If you have followed this blog you will know that with the maternity reforms came the Determination, which on the one hand gave midwives access to a Medicare provider number and with the other hand effectively tied both our hands together by demanding that we have a collaborative arrangement with an obstetrician, this seemed an unfair advantage to obstetricians..... Now this might of worked if the obstetricians agreed to collaborative with midwives however this proved difficult for one reason or another and only a hand full of midwives were able to obtain a collaborative arrangement. Midwives wanted collaborative arrangements to be with a Health Service rather than with an individual doctor….. hopefully this system would be a fairer option.
Midwives began to collect data,that is evidence that collaboration was not working. Private midwives have been actively seeking collaboration for two years and there are only a few arrangements within Australia. We began to lobby the government for change…and finally this has happened. There was a round table consultation in July with key maternity stakeholders including the AMA and RANZCOG to discuss indemnity insurance and collaboration or the failure of the Determination in its current format…. hence the announcement after the Health Ministers meeting 10 Aug…..
Professional Indemnity Insurance for Privately Practicing Midwives.
Ministers agreed to an extension of the professional indemnity insurance exemption for privately practising midwives until June 2015. This will mean that privately practising midwives will continue to be covered by the national registration and accreditation arrangements.
The Commonwealth agreed to vary the determination on collaborative arrangements to enable agreements between midwives and hospital and health services.
Ministers agreed that WA would develop a paper on longer term arrangements and that this would be presented at the November meeting of Ministers
The health ministers also agreed yesterday to change the existing rules which require midwives to work in collaboration with doctors.
They'll now be able to enter agreements with ''hospital and health services'' as well. That move will be welcomed by midwives who have long argued the current determination effectively gave doctors a veto over midwives.
But doctors are outraged, with the Australian Medical Association labeling the decision ''dangerous and unexpected''.
''If the Commonwealth proceeds with today's decision it will be essentially allowing independent practice by a midwife,'' AMA president Steve Hambleton said in a statement.
''When the collaborative care arrangements were being developed it was agreed the midwife could have an agreement with a doctor in a hospital who would ensure appropriate care arrangements were in place.
''This decision is transferring sensitive patient care and management from a doctor to a bureaucrat. It must not proceed.'' AAP
It is not surprising then to see that the AMA is not happy with this outcome…however to say the "decision is dangerous and unexpected"…is unacceptable and scare mongering…..Midwives are heavily regulated through legislation, (AHPRA) Registration, Quality and safety framework, policies, guidelines and Professional Standards….. this is about implementing the maternity reforms, offering women more choice and allowing midwives to practice as autonomous practitioners……midwives are always willing to collaborate..
Private midwives want access to hospitals to enable women continuity of midwifery care…. putting women at the centre of their care.