Medicare funding for Midwifery Care

Australian College of Midwives Media Release

Access for pregnant women to Medicare funded midwifery care on the way

Less than 6 weeks after the Federal Budget, Heath Minister Nicola Roxon has today introduced the first bills to legislate giving women access to Medicare funding for expert midwifery care.

“This is historic legislation for childbearing women and their families” said Dr Barbara Vernon, Executive Officer of the Australian College of Midwives. “The ACM commends Roxon for her leadership in taking evidence based steps to enhance women’s choices in maternity care.”

“From November next year, women will be able to choose the care of a midwife to provide their pregnancy care in the community, follow the woman into hospital to provide her labour and birth, and follow her home again afterwards to provide the vital professional support in the early weeks of caring for a newborn baby”.

The government’s bills will pave the way for women to receive Medicare rebates for private midwifery care, as well as providing for Pharmaceutical Benefits Scheme rebates for relevant tests and drugs. One bill will specifically support eligible midwives to access professional indemnity insurance for their care.

“These reforms stand to benefit most Australian women. Once midwives are on the ground, women in rural and remote communities will particularly benefit. Closure of more than 120 rural maternity services in the past 10-15 years has left thousands of women with little or no access to local maternity care and even less access to continuity of midwifery care. Midwives, working collaboratively with GP obstetricians, will help meet women’s need for local care.

“This national legislation recognises for the first time that midwives make a valuable contribution to maternity care in their own right. Evidence confirms that women who receive continuity of care from a known midwife have shorter labours, less need for surgical interventions during birth, reduced rates of admission to special care nursery for their babies, reduced vulnerability to postnatal depression and higher rates of breastfeeding.”

Midwives who provide Medicare funded care will work collaboratively with doctors and other health professionals to ensure the individual needs of each woman and baby are fully met. Midwives will have visiting access to hospitals, and clear referral pathways for women in their care who need obstetric or other health care during their pregnancy, labour and/or postnatal care.

“We’re not expecting midwives to abandon employed positions in large numbers as a result of these policies. There will always be a need for hospital employed midwives to care for women and babies Rather we anticipate a gradual change, as midwives who are eligible to provide continuity of care in the community move to take up this opportunity”

“These reforms will not only give women greater choice than they currently have, they will also give most midwives more choice about how and where they provide care to women, thereby helping to reduce stress and loss of midwives to the maternity care workforce.”

“The only dark cloud in these historic reforms is that they will not provide for women who choose to give birth at home under the care of a midwife. There is mounting international evidence that the option of birth at home is safe for low risk women. ACM is concerned that the rise in unattended homebirths will only get worse unless the government extends its proposed indemnity scheme to ensure healthy low risk women can continue to choose homebirth with competent networked midwives.”

This is progress, lets keep the pressure on!

It is important to have your say about National Registration for Health Professionals:

The aim of this blog is to disseminate this information to as many people as possible and for you to read it and make comment. This is legislation that is going to affect your clinical practice, choices for women and the way in which registration and complaints will be dealt with. So please if you have never been proactive now is the time to start. It is time for public consultation and the submissions close 17 July 2009.

This is how we have a voice, by making submissions. We need to find a way to save Private Practice or independent midwifery, there are some very good practitioners out there that want to work in collaboration with our medical colleagues.

The National Registration and Accreditation Scheme for the Health Professionals:
The Health Practitioner Regulation (Administrative Arrangements) National Law Bill 2008 received Royal Assent on 25 November 2008, giving effect to the new national law.

The council of Australian Governments (COAG) in March 2008 signed an agreement to start the ball rolling creating a single national registration and accreditation system for health professionals. To start with, there are 10 health professions; chiropractors, dentists (including dental hygienists, dental prosthetists and dental therapists); medical practitioners, nurses and midwives, optometrists, osteopaths, pharmacists, physiotherapists, podiatrists, and psychologists.

Now it is time for you to review the next phase of this process The Health Practitioner Regulation National Law 2009 (Bill B)
Exposure draft of Bill B released for consultation - submissions close 17 July 2009

The bodies in the new scheme: Ministerial Council, Advisory Council, National boards, State/Territory boards (committees of national boards), Accreditation authorities, and Australian Health Practitioner Regulation Agency (AHPRA).

What does this mean to you as a Midwife – in a nutshell this is what is important:

Independent accreditation will be independent of governments – the final decision on whether the accreditation standards, courses and training programs are approved for the purposes of registration is the responsibility of the national board.

National accreditation standard which exist prior to the commencement of the new scheme are to continue until they are replaced by new standards.

Existing external accrediting bodies such as the Australian Medical Council are expected to continue.

