Check out the Determination for Medicare Provider Numbers

Please have a look at the Health Insurance (Midwife and Nurse Practitioner)Determination 2010Health Insurance Act 1973
I, NICOLA ROXON, Minister for Health and Ageing, make this Determination under
section 3C of the Health Insurance Act 1973.
Dated 4 October 2010

This determination comes into force 1 November; Midwifery services and fees range from $31.10 - $724.00 and providing a service fee for 6 weeks postnatal period...

We have to remember that this does not cover homebirth and we need to continue to put pressure on the government to pass this midwifery services fee onto women who choose to have a homebirth.....

Why do people read and not leave a comment?

I am expressing a level of frustration; how are people to make decisions when you put out information and you get no responses; what does it take for people to respond? i know you read the blogs, but never a comment; this is so important; does this mean you accept the staus quo, you don't give a toss, you have no opinion, or really doesn't matter what you say nothing will change? I have no idea what to think....because it's one way communication here....

I liken the position of the Australian College of Midwives to the recent federal election: everyone you speak to is voting for the person you want.... or not voting for that person....the numbers are close all the polls predicated 50 - 50 or thereabout.....Now with the Determination; I have to say the polarity is almost the same, although I think that because the majority of midwives are not commenting.... the minority who believe that the determination should be squashed have a louder voice. Therefore this is the common view because the rest aren't speaking..... we have 500 members in WA.... and i have heard from less than a quarter.....it is time to be vocal.....

The facts are that the Determination was passed in July...when it comes up in the Senate next week it is to allow or disallow..... there is no discussion about the determination....the time for talking is over... Any debate that would be had, would then be as to whether, or not, the disallowance motion should be passed.
... the bottom line is if it is not allowed... we then lose everything, because the Government of the day will not reintroduce it. I have to add why would they?

The argument I have been given is that the determination will create a two tier midwifery service.... I believe this happened when we created 'the eligible midwife' not the medicare provider number.... and rebate.... in fact i could argue there has always been a two level midwifery service...those midwives who believe their scope of practice is the experts in normal childbirth.... then to collaborate when things move outside that scope with an Obstetrician.... however there are those midwives who will accept and care for a woman from any risk category because it is the woman's choice..... there we have a dichotomy: my solution is if you had that , trusting, supportive arrangement with your women it wouldn't matter if you had to seek collaborative advice from an Obstetrician..... it is all about the relationship you build with the woman.....

is this a topic to which we will get no agreement or have things just got to a point where the passionate people from both sides are at logger head... and the majority of midwives are just not engaged.....?

For those midwives wanting to read more about what is happening: .. please click on the link HEALTH LEGISLATION AMENDMENT (MIDWIVES AND NURSE PRACTITIONERS) BILL 2009

Its good to go to page three and read some of the definitions:

Schedule 1--Amendments relating to 1 medicare benefits and pharmaceutical 2 benefits

2 6 Subsection 3(1) 3 Insert: 4 participating midwife means: 5 (a) if the Minister has approved a common form of undertaking 6 under section 21A--an eligible midwife in respect of whom 7 there is in force an undertaking given by him or her and 8 accepted by the Minister under section 21B; or 9 (b) otherwise--an eligible midwife

We have to watch and see how this will be determined.... "the eligible midwife"

cheers Pauline

Review of the ACM Conference: The Magic of Midwifery

I will start by saying it was an excellent day the ACM education committee did very well in organising a fantastic program, there was something for everyone. The conference was held at City West a brilliant venue, lots of free parking, the food/refreshments were tantalising and the AV equipment went without a hitch, what more could you ask for.


There are several key components for organising these conference / educational days, initially you do need topics that will attract midwives to attend, and this can often be difficult because the needs and wants of midwives within the State are varied. Secondly it is choosing presenters that will be inspirational, because I think midwives attend these days not only for education but to be inspired and network. Work places can be stressful and the demands on a midwife can be enormous therefore it is imperative from time to time to refocus and remember why you became a midwife and be inspired to be ‘with woman’ with like minded people.


The day started with an inspiring opening by our ACM President....”we are in unprecedented times, there are many changes occurring and we need to get it right”. This was followed by Abby Clemence from the National ACM Office providing us with a synopsis of the Maternity Services Review Recommendations (2009), Federal budget 2009 and National Registration July 2010. To recap the main points for me: 120 million dollars over 4 yrs – Midwives to have Medicare & PBS access from 1 November 2010 for care provided in collaborative teams. Commonwealth to support midwives with access to professional indemnity insurance – unfortunately no support for Homebirth – however Private Practice Midwives do get a reprieve for two years, that means no decision until 2012 and we have to find someone to cover us for indemnity insurance.



