The Bessie Smyth Foundation Pty Ltd

A specialist feminist women’s health service in transition from a termination of pregnancy service to a pregnancy counselling; abortion information, referral and advice; advocacy; public research and education service

Activity report - Calendar year 2002-2003


Organisation Profile

The Bessie Smyth Foundation is a specialist women’s health service established in July 1977 to provide health care and fertility control services to women and to undertake public research and education promoting women’s health.

For the 25 year period from July 1977 to August 2002, the above objects were met via the operation of a termination of pregnancy service owned and operated by The Bessie Smyth Foundation, and which traded as The Powell Street Clinic, located in the inner western Sydney suburb of Homebush.

Due to factors beyond the control of the organisation and their impact on the organisation’s financial position, a decision was made by the Board of Directors, in June 2002, to sell our business, The Powell Street Clinic, and premises. The sale was concluded on August 26th 2002, with the purchasing company, Marie Stopes International, moving in on that day and The Bessie Smyth Foundation moving out the same day.

For the remainder of 2002 the organisation functioned in a very limited way with one staff person employed on a casual basis working from a small office located within Wilma Women’s Health Centre at Campbelltown. Initially, when moving out of Homebush, all records and furniture not sold to Marie Stopes International had to be placed in storage as we were not able to move into Wilma Women’s Health Centre until 30th August, 2002.

At the Annual General Meeting of the Foundation in December 2002, a decision was made to employ on a full-time basis one staff member who would be responsible for working with the Directors and the members and the generalist women’s health centres to re-establish the organisation as a pregnancy counselling, information and advocacy service.

This was to be undertaken via a pilot project during 2003 which would draw on the existing work the Foundation had undertaken within its clinical setting over the period July 1977 to August 2002. In particular the provision of pregnancy counselling, information and advocacy undertaken by the staff of The Powell Street Clinic would be drawn upon to inform the development of the pilot project.

The Foundation was closed for xmas-new year 2002 and the closure extended to the end of January 2003 with our office reopening in February 2003 at Wilma Women’s Health Centre.

There was an initial diversion over February and March 2003 as a decision was made to relocate the organisation to an office in the Pride Lesbian and Gay Community Centre’s building in Surry Hills due to new services developing at Wilma Women’s Health Centre and space limitations.

Relocation required a further round of notices of change of address and other administrative matters associated with relocation of an organisation.

After settling in at the Surry Hills premises, The Bessie Smyth Foundation then began to find its feet and work more seriously on the pilot project. For more detail about the pilot project please see the Activity Report section of this report.

Foundation’s objectives

  • To provide health care and fertility control services to women and to undertake public research and education promoting women’s health
  • To provide and operate medical practices such as consulting rooms, hospitals and clinics for the carrying out of lawful termination of pregnancy by qualified medical practitioners; and to make such consulting rooms, hospital, clinic and services available and accessible to all women regardless of financial means
  • To provide free information and advice to women about lawful termination of pregnancy and reproductive health. To provide counselling and support to all women, in particular, to women experiencing distress and misfortune related to pregnancy. To provide surgical operations and medical treatments and methods of contraception to women and members of the public requiring such information and advice; and to support, by legal means, the right of women to reproductive self-determination
  • To teach and train paramedical and counselling personnel in relation to the matters referred to in the sub-clause above

Management Structure and Decision-Making

The Bessie Smyth Foundation is a company limited by guarantee and is managed by the Board of Directors all of whom are appointed from the membership at the Annual General Meeting. All decisions regarding policy and practice of The Bessie Smyth Foundation are made by the Board of Directors and those policy and practice decisions are implemented by the Coordinator. Sub-groups and working parties are appointed from time-to-time to carry out specific tasks.

Due to lack of time at the end of 2001, which resulted in no annual report being produced for the 2001-2002 period, the Foundation would like to take the opportunity in this Annual Report to express its thanks to the Board of Directors, appointed at the AGM held in November 2001, for their time, support, experience and commitment to the Foundation during the very difficult period 2001-2002 wherein the then-Board made the decision to sell our business and premises to Marie Stopes International.

