator, is it okay if I call you Marielle? Oh, my gosh, of course. Yes, Marielle. Why don't you start things off? How about a little introduction as to who you actually are and why you are a good person to us to talk to about this?

Thanks, Sonya. Well, I'm Labor Senator from South Australia and one of the reasons I ran for parliament is because I wanted to do more to close some of the divides and inequities we see in our healthcare system. A lot of the work I do is around maternal health and new mums, because we see big, big differences in the way women experience their maternal health journey, whether they live in regional areas or open areas and across different states. But when I started this work, what became really clear really quickly is that maternal health is at the only area in our health system where women feel let down or unheard. We see it right across the healthcare system, and menopause and perimenopause is absolutely one of those examples, and I want to use my position as a senator to do what I can to shine a light on these issues and try and get some change.

And it's so wonderful to know that we have politicians specifically female politicians out there that are actually prioritising and highlighting the need improvement in health equity for women across the board in Australia. So, alongside Senator Larissa Waters, you at the end of last year co-sponsored a successful motion to establish a Senate inquiry into menopause and perimenopause. Can you explain to anyone that's listening today what a Senate inquiry? Actually is and why it's so important.

Absolutely so. The Senate I mean our main business in the Senate is to review and scrutinise legislation. That's what we do with the bulk of our time, but we also have the power to investigate particular issues of policy and to put some of the resources of the Senate in terms of research and conducting inquiries into that process. So my committee is community affairs. We look after health and social services and as part of this inquiry, we have the opportunity to use all of those resources to go out, talk to women, talk to experts and try and uncover what the situation is where we can help and bring all that information together into a format where people really sit up and listen and take notice. What I've heard over and over and I know Larissa is the same that for many women who experience menopause not all, but for many there's really significant and often unexpected costs they face, whether they're economic costs or the requirement to either adapt, change or drop out of things like study in the workplace. Menopause and perimenopause can have significant impact on women's relationships. Some women experience really significant pain and whilst this happens to a lot of women, these kinds of experiences many, many women are telling me they feel either uncomfortable speaking out about it or when they do speak out about it, they feel like people don't really listen. Now, that could be their GPs, the medical practitioners, it could be their workplaces, it could be people in their life, in their family, and that's really hard. That's really hard when you're going through something which is having a big impact on you and you don't feel heard or you feel dismissed. Larissa and I both heard these stories and we wanted to do something about it, and having this inquiry is a way we can bring all of that out into the open, make sure that women are being heard and do what we can to make recommendations to see some change where we know there are things we can do to make it easier for women who do have a negative experience of perimenopause or menopause.

Obviously, there'll be legislative changes, so we would expect to see recommendations for changes come out of the inquiry along the lines of impacting menopause in the workplace, potential changes to the healthcare system as a result. Is that right?

Perhaps, but it doesn't have to be legislative changes. So Senate committee can make recommendations, not just to federal government. We can make recommendations to state government, but we can also make broader recommendations at a community level, to workplaces as well. So what we'll do is we'll hear all the evidence Hopefully we'll hear a lot of personal testimony from women as well and then we'll come up with some recommendations which we think will make a difference in women's lives. We already know at the outset that, in terms of some of the things women are looking for, they're not always things that governments can do or should be involved in. There might be changes in the workplace, there might be changes in the way GPs interact with women who are experiencing symptoms of perimenopause and menopause, and indeed there may be some things which require legislative change too. But we're not limited to that and I don't want to be limited to that in terms of our recommendations. I want this to be a really broad conversation, because the change which I think needs to happen needs to happen at a community level, not just from government.

One of the questions that I do have for you and I think this is a good way to segue into that is what does the inquiry mean for the average Australian?

woman.

So often we think of. There's many women out there I would imagine that are listening, perhaps that haven't interacted with government before, whether that's at a state level or a federal level, and maybe they're feeling that this isn't necessarily a place for them to be heard. But what tangible results other than what you've already just mentioned? Do you think that? A woman that is really heavily invested in creating some change in this space likely to gain.

Yeah, well, first of all, a fantastic platform where we're going to bring everyone together, in terms of both experts and women with lived experience I mean the Senate. When we do hold an inquiry, we do so in a public way. We have the opportunity to travel around the country and to hear evidence and to make that evidence public and promote it. That's all really important in terms of sparking that broader public conversation and shining a light on some of these challenges bringing people together in a public way to have a structured conversation which then leads into a report, some recommendations and hopefully, some really strong action. So I love women to be part of this process and have a little trust in us that we will take their stories and try and translate them into some policy change. I know the Senate can seem a bit of a funny old institution sometimes and some of the images women may be familiar with is, you know, a role of senators asking lots and lots of questions of witnesses in a very serious way. But it doesn't always have to operate like that. We have a very friendly committee and I know every senator on the committee is just really keen to get the best evidence we can. We want women to participate so our report can have real meaning and impact. So I hope women feel encouraged by that and come forward and speak to us. You can do so confidentially. You can do so anonymously as well if you prefer not to be part of the public process, but we, you know, it's a great opportunity to get these stories heard and try and get the spotlight on it and some change.