It was hard to hear (although I know it is true) that as a workforce midwives are a fragmented profession and do not support the ACM, unlike the medical profession that stick together. This is something that needs to change... do you remember the saying “united we stand, divided we fall” this should be our new motto! I didn’t know that the GP’s have 98% membership to the College of GP’s which makes them very a powerful organisation and as Midwives we have less than 30% membership to the college we need a unified front. You might ask what does this mean or why is this important? Well it shows UNITY especially when attending forums and meetings to change policy etc. And this is part of what the Australian College of Midwives (ACM) does for us whether you are a member or not. I was also surprised to see that Obstetricians make so much money (in one year they can earn 1.5 – 3.5millons dollars) despite having to pay huge indemnity insurance fees and that the safety net assists them in earning or structuring their fees.

If you are currently not a member of the Australian College of Midwives, please join now....
What will be good about having Medicare provider numbers for midwives is that it will raise the profile of Midwifery as a profession in its own right, therefore Midwifery and Midwives will be more valued. This creates an air of excitement as midwives began to think about working within different models of care; private practice and Dominos, Group Midwifery Practice etc. It is very exciting times for a midwife.... for me I think it would be excellent to have my own private practice, (with indemnity insurance for homebirth, however currently not an option) provide women with antenatal care in the home, have the choice for visiting rights to hospitals for the birth allowing me to provide the primary care, for the woman then allowing a 6hr discharge home if all was normal..if a hospital birth was required as opposed to a homebirth. Then provide the follow-up postnatal care in the home..... what a great alternative to care.....

National Registration has been talked about ever since I can remember... and I have been around in the health industry for over 25 years. So it is finally happening... part of me will only believe it when it happens in July 2010 – it is long overdue, Nurses and Midwives will be able to register Nationally and work anywhere in Australia....fantastic.. This will also regulate disciplinary issues preventing State hopping for Nurses and Midwives who have competency or disciplinary issues within their current place of work and resign and go interstate to escape the consequences of their actions.


Nurses and Midwives will be able to register on separate registers; for Midwives there will be four categories: Registered Midwives: Restricted Midwife: student midwife: and non practising midwife... this will enable a true reflection of the numbers of midwives within Australia. This will also cause new problems for employees because some midwives who are currently registered as both a nurse and a midwife may not do so after 2010. What nurse / midwives have to remember is the terms of their current employment..... so there current employment contract, which might be to be registered as both a nurse and midwife...........For more information relating to National Registration please visit National Registration and Accreditation Scheme http://www.nhwt.gov.au/natreg.asp


Read about the first meeting of the new Nursing and Midwifery Board of Australia and who is on the Board. http://www.ahpra.gov.au/documents/First%20Meeting%20of%20the%20Nursing%20and%20Midwifery%20Board%20of%20Australia%20-%2020%20September%202009.pdf

Abby Clemence is passionate about what she does, she has the woman & midwife first and foremost in her sights and presented very well, the audience was captivated by all this knowledge and information.... even though at times there was not enough information, this was due to the fact that the questions asked by the audience, the answers have not been clarified by the government.... so watch this space........................................... Abby finished with MidPLUS - Continuing Professional Development (http://www.midwives.org.au/ ) the importance of midwives showing evidence for the care that we provide and our continuing education processes. So please if you have not joined up for MidPLUS do so now and if you have like me.... get it started....for me this blog will be my reflection, I am sure I can claim some points.............again watch this space; Thank you Abby for your passion and your much appreciated hard work.


The afternoons presentations were more clinically based: they were fascinating and inspiring; several spring to mind; the use of “Language in Midwifery” and the “Follow through Experience”. These two presentations were given by a graduate and a student midwife; they were refreshing, passionate and stimulating. It is great to see forward thinking new midwives to carry us forward.

Intermittent Auscultation – this is always an interesting topic, I have always struggled with the idea of being able to hear variability with a sonicad or pinnard and have had numerous discussions about this topic over the years.... I believe that you can determine the baseline and hear accelerations and decelerations however have been sceptical about the ability of hearing variability.... today I got the answer.... Lesley presented very eloquently and provided a formula of how to hear variability....” Listen for a full minute, in 4 sections of 15 seconds. Count the beats for each 15 seconds separately and multiply each by 4. Compare these four averages to produce a variant amount which should be more than 5 beats”.
We all tried it and I was amazed it worked….. You can teach an old dog new tricks…. Thanks Lesley I now have a new skill together with evidence to back it up….