CHANGES TO THE REGISTER;
- There will be both general and specialist registers available for the professions including medical and dentistry

- Separate register for nurses and midwives

OTHER IMPROVEMENTS TO QUALITY AND SAFETY OF HEALTHS SERVICES;
- Mandatory reporting of registrants – who is placing the public at risk of harm
- Reportable conduct

- Criminal history and identity checks

- Simplified complaints system

- Students registrations – students will now have to register from 2011

- PRACTITIONERS WILL BE REQUIRED TO HAVE SUITABLE PROFESSIONAL INDEMNITY INSURANCE during the period of their registration. (see clauses 69, 73, 75, 80, 83, 101 and 125)

73 Professional indemnity insurance arrangements
(1) Professional indemnity insurance arrangements in force in relation to
individual are appropriate for the purposes of registering the individual
in a health profession only if:
(a) the arrangements will not expire before the end of the
individual’s period of registration, and
(b) the National Board established for the health profession
considers the type and level of cover provided by the
arrangements are sufficient in the circumstances.
(2) A National Board may accept as evidence that there is, or will be, in
force in relation to an individual professional indemnity insurance
arrangements:
(a) written advice from an insurer or insurance broker that an insurer
has agreed to issue a professional indemnity insurance policy or
that the premium has been received and accepted by the insurer
for the issue of a professional indemnity insurance policy, or

These are some of the major changes, but for Private Practice or independent midwives the death nail is, the requirement to have indemnity insurance with registration. See the above clauses within the Bill. The second most important issue is that of complaints. From my limited understanding at this early stage is the there will still be an office in each state – I will update you all on this section when I have finished reading it.

Please visit the http://www.nhwt.gov.au/natreg.asp site and make a submission:

go one just hit the hyperlink and have a read.
Pauline

Seeing red in 2010

Hi all

The registrations for the 2010 Breathing New Life conference co-badged by Australian College of Midwives, RANZCOG and Australian College of Rural and Remote Medicine (ACRRM) have just been released. It is to be held in ALICE APRINGS!!!!!

What a fabulous opportunity to see the Red Centre from July 1-4 next year.

Link for registrations here.


Of course this year's 2009 conference will be in Adelaide from September 22-25 and you can link to that through the national ACM site here.

Result of the Monkey Survey: Education Committee

Members and non members were asked to complete the SurveyMonkey.com this was a free survey product I tried, like anything free there is a down side and that is I cannot publish the results, this is where you have to pay extra. Therefore I will summarise the results here for you. There were a grand total of 15 respondents, thank you for those wonderful people who took the time to respond.

It was excellent to see that 11 students completed the survey, well done, taking the lead. Everyone should follow your example.

The survey: What midwifery professional development do you require?

1. What is your occupation? There were 11 student midwives and 4 midwives

2. What topic would you like discussed at the next ACM study day 17 October 2009? comments:
if the budget proposals for midwives to be able to provide medicare-rebate services go through the upper house, I'd like a session on setting up a private practice

2. cord clamping
3. midwife-led care for healthy women / marketing midwife-led care in the media
4. Rural maternity services and issues
5. course content: need more clinical based subjects, not airy fairy sh@#$
6. Case study extravaganza
7. "How midwives can bring about change in our workplaces
8. continuity of care issues
9. How to stay politically involved and aware of issues facing abd challenging the midwifery profession
10. Can't be present so N/A

3. Do you maintain a professional portfolio? There were 11 yes and 2 no 2 skipped the question

4. Would you like a session on how to maintain a professional portfolio? 11 yes and 4 no

5. How often do you formally (written) reflect on your clinical practice? Weekly – 5. Monthly – 1. Only for a critical incidence – 5. Other comments, only at yearly review, once or twice per clinical rotation. Weekly as a student.

6. When reflecting which reflective model do you use? Gibbs – 7, Johns – 1. Other 7. Comments, don’t know, curtin portfolio, expressive journal model, simplified Seedhouse’s.

7. Do you want an education session on Reflective Practice? Yes – 8 , no -7.

8. Are you politically savvy? Yes – 6. No – 5. Maybe – 4

9. Would you like a education session on how to become more politically savvy? Yes – 9. No – 5, other 2. Comments having more of a political impact, better networking.

10. What activities or sessions would you like the ACM Education Committee (WA Branch) to offer you as a member?

1 Given the recent budget announcements, the college will need to provide midwives with practical workshops about how to go about setting up a private or group practice.
2. journal CLUB
3. any, but with online options as I am rural
4. Being a student, this would be broad. Perhaps major current issues facing women today, and a follow up on Indigenous maternal health.
5. Unsure at this time
6. Case study format (both presentation and workshop)
7. I’m always finding flyers about different up skilling workshops I can attend over the state but would find it easier if they were collated by an organisation and put in a calender.
8. active birth workshops and breastfeeding talks - how to encourage women to continue
9. I would like further clarification of what is expected to create a great portfolio and the easiest way to accomplish this, how to become more politically involved with practical suggestions on how to do this (lobbying etc), how much formal written reflective practice is required and if this is to be included in our port folio. So far my experience of these issues has been to complete university assessments. I want to ensure that when I am a registered midwife that I follow through with these things in a practical manner and know what is expected from me and my portfolio, when I don't have the support of the university. I would like to stay politically aware and active.
10. Anything is good - am a student.
Breastfeeding with diabetes would be good

Thank you all for completing the survey: I will leave the survey up for any of you who have not completed it, give it a go. The education committee will review these comments and will endeavour to facilitate your requests.

Pauline
ACM Education committee 2009