A lot of extra time and effort had to be put in by that Board for due diligence processes and to protect the interests of the Foundation. There was also a lot of additional pressure on the then-Board as it consisted of only 4 members (out of a possible 6) - those Board members were: Tessa Boyd-Caine, Suzanne Christie, Suzanne Jamieson and Emma Keene. Their time, support, experience and commitment in the first half of the current reporting period, 2002-2003 is also much appreciated.

The Board of Directors for 2001-2002 were:

  • Tessa Boyd-Caine, appointed 21-3-2000 to 14-12-02
  • Suzanne Christie, appointed 8-9-2000 to 30-9-02
  • Suzanne Jamieson, appointed 29-11-00 to 14-12-02
  • Emma Keene, appointed 14-12-99 to 14-12-02
  • Denele Crozier, appointed 9-7-02 to the present
  • Nola Cooper, appointed 21-10-02 to the present

In addition, the Foundation would like to thank the current Board of Directors for their similar time, support, experience and commitment to the Foundation’s original aim to maintain a feminist perspective on fertility control services and the needs of women to access appropriate abortion services and support.

The Board of Directors for 2002-2003 were/are:

  • Nola Cooper, Chair, appointed 21-10-02 to the present
  • Denele Crozier, Treasurer, appointed 9-7-02 to the present
  • Karen Willis, appointed 14th December 2002 to the present
  • Francesca Guimaraens, appointed 14th December 2002 to the present
  • Yvonne Tudela, appointed 14th December 2002, resigned due to work pressures 14th April 2003
  • Sharon Bailey, appointed 19th December 2002, resigned due to study and work pressures 21st March 2003
  • Beverly Lloyd, appointed 16th June 2003 to the present

Staffing

The day-to-day operations of the Foundation for the period 1st July 2002 to August 26th 2002, (our last two months of owning and operating The Powell Street Clinic), relied on a core counselling and medical staff consisting of the following:

  • Mandy Ashton, Recovery Nurse
  • Sharon Bailey, Clinical Supervisor, resigning for other full-time work in mid-August 2002
  • Tina Busic, Nurse/Counsellor
  • Margaret Grant, Counsellor
  • Francesca Guimaraens, Counsellor
  • Annette Hartmann-Hahn, Counsellor, resigning for other full-time work in mid-July 2002
  • Marianela Millar-Pavez, Counsellor
  • Yvonne Tudela, Counsellor, resigning for other full-time work in early August 2002
  • Lee Yap, Nurse/Counsellor
  • Margaret Kirkby, Centre Manager
  • Dr Michelle Kenney
  • Dr Kevin Pedemont
  • Dr Peter Johnson

In the period August 27th to December 19th 2002, the Foundation relied on the work of one casually employed staff person, the former Centre Manager, Margaret Kirkby (for a maximum total of 200 hours between September and December 2002) and the bookkeeper, Heike Obermayr.

In the period February 2003 to June 2003, the Foundation relied on one full-time staff person, the Coordinator, Margaret Kirkby, to develop the service during its transition period and

Heike Obermayr as bookkeeper for approximately one day per month.

Activity Report

As well as undertaking clinical work for The Powell Street Clinic on the clinic days we had during July and August 2002, several staff made themselves available to assist with tasks associated with due diligence processes related to the sale (e.g. developing an inventory of our assets contained within The Powell Street Clinic; an inventory of our consumables; documenting our client numbers for the period July 1999 to June 2002) .

Despite this being a very difficult time for us all, all staff remained focussed on meeting the needs of our clients and ensuring maintenance of standards of care in terms of infection control, in terms of our dealings with the Health Insurance Commission and in terms of our dealings with fellow providers and agencies.

A large amount of administrative work had to be undertaken to meet requirements of solicitors and other consultants employed by the Foundation for this period and for the sale process. Meetings of the members of the Foundation were also convened several times in this period.

During the month of August, as the settlement date became more evident, all staff remained additionally focussed on meeting the handover requirements to the purchasing company, Marie Stopes International.