And I think one of the things to highlight at this point as well is that you're looking for a real balance of stories, aren't you? It's. You know, often when we have this conversation, women, or anybody having the conversation tends to fall into one of two camps, and it's a frustrating place that I think we find ourselves in right now in the conversations around menopause in this country, and that is that you're either highlighting the negative, really challenging really traumatic experiences that some women have or you're wanting to shine, to match the spotlight on. It's all positive and it's all great and it's going to be absolutely fabulous when you get to the other side. I think what you're trying to do is hear stories from both sides.

Absolutely. I want this to be real. Let's keep it real and I'm sure both Sonia that not every woman experiences perimenopause or menopause in the same way. I don't certainly want to perpetuate that kind of myth either, because it is different for different women, and that's why having a diversity of stories is really important, because that's what's going to give us the flexibility in our recommendations. You know, an example is leave. Not, not every woman will require leave for her experience of perimenopause or menopause, but for certain women that will be really important and we need to think through what that might then look like in terms of our policy recommendations. But please, we just want to have a chat. We want to hear from as many women as possible about their experience the good, the bad, the ugly and have that honest chat.

Yeah, and I think that's really important to bear in mind is that you know you can learn so much from the good experiences of okay this woman had a great experience. She was really well supported at work. She was really well supported by her GP and her healthcare team. So what worked so well there that we can take across into balancing out the women that have not been as supportive, that have had such terrible situations?

Exactly, sonia, like I really want to know, if you've got a GP who's been a fantastic GP, come and tell us why they were fantastic. What did they do to make you feel supported and get you the support you need? In the same context, you know if your workplace has been wonderfully supportive or made adaptations for you when you've needed them. Come tell us that too, because it's those examples of really positive experiences and interactions which are going to help us in guiding our recommendations for where we know some women are feeling let down.

So let's talk a little bit about what putting a submission in actually involves.

Yes, so we're really flexible. You can send us a submission which is beautifully typeset and many pages long If you like, full of research and references. We'll take that and we'll have a good rate of it. But equally, if you just want to send an email, a few lines in the submission process explaining what your experience has been or your tips or suggestions for recommendations and change, that's fine too. It doesn't have to be super formal. And what then happens is we take all of those submissions, we look through them and then we make decisions about the public inquiries we'll hold and we invite people with both lived experience and also different organisations, experts and stakeholders to come present evidence in person. Some people really love to do that and give evidence in person. Others will prefer to write a few notes and flick them off to us, but all of it forms the evidence for our report.

It doesn't sound like there's any reason to be scared or nervous or feel that it's a super formal process, that anybody who feels that they'd like to have their voice heard has a way to put a submission in that's not daunting.

Absolutely. I mean, the Senate belongs to the Australian people. I'm really passionate about making sure our processes are accessible for people and that people feel comfortable using them. So, please, you know, if you want to make an informal submission, that's fine. Also, you know, if you want to make a submission for us to read, you don't really want that evidence made public, you can indicate that in your submission too, and we'll deal with that respectfully and make sure you get your views across, but in a way which protects your privacy too. So just be clear to us when you're making a submission how you want your evidence treated and we can go from there. And yeah, you know, even if you want to send pictures, whatever it is you want to send to us to help inform our research and then, therefore, our recommendations, it's gratefully received.

Fantastic. Now you've referred to the collective we a number of times when we've been chatting, and a committee, so can you give us a little bit of an insight into how big that committee is? How do you work together? Because obviously that is a integral part of the HIRY process.

Yep. So there's six regular senators on the committee, but often when we're taking evidence there may be two or three or four of us in the room. When we're doing that, it's a small committee. We work together a lot on issues across social services and the healthcare system. We've worked together for a very long time and on this one I know every woman on the committee is very, very keen to hear women's stories and to develop a great report with great recommendations. I think you might have been listening, sonja, in the Senate when we announced this inquiry and we had contributions from myself, a Labor senator, from Larissa Waters, a Green senator, and from Maria Kavassik, who's a Liberal senator, all in support of the inquiry. It happens in a very bipartisan way and we're really keen and excited to get stuck in.

I think Senator Hanson Young as well made a brief mention of it as well, which is you know, for someone that has been in the Senate for such a long time, it was really interesting to hear that she actually said that for as long as she's sat in the Senate, she has never heard a debate about menopause.

Well, this is the thing, right when you change the people in our Parliament's, you change the conversations our Parliament's engaging. We now have a majority female government, the majority of senators and our women, and it is amazing. You do see the conversations changed. You see the things we look into change and I think that's a really powerful, positive, important thing, and this menopause inquiry is a great example of that.

Yeah, sure is. Now there are terms of reference around the inquiry, a really clear indication of the outcomes of the inquiry.

