Update - less than eight months to 1 July

[Pic: a card by curly girl design]

As the countdown progresses relentlessly in the same way that the sands pass through the constriction in an hour-glass, midwives continue to ask what will our lives, our practices look like, in less than eight months' time.

Remember that the rationale for the current package of reform was to *improve* health care, *in the public interest*, across the range of regulated health professions. A decision was made in the rarified air of health bureaucracy that the system needed to mandate professional indemnity insurance for all registered health professionals. Even the vocal maternity consumer groups, Maternity Coalition and Homebirth Australia, and professional groups chimed in with calls for mandatory indemnity insurance as a condition of registration.

The rationale was that they were demanding equity. If the government provides subsidised indemnity insurance for doctors, let's demand it for midwives as well. That sounded reasonable enough to ordinary folk.

Few seemed to stop and ask in whose interest indemnity insurance was, and noone was listening to them anyway. The groupthink was that everyone needs it, so that's that.

I recently received a letter from the Victorian Health Minister, Daniel Andrews, in response to some of my correspondence to him. I was amazed to read in that letter, a statement that professional indemnity insurance “goes to the very cornerstone of the scheme which is public safety.”

This is an example of spin that is simply indefensible. Statutory regulation must be in the public interest, to enhance public safety, but there is no evidence of a connection between public safety and the mandating of professional indemnity insurance, nor is there any logic in that statement.

From the start in this ‘reform’ it was delegation of the regulation of midwives to the insurance companies, now with the amendment it will be double regulation again, this time by a doctor. The logical question is “which doctor?” [My lateral thinking says the Minister would then be obliged to provide a doctor for private midwives, in that if a regulation is written into the Act, surely the government must provide the means for it to be carried out. I WISH!] Can anyone imagine the legal ramifications for the doctor who does enter a collaborative arrangement with a privately practising midwife???

The Department of Health and Ageing is very concerned about cost blowouts as a result of their reforms. Good grief, if they would only do their sums they would see that the government could save buckets of money if maternity care was managed consistently with the evidence, following basic principles, in stead of the current ‘anything-goes-as-long-as-the-doctor-says-so’



As it looks today I doubt that any midwives will be able to do any private practice lawfully, although we will be on the register of midwives after 1 July. But I encourage everyone to discuss the situation as openly as you can with women who contact you for bookings. If they are scared off, that’s a shame, but if they want to book us knowing the facts, then we are bound by our duty of care as midwives to give them the best we can.

Perhaps there will be mass complaints to the health ombudsmen, perhaps even some brave law firm will work probono for a group claim. ??? (just musing!)