The last clinic day for Bessie Smyth Foundation’s Powell Street clinic, was Thursday 22nd August 2002. All staff on duty that day were presented with small gifts to thank them for staying with Bessie through such a difficult period. Below provides an overview of our 25 years of managing a termination of pregnancy service.

OUR PHILSOPHY WHILST WE MANAGED A TERMINATION OF PREGNANCY SERVICE

The Powell Street Clinic was run with a philosophy that it was a SERVICE not a clinic! A service to meet the needs of woman when making a decision about a pregnancy; a service to meet the needs of women for empathic, non-judgemental, supportive care whilst implementing their decision if their decision was to have a termination of pregnancy.

A second element of our philosophy was that no woman would be turned away if she did not have the money to pay for the operation — as this was well known amongst fellow abortion providers and women’s health and welfare agencies, it would be true to say that Bessie saw a higher proportion of low-income and disadvantaged women because of referral to us by fellow providers and other agencies of such women.

In practical terms, and in fulfilment of our object that we make our services available and accessible to all women regardless of financial means, we wrote off each year approximately $10,000 in fees owed to us by women who had undertaken to pay off by instalment the cost of their operation. We did not want to turn ourselves into debt collectors and we recognised that as women are on lower incomes than men and, oftentimes, had carer and other responsibilities, they were simply not in a position to pay us back even though they wanted to.

In the period Friday August 23rd to Monday August 26th 2002, casual staff were employed (Marilyn Roy, Zhan Chaim, Meredith Russell, Francesca Guimaraens) to assist the Centre Manager pack up the records of the organisation; to organise the categories of materials to either go to storage; to the new Bessie office; or to the State Library eventually as archival material; and to finalise the inventory of consumables.

In addition the pack-up required secure shredding of medical records which the Foundation had been storing for Everywoman’s Health Centre, ( which went into liquidation in approximately November 1995) and secure shredding of confidential Foundation records not required to be kept any longer and not required to be passed onto the purchasing company.

The achievements of The Bessie Smyth Foundation in the 25 years that we owned and managed The Powell Street Clinic

  • The fact that the Women’s Liberation Movement had a reputable and high standard business and premises to sell is, in itself, a huge achievement;
  • In the 25 years we owned and managed The Powell Street Clinic we provided over 42,000 safe and affordable abortions to women of all ages in the reproductive years; to women of many cultures; to women of all income brackets;
  • We provided those 42,000 women with high quality, individualised care and support in a non-directive and non-judgemental manner;
  • We provided training and employment for numerous doctors and counselling staff in that 25 years — doctors trained by The Bessie Smyth Foundation were sought after by fellow providers — all of the doctors working for us last year, who wanted to stay in the field of abortion, quickly found employment with fellow providers; all of our counsellors were sought after and quickly snapped up once the sale was concluded;
  • We provided an income for many, many women over the years who worked as counsellors at Bessie;
  • We provided supervision and placements for a number of university students over the years;
  • We maintained a commitment, in the face of adverse policy changes from federal and state governments over the years, to access to abortion for the marginalised and the disadvantaged in our society — this included our willingness to see women who were ‘illegal’ migrants (illegal by the federal government’s definition that is); women who were sex workers; women on methadone programmes; women exiting the prison system or still in the prison system; women with drug or alcohol-related problems — and all of these women were treated with dignity and respect;
  • We maintained the most extensive and comprehensive referral information for our clients — whether it was to drug and alcohol agencies or to women’s health centres or to welfare agencies our Resources Room housed a huge amount of referral information;
  • We maintained and updated our resources regularly such as our risks and complications information sheet; our aftercare information sheet; our multilingual information; information about the procedure; information about methods of contraception;
  • We maintained membership of the National Association of Testing Authorities (NATA) and compliance with their guidelines so to be eligible to undertake a selected number of pathology tests; we maintained membership of the Infection Control Association so to stay on top of changes to infection control procedures and to contribute to debates in the field of infection control;
  • We maintained links with the women’s health centre movement via the peak body Women’s Health NSW; with the community sector movement via membership of the NSW Council of Social Services; with fellow abortion providers through links with the Abortion Providers Federation of Australasia; with the international women’s health movement via organisations such as the Women’s Global Network for Reproductive Rights based in Amsterdam, the Boston Women’s Health Book Collective and the Latin American and Caribbean Women’s Health Network; and with developments in the politics of abortion and abortion service delivery via participation in the group, Women’s Abortion Action Campaign, and other abortion rights initiatives over the years such as the Liverpool Abortion Defence Campaign (1976 to 1978), the Right to Choose Coalition (1982-1988) and the NSW Abortion Rights Coalition (approx 1988 to 1994). In terms of developing resources for women of all religions we maintained links with the US-based abortion rights group, Catholics for a Free Choice an the Malaysian group, Sisters in Islam.

