The ACM has sent an urgent e-bulletin out to its members to let them know about the delicate position the College finds it's self in - Whilst the College is not happy with the terms of the Determination we are in real danger of losing everything we have been working for by not accepting this Determination; That is Medicare for Midwives:
The College has consistently requested some changes to the Determination:
".....while we were very committed to seeing the maternity reforms progress there are several concerns regarding the implementation of the Determination. We also noted that very small changes in the wording of the determination would resolve many of these issues. Our suggested word changes are,
• Removing the words ‘named medical practitioner’
• Removing the words ‘acknowledgement by a named medical practitioner’
• Addition of the words ‘a health provider organisation’ to Part 1. Section 4 c (important for rural & remote purposes and also applicable to urban Aboriginal Health Services)."
Also the Minister will continue with the plan for Nurse Practitioners however would let the Midwife Determination go....
"We were also advised that the Minister is very aware of the potential move to disallow the Determination and the government is therefore seeking urgent legal advice about uncoupling the Nurse Practitioner (NP) Determination from the Midwife Determination to enable the NP Determination to progress through parliament. They stated that the Minister has no intention of letting the NP Determination fall through (if the Midwife Determination is challenged) and will work hard to ensure this does not occur. However, the Minister’s advisors also stated that Minister Roxon has ‘lost political capital over this and will not seek to reintroduce the Midwife Determination if it is disallowed’. Sadly maternity care is not high on the agenda in health at the moment despite all our (consumers and midwives) efforts to make it so."
The Minister has clarified these points:
"The Minister’s advisors also stated that in the Determination:
• The requirement for ‘acknowledgement by a medical practitioner’ could be met simply by a midwife recording in the woman’s medical history that information had been sent to a medical practitioner, and
• That the medical director of a hospital could be the ‘named practitioner’ (we have this in writing from Minister Roxon dated 27th November 2009) signing on behalf of the hospital medical staff.
• Clinical Privileging is a Collaborative Arrangement which does not require any further sign off from a ‘named medical practitioner’.
You have to ask yourself whether it would be better to let the determination be disallowed and work really hard to try and get it up in a way that we feel is workable from the beginning?
However, the consequence of this means we risk not getting Medicare for midwives in the next three years or perhaps at all.
This is too big a risk to take! We believe that over the next few years we could see thousands of women benefiting from access to Medicare in a variety of different models. Specifically, we see this will increase access to funded continuity of midwifery care which many women do not currently have.
Please be proactive and leave a comment: what do you think? and please leave you first name when commenting: no anonymous comments will be published
Pauline Costins
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