Absolutely so. First of all, in the terms of reference, it's really important to be clear that we're looking at menopause and perimenopause and we're looking at the impact of those things on women's economic participation, on their health, impacts on their well-being. We're looking at awareness among medical medical professionals. We're looking at the existing policies which might exist in Australia, not just at a government level but in different workplaces, and we want to hear about international best practice too, because we know some countries are ahead of the game when it comes to many menopause and perimenopause. You know women have experience with that. Please share that information with us too. But we'll also be bringing in the experts and the legal experts to step us through that too.

That's really good to know because you know there are, from my own research, my own conversations that I've had, you know, on the podcast and with you know connections that I've built over time. There is such a difference in some areas of perimenopausal and menopausal management and treatment and conversations in countries outside of Australia, and I do feel that we are a little bit behind the eight ball in Certain areas. So it will be great to be able to take that lens wider and to to cherry pick what's working well and bring it back here as well.

Absolutely, and I do want to emphasize. I mean, I hope there's some things government Can change as a result of this and if there is, we'll put that into our recommendations. But it's not just about government. You know, I want this inquiry to spark big public conversation about menopause and perimenopause, and I want businesses and employers to sit up and take note of the evidence we're receiving too, because if we are going to make a difference in the lives of women, what we need to see is change not just from government, but across workplaces and in our medical profession as well.

So, when it comes to the submissions, is there a deadline?

Yeah, so at the moment submissions are due on the 16th of February. But I'll let you in on a secret we're not super strict about Because we know life gets in the way and we never want to miss good evidence because we're adhering to a strict deadline. But aim for the 16th of February. But if that's impossible, don't stress, you can absolutely make a submission after that and it will make its way into our processes. I'm sure the secretary will get a little cross with me for saying that, but Make sure that your evidence makes its way in. And then we're looking to conduct public hearings. After that We'll probably have a few around the country, but we haven't made that decision as a committee yet. We wait and see what evidence comes in first and then, following that, will put some work into report and recommendations, and that report should be public in September of this year.

Okay, fantastic. So it's gonna be a big year, isn't it?

It sure is, but I'm really, really excited. I mean, I think a lot of women have been hoping for an opportunity like this for a long time to have this public debate. I'm really excited that the Senate committee that I'm on can be part of that process and Provide a forum and a platform to have that debate. So I'm really looking forward to the work We've got ahead. There'll be a lot of work and, yeah, I hope many of you listeners Feel encouraged and throughs to be part of it and join that conversation with us.

Yeah, fantastic, and you know I'm. I can share that. I am working Very, very hard in the background on my own submission and for anyone that's listening from my audience that is impacted from a, you know, menopause and cancer, rather than it being a natural transition through perimenopause and menopause, that the information that you're looking to receive needs to come from everyone that has experienced menopause. We have women that go into surgical menopause. We have menopause women that come into induced menopause. We have natural menopause, obviously, but we also have POI and we have women that go into an early menopause before the age of 40, just naturally. It just happens. One of the points I want to get across is that I would love the inquiry committee to be hearing from everybody across the board.

Absolutely, and I'm really keen to. Our terms of reference are deliberately broad so we can capture that breadth of evidence and, sonya, I will say you know, at the end of this process our committee will make some recommendations and then I'd love to chat to you and your listeners again about how we can get behind those recommendations and back them in and get people to take notice and lead to some change.

Yeah, absolutely. That would be fantastic to bring you back on at that point and have a little bookend to this conversation. So how do people put submissions in?

Yeah. So the easiest way to make a submission is to jump online to the aphgovau website, probably for your listeners. If you just pop into Google, community Affairs, menopause Inquiry, that will lead you to the link and it's quite a straightforward process and there's sort of some troubleshooting there if you need assistance. But that's definitely the best way to put your submission in that if you have any issues you can reach out to the committee secretary. All of their details are there and I know you'll be sharing that as well, sonya. But jump online and, again, don't be daunted by thinking you have to submit something super formal or super long, and we just want to hear your experience the good, the bad, the ugly and everything in between and we'll take it from there. We'll have a good read of. I'll set aside many, many hours to read those submissions and then we can put that into our report. I just wanted to say thank you so much for your advocacy here, sonya. I mean, we see right across our healthcare system so many instances where women feel that down, what they feel like they're not being heard, and platforms like this help women feel heard and listen to and help build and create change. So thank you for having me on.

It's a real privilege to be part of it. Oh, my absolute pleasure, and and thank you for making the time for us today. I think that's pretty much where we'll leave it. Mario, you have a big year ahead of you, you've got a lot of reading to do and I'm really looking forward to having you back. Sounds excellent.

Thanks so much, sonya.

Thank you for listening today. I am so grateful to have these conversations with incredible women and experts and I'm grateful that you chose to hit play on this episode of dare men a pause. If you have a minute of time today, please leave a rating or a review. I would love to hear from you, because you are my biggest driver for doing this work If this chat went way too fast for you and you want more. Head over to stellarwomencomau slash podcast for the show notes and, while you're there, take my midlife quiz to see why it feels like midlife is messing with your head.