The main work of the organisation from August to December 2002 was:

  • working cooperatively with the purchasing company, Marie Stopes International, so that The Bessie Smyth Foundation handled all after hours calls from our clients for eight weeks after our last operating day (Thursday 22nd August 2002) to ensure that we met our duty-of-care responsibilities to our clients;
  • dealing with ongoing matters related to the handover of our clinical service to the purchasing company, Marie Stopes International;
  • ensuring all staff were paid out their entitlements and received references for their work with the Foundation;
  • ensuring all legal requirements in terms of reporting to the Australian Securities and Investments Commission and the Australian Taxation Office were met;
  • handling any matters which arose from former clients of and suppliers to The Powell Street Clinic;
  • ensuring administrative matters such as notifications of our change of address; redirections of mail; dealing with email inquiries; and so on were undertaken;
  • some minor casework was undertaken by phone and email as such calls and emails continued to come through, despite having relocated and not advertising our new phone number widely.

February 2003-June 2003 — First Phase of Pilot Project

It was resolved during a Strategic Planning Day held on 3rd March 2003 to undertake casework on a limited basis so to test whether our understanding of women’s needs, based on having been an abortion provider, was matched by our experience arising from dealing with women in a non-clinical but related capacity. We hoped our casework would assist us to identify:

  • the problems women have in accessing appropriate abortion services and appropriate information;
  • the information and advocacy needs of women in relation to distress arising from a pregnancy;
  • to provide assistance to those women who sought same from our limited service.

Due to the Foundation’s decision to undertake this work on a self-funded basis and the consequential responsibility towards our members to be restrained with expenditure, it was also resolved to not widely advertise our service but to target referral agencies such as women’s health centres, social workers in hospitals and abortion providers for referrals to our service. No widespread advertising to the public was undertaken due to the limitations on our staffing levels.

As well as undertaking our casework, our Coordinator was responsible for all administrative, all liaison, all resource development, and all other work (except bookkeeping), required for the Foundation in the reporting period.

Analysis of our casework in the period February 2003 to June 2003

It is not surprising, given that we moved twice in this reporting period plus the decision to inform only referring sources of our new contact details, that our casework in the first phase of the pilot project was small. Notwithstanding small numbers, due to the high and multiple needs of some of our clients, our staff member’s time was, at some points in time, completely dominated by addressing and meeting the needs of clients.

The only advertising to the public maintained during the reporting period was our Yellow Pages Online advertisement. Our casework data indicates that the internet elicited just under half of our inquiries in the February to June 2003 period. The phone remained the main point of contact, particularly for women in high states of distress related to a pregnancy and their repeated efforts to have a termination. The middle of Friday afternoons seemed to become a common time for the high distress calls to come in.

The fact that these women and/or agency workers such as doctors, psychologists and social workers managed to contact us after multiple phone calls to different agencies, is a testament to the tenacity and resilience of women and some agency workers.

For those women whom we helped comprehensively (transport, accommodation, other expenses) their persistence in the face of quite insurmountable circumstances, is a testament to women’s determination when they realise that the pregnancy they are carrying is at not-the-right-time.

A common element for those women who rang us with a high level of distress was the fact that they had rung so many agencies for assistance that, by the time they rang Bessie, they did not even know who they were ringing. The referral round-about and the frustration levels this creates in women is an issue which needs further addressing.

