indemnity insurance, smoke and mirrors

Australia's private midwives provide a professional service that has stood the test of time, and survived in spite of professional, social, and financial restrictions and disincentives.

The service we have provided to the women and families who employ us is demonstrably effective and highly valued in our communities.

The current media focus on private midwifery and homebirth - the main practice area of private midwives - is disproportionate to the number of midwives or the number of births we attend. Our future is now threatened in an unprecedented way.

Every day or so independent midwives are receiving messages from those who are representing us at federal and state political levels. Messages are also circulating in consumer advocacy circles. The situation is volatile. Our inboxes are clogged, and our minds are too. It is difficult in the multiple conversations that are happening to see the picture clearly. It is difficult when under serious threat to know who to trust, who to avoid, and who to fight.

Differences of opinion are bound to exist, and to become more polarised as time passes. One key issue is professional indemnity insurance.

Organisations that seek to represent the interests of the maternity consumer have come out clearly supporting the mandating of professional indemnity insurance for all registered health professionals. This requirement has been written into the new health practitioner legislation, to come into effect 1 July next year, and appears to have strong political support. Midwives' organisations have also joined the band wagon with idealistic statements about every consumer needing to be able to sue if they suffer harm at the hand of their health care provider.

I don't know how smoke and mirrors work in magic shows, but they do the trick. Every time I see someone put on a self righteous face and talk about the importance of professional indemnity insurance in health care, I wonder if they really believe what they are saying. Are they in effect the children in the front row, believing everything they see and hear as the magician wows the crowd?

The only consistent winners in the professional indemnity insurance scene are the insurance companies - businesses which collect huge premiums, with government support for bigger claims, and the lawyers. The people who suffer as a result of professional misconduct, negligence, incompetence, or a potentially avoidable mistake face a huge complex legal process in making claims. They might do better buying a lottery ticket.

There is much in maternity care that is unknowable and unpredictable. The midwife who works in harmony with natural physiological processes in birth embraces the unpredictability of birth, and is ready to act to protect wellness at any time. This midwife promotes health in the leadup to the climax of birth. It is no secret that the safest way to proceed through the complex terrain of birth is to do so without drugs or surgery. And the person with the professional expertise to facilitate physiological birthing is the known midwife, working in partnership with each woman.

These words have been repeated over and over again in midwifery literature. I doubt there will be anyone reading this blog who does not know this fact.

Indemnity insurance for private midwifery practice has not been available since 2002. Will Nicola Roxon find an indemnity product that can be afforded by midwives, passing on the costs to our clients, and working within the constraints that inevitably come with the product?