After months of suspense, the Determination defining “collaborative arrangements” was quietly signed into law by the Governor General on 16 July, without notification to stakeholders. The Determination can be downloaded from this link.
The Determination provides 4 options for collaborative arrangements. Each option requires the midwife to have some form of permission from a doctor, before a woman can receive Medicare rebates.
A group of mothers, daughters and quite a few babies gathered outside Member for Macquarie Bob Debus’ electorate office in Katoomba on February 18 in a show of solidarity for home birthing.
Your submission does not need to be a long one. You do not need to write a detailed review of the legislation or understand everything that is going on. Telling your individual story is the most important thing you can do. We need to demonstrate that private practice midwives are educated, experienced and competent caregivers who should not be under the control of doctors. We also need to show just what happens when doctors are in control of pregnancy and birth.
A group of outraged local mothers convened in Springwood earlier this week as a part of a nationwide protest against an amendment to proposed legislation that could effectively restrict midwives’ ability to work independently.
The amendment, made public last week, reveals that to work in private practice midwives will first have to ‘enter a collaborative arrangement with one or more medical practitioners’.
The “Medicare for midwives” Bills have been amended to require midwives to have collaborative arrangements with medical practitioners before they are eligible for professional indemnity insurance. Private practice midwives registration will rest in the hands of doctors instead of regulators. Under this arrangement women’s access to Medicare rebates for midwifery care will rest with doctors.
MIDWIVES’ ability to work independently - promised by the federal Health Minister, Nicola Roxon - would depend on endorsement by individual doctors under an amendment to proposed legislation that has infuriated women’s groups.
Birth advocacy groups will rally today at sites across the country, including the Brisbane headquarters of the Prime Minister, Kevin Rudd, and in Sydney outside the Surry Hills office of the Minister for the Status of Women, Tanya Plibersek, to protest at the amendment, made public last week, which reveals that to work in private practice midwives will first have to ”enter a collaborative arrangement … with one or more medical practitioners”.
A range of very serious consequences would flow if these arrangements were restricted to privately practicing doctors. Consequences could include:
= No new midwifery models in public hospitals.
= No private midwifery practice.
= No homebirth care from midwives in private practice.
= Practice midwives in private obstetricians rooms could be the only viable model of private practice or Medicare-funded midwifery.
I promise this is the last hurrah for the year, but it is important. Please don’t feel deflated (I know it is exceedingly hard) we are fighting against such a very powerful lobby but together we will win, maybe not tomorrow but ultimately and before the next election.
This is NOT acceptable. How will it be possible for a midwife who attends homebirths and for women wishing to birth at home to gain the support of a GP ob or private obstetrician when their own college statement does not support homebirth.
“The College does not support Home Birth or ‘Free-standing’ Birth Centres (without adjacent obstetric and neonatal facilities) as appropriate Health Care Settings. The College acknowledges that a very small minority of women will choose to birth in these centres, even if appropriately informed of the
consequences” RANZCOG statement
On the morning of 24 June this year, Nicola Roxon entered the House of Representatives and proudly introduced three bills that amounted to a revolution in midwifery in Australia. Midwives have been able to access some limited Medicare items since November 2006, but Roxon’s bills would dramatically extend Medicare and Pharmaceutical Benefits Scheme funding to midwifery and nurse practitioner services.