The highest area of need identified in this period was that of plain, old simple INFORMATION; next was allaying of fears; the next was counselling; and, the smallest but the most time consuming, was meeting the needs of women in high levels of distress related to a pregnancy which, for various reasons, had progressed to well into the second trimester.

This initial phase of our pilot project confirmed our suspicions:

  • that women are still experiencing high levels of distress related to unintended pregnancy, and that this is accentuated and exacerbated if you live in the country; if you are young and unemployed and/or homeless; if you are a single parent;
  • that there is a need to provide comprehensive, factual information — both to allay fears and to correct misinformation which women have received either from anti-abortion sources or from family members and friends;
  • that previous negative experiences of abortion and/or complications thereafter and incorrect handling of these either by a clinic or by an Emergency Department in a hospital can greatly influence how a woman feels about the possibility of a further termination of pregnancy.

Further to these concerns, women also presented with a great depth of impoverishment resulting from:

  • the breaching policies of Centrelink wherein women on benefits are penalised percentages of their entitlement;
  • women having to pay debts to Centrelink which actually belong to an ex-partner;
  • failure by ex-partners to pay maintenance and/or deliberate maintenance of low-employment levels by ex-partners to avoid child support responsibilities;
  • changes in government policies surrounding emergency payments from Centrelink such that it is almost impossible to receive these.

Our pilot project moved to its second phase in the second half of 2003. This will be reported upon in our next Activity Report.

 

Thanks

We would not have got through such a difficult period if we had not had the support and assistance of many individuals and organisations. The Bessie Smyth Foundation would like to thank the following for their support during the 2002-2003 period:

• The members and staff of the Foundation

Women’s Health NSW as an organisation and the WHNSW statewide conferences during 2002 and 2003 wherein a great deal of moral support was provided to Bessie Smyth Foundation

The individual member organisations of Women’s Health NSW:

  • The Women’s Centre, Albury-Wodonga
  • Bankstown Women’s Health Centre
  • Blacktown women’s and Girls Health Centre
  • Blue Mountains Women’s Health Centre
  • Central Coast Women’s Health Centre
  • Central West Women’s Health Centre
  • Coffs Harbour Women’s Health Centre
  • Cumberland Women’s Health Centre
  • Dympna House
  • Hunter Women’s Centre
  • Illawarra Women’s Health Centre
  • Immigrant Women’s Health Service
  • Leichhardt Women’s Community Health Centre
  • Lismore and District Women’s Health Centre
  • Liverpool Women’s Health Centre
  • Penrith Women’s Health Centre
  • Shoalhaven Women’s Health Centre
  • The Woman’s Centre, Campsie
  • NSW Rape Crisis Centre
  • Waminda Women’s Health and Welfare Co-op
  • WILMA Women’s Health Centre
  • Wagga Women’s Health Centre

We’d like to make a special extra thanks to Wilma Women’s Health Centre for allowing us to move to their premises for the period August 2002 to early March 2003.

We’d also like to thank the Pride Lesbian and Gay Community Centre

Fellow abortion providers:

  • The Preterm Foundation, particularly Colleen Hannon-Mills and counselling staff
  • Australian Birth Control Services and its staff
  • Contraceptive Services, particularly Dianne Eddington and Dr Tuncer Cimenbicer and counselling/nursing staff 

The purchaser of our business and premises, Marie Stopes International, particularly Ms Suzanne Dvorzak and Ms Julie Fitzgerald for their recognition that the due diligence process was a huge effort for a small organisation such as ours with no infrastructure and very few resources. We’d also like to thank Marie Stopes International for their patience in their dealings with us.

Our thanks also go to the Head Office (in London) of Marie Stopes International.

Our suppliers to The Powell Street Clinic (Richard Thomson; Stericorp; Neverfail; Australia Wide Locums; BOC Gases; Ecomed)

Our doctors, particularly Peter Johnson, Kevin Pedemont, Michelle Kenney, for assisting us in July and August 2002 and we’d also like to thank the following:

Craddock Murray and Neumann

Darren Pearce and other staff at Lawler Partners

Maryanne Ofner

The SEARCH Foundation

The Women’s Health and Resources Foundation