Midwifery Group Practice… an overview of this model of care… key points for me were: make sure you know what the population wants…. Is this a model of care women want… also do you have the staff who wants to pursue this model of care, very interesting presentation.

The last three sessions, Waterbirth Policy, The Role of the Doula – Australian Doulas (http://www.freewebs.com/australiandoulas/ ) and Antenatal education – a menu approach - that means exactly that...“providing a menu approach to choice about antenatal education” “people like stories, like real life experiences” “ a show and tell experience of learning” -kept the audience riveted to their seats...


WA has been a long time waiting for the Waterbirth Policy... I remember coming to WA 6 years ago after working in the UK within the community & Birth Centre as a midwife and was used to women having the choice of waterbirth... to find that it was not an option here... so I am absolutely thrilled that finally this waterbirth policy was launched today at our conference..Yes it is official you can conduct a waterbirth in the hospital.... make sure you read the policy..Clinical guidelines for women requesting immersion in water for pain management during labour and / or birth. I am sure there are many more midwives equally as happy as I am about this outstanding achievement. Improving Maternity Services (http://www.changechampions.com.au/resource/Janet_Hornbuckle_Mat0209.pdf

It was good to see that we had approx 100 attendees for this annual conference, consumers, midwives and sponsors. There were midwives from Albany to Geraldton, and Kunnunurra and Broome attending, absolutely fantastic.....The day ended with a well deserved Sundowner 1630 – 1730 includes drinks and nibbles ( sponsored by ACM WA Branch), throughout the day there were many opportunities for networking socialising and lots of photos.(watch this space will be posted over the next couple of days)...............it was an excellent conference, I feel inspired and empowered and am excited about the future for midwifery in WA..... thank you to all those who attended..............see you all at the AGM the week before Xmas.

Life members of the ACM Jill Thompson and Janice Butt.

Opposition Threatens to Obstruct Landmark Health Reform legislation

This is very disappointing news and I hope that it amounts to nothing.

A media release from the Australian Nursing and Midwifery Council

report that the federal opposition is not supportive of the new legislation:

The federal opposition has indicated their unwillingness to support landmark legislation which will improve access for the Australian public to quality healthcare and a greater choice of providers by enabling nurse practitioners and eligible midwives to access the Medicare and Pharmaceutical Benefits Schemes. Related Bills will also guarantee access for eligible midwives to professional indemnity through a scheme underwritten by the commonwealth government.

Please contact your local member of Parliament and have your voice heard, urge for the support of these Bills:

The ANMC urges all parties to support the passage of this key health reform legislation through the parliament to demonstrate their commitment to high quality healthcare provision and choice for Australian healthcare consumers............

Minister Roxon has also indicated a commitment to resolving those issues of access to professional indemnity insurance for eligible midwives assisting women who chose to birth at home. These issues have arisen through the revised requirements for national registration and accreditation of health professionals. ANMC will also continue to pursue this dialogue to a positive outcome for consumers of maternity services in the interests of safe, quality healthcare for the Australian community.

Come on now is the time to be pro-active and be heard!

Pauline

2500 submissions to the Senate! Buy your virtual rally ticket?

Have you bought your Virtual ticket for the Homebirth Rally? I have, its the first time I'm participating in a virtual rally, its all very exciting, I have uploaded my picture and 25 words for my banner, can't wait to see it.

Homebirth Australia Virtual ticket $25.00

This has been taken from the homebirth site, please click on the link and have a look at whats happening with Homebirth.

NEWS RELEASE
Thursday August 6 2009
Contact: Justine Caines 0408 210 273

2500+ submissions received. A likely Senate record.
Women tell Minister Roxon their rights matter


"The intersection of two pieces of proposed legislation has the ability to make homebirth midwifery unlawful in Australia. Bills related to Medicare are under review of the Community Affairs Committee. Public hearings will be held today on an issue that is shaping up to be the catalyst of a new wave of feminism."

Now we know that the Bills are likely to be passed, however Homebirth continues to be at the forefront of discussions.

watch this space, buy your virtual rally ticket.

Pauline

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!