Friday, August 21, 2009

meeting with health Minister Nicola Roxon

Nicola Roxon convened a meeting yesterday with representatives of midwifery and consumer groups around the current legislative reforms and ensuing problems of homebirth and private midwifery.

Those who attended represented the Australian Private Midwives Association, Australian College of Midwives, Maternity Coalition, and Homebirth Australia.

It is reported that the Minister acknowledged the unlawfulness of privately attended homebirth under the new legislation, and declared her commitment to working to resolve the problem. However, she went from this meeting to the Parliament to present the midwife and nurse practitioner bills for debeate. (link to the Hansard Aug 20, 2009)

Messages have circulated by email from the various members of the groups represented. Some of these messages go to email groups that have restricted access only to members, while others are publically accessable. Some of the readers of midwifery blogs are not able to access the email groups, so here are a few pertinent points:

A state/territory (S/T) arrangement, in which public hospitals are the providers of homebirth services. [This is more to do with buck passing between state and federal health departments than initially meets the eye. The S/T funding for all in-hospital care, including birth, is part of a complex funding agreement with the federal government. The federal treasury would be unlikely to let anyone upset the apple cart, particularly an insignificant group of people who they expect will settle down into their hormonal worlds and get used to the new rules!]

Homebirth Australia secretary, Justine Caines, wrote: "We clearly articulated that the state solution was not workable.

"So far we know the following from the states:

"SA have basically told supporters they will not meet with them and to take it to Nicola.
"NSW will not meet with Homebirth Australia
"QLD is saying NO WAY to state based homebirth
"VIC Minister said yesterday that 'Private Midwives have no place in Victoria' and he doesn't care about ANY of the 350 or so women who gave birth in Victoria last year. (YES REALLY).

"She [Roxon] said that she was optimistic that a product could be found if we used a framework like the SA Homebirth policy. Homebirth Australia clearly argued that the SA policy is being used as an 'exclusion criteria' and while HBA supports the SA policy in principle we need to also establish a duty of care clause to ensure that midwives are able to care for women that want to homebirth but fall outside of the guidelines. I specifically made mention of VBAC here.

"Nicola said there will be no Medicare funding for homebirth.

"Homebirth Australia finds this totally unacceptable that funding should be excluded from homebirth.

"Nicola has spent a long time diminishing homebirth women as so small in number, the money would not be an issue and as we all know every woman out of hospital SAVES considerably.

"Our rally platform will be that women must be empowered to make decisions about their body and their baby, just like any other person can in healthcare. ALL WOMEN - EQUAL RIGHTS

"All women MUST have access to a registered health provider, midwife, or Dr and in the case of homebirth obviously midwife.

"With the Medicare funding arrangement we are on the cusp of funding 'private practice' midwifery, The funding must include homebirth.

"WE HAVE 2 WEEKS TO CONTINUE OUR WORK IN LOCAL ELECTORATES. SOON I will have a letter to draft to local politicians and some early preparation for communities with good numbers coming to the rally to get local media engaged."

Comment added by Joy Johnston
I don’t mind if there’s no medicare scheduled payment for homebirth. But I do mind that the medical profession can charge a fee that is unregulated, and the safety net kicks in. When I was still a teenager we had big union action to get equal pay for equal work. Haha! The government’s payment for basic maternity care (the uncomplicated, universal bit) should be the same regardless of whether that basic care was provided by a midwife, a doctor, or a mix of midwives and doctors – as in New Zealand. I consider Medicare unsuitable for the pregnancy-birth-postnatal maternity episode, so any fiddling on the edges is just that. As long as the unfair monopoly is supported by the government it is against all codes of fairness and equity for mothers who want private midwifery care, as well as for midwives whose main practice area is homebirth. I will continue to aggitate against and resist such laws.

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