Monday, September 20, 2010
Would you throw out the baby with the bath water?
Currently midwives particularly homebirth private practice midwives are up in arms (and rightly so) about the recent Determination where Midwives are to be virtually signed of by doctors. That is as a privately practicing midwife (independent) you need to collaborate with an Obstetrician or GP obstetrician before being able to claim a Medicare rebate for the midwifery services provided. I might add that there is nothing in the Determination to make doctors collaborate with midwives or any benefit for doctors to collaborate.... so I am not sure why they would even consider it as we (midwives) would be competition for them in terms of financial remuneration therefore less money in their pockets..... emm not sure this will work?
If you are a midwife this seems a sort of sellout, Medicare for collaboration; However the woman is able to recoup some funds with this system therefore allowing more women this option of care....that is continuity of midwifery care and also midwifery led care;
Now as I see it there are two schools of thought......
1: If the government does not change the wording of the current determination; you go all out and say no to collaboration as it stands therefore we lose the right to a Medicare rebate and the legislation falls over; and we maintain the status quo as in the past which is no funding or rebates for women choosing private practice midwifery led care.... and it does not go before Parliament again for three years.... and if the government changes we may never have this opportunity for a long long time.... we will still have insurance requirements and regulations, that will not change.
2: we say yes to the collaboration as it stands, work to make it a viable option and see how and if it would work and if it does not work we then collate the evidence and go back to the politicians to lobby for changes to the determination knowing it does not work, rather than speculating that it does not work....therefore whilst we are battling for change women are able to claim a Medicare rebate for midwifery services? and Midwives are recognised for the profession that it is... which should have a medicare provider number.....and be recognised as autonomous clinicians.
Once the system (Medicare) whether it is effective now or not would be beneficial as we can work on changes....but if we never get it in place it will be years before we get back to this position and all our work up to this point would be for nothing as would of achieved nothing and the status quo remains.
What would you do in this situation?