The obstacle that has been obvious to midwives throughout the maternity reform process is to do with the requirement for a 'collaboration' agreement between a doctor and the midwife.
OF COURSE midwives want collaboration. We do it all the time.
BUT we will not agree to another professional (a doctor or anyone else) being given authority to sign off on a midwife's professional decisions. That is not collaboration, it's control.
In recent weeks an announcement has been made by the Health Minister Nicola Roxon that a government-supported insurance policy is now available for midwives to purchase. This MIGA policy, as it stands, does not meet the needs of private midwifery practice, and is unacceptable.
Professional Indemnity insurance, which is not available for homebirth, is mandatory from 1 July this year - with an exemption for homebirth. Midwives whose field of practice centres on women who intend to give birth at home, employing a midwife privately to provide a professional service, do not want an insurance that covers birth in hospital. Hospital visiting access is simply not available for midwives, so why would they want to buy an expensive insurance product that covers hospital birth, if they have no opportunity to attend their private clients in hospital?
For more discussion go to the MiPP blog.
The Australian College of Midwives (ACM) has issued a press release supportive of the MIGA insurance, and hospital birth attended privately by a midwife. ACM spokeswoman, midwife Tina Pettigrew states that:
“To be able to look after a woman throughout her pregnancy, follow her into the hospital to have her baby and follow her home again afterwards to help her settle into being a new mother is what I’ve always wanted to do. Now I can to do all this with full indemnity cover”
ACM also claims that:
"The provision of insurance cover for private midwives is one of the necessary precursors to midwives gaining access to Medicare funding for their care from 1 November this year.
"Medicare funded midwives will be able to work in practices in the community, with other midwives, with doctors and with allied health professionals as well as in hospitals to offer more women the choice of having one-to-one care from a known midwife throughout their pregnancy, labour, birth and early parenting."
The deadline, 1 July, is approaching. Many midwives in private practice have indicated in discussion that we we plan to buy the cheapest insurance product that meets the requirements of the new national registration and accreditation legislation.
Insurance does not protect the mother and baby in our care. Good midwifery practice, and promotion of health in pregnancy, birth, and mothering does. As I wrote in August last year, the insurance debate is more about smoke and mirrors than safety.
It's more about business at the top end of town than protecting the little person.
Until our government provides a no-fault insurance product that deals equitably and fairly with all consumers who suffer loss or disability in health care, the insurance industry, and the law industry, will be the only ones who benefit.
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