Sunday, February 21, 2010

Community Cabinet in Ballarat

Consumer members of Maternity Coalition in Ballarat were successful in putting key questions to the Prime Minister, Kevin Rudd, who passed the questions to Health Minister Nicola Roxon.

Anyone who has not followed the process of maternity reform, who listens to this film clip, may ask what's the problem. The Health Minister has absolutely guaranteed that:
  • homebirth will not be forced underground
  • women's rights in birth will not be vetoed by the Australian Medical Association
 The spin doctors have carefully woven this web, and the Minister is well scripted.  There are clues in subsequent statements, even in this video clip.  For example,

  • homebirth will not be forced underground. Of course not! The Victorian government has announced three publicly funded pilot homebirth schemes that are connected to public hospitals.  As long as there are women who can jump through the hoops set by these pilots, and as long as there are midwives who are prepared to work in managed programs, homebirth can continue.  Anyone who lives outside the radius covered by these pilots, or whose 'risk' profile excludes them from participating in the pilots, or ... - well you're on your own.  BUT this government is NOT forcing homebirth underground.
  • women's rights in birth will not be vetoed by the Australian Medical Association.  The doctors don't want homebirth at all.  The AMA, RANZCOG, NASOG, and others consider that birth can only be safe if it happens in hospital.  So as long as women are in hospital, or in the virtual hospital in the home (under the supervision of the hospital), women's rights haven't changed. 
  • people (midwives and doctors) will be requred to work together!  The Minister put on her most paternalistic/dictatorial (Queenly, as in Alice in Wonderland) voice to make this proclamation.  She illustrated it with telling us that we will need to have backup arrangements (for homebirth).  Excuse me!  If she, or her advisors/spin folk had read even a few of the thousands of submissions made to the multiple government reviews, she would know that midwives and women planning homebirth do make backup arrangements.  She would know that the obstacles are erected by hospitals, not as a result of any unwillingness by midwives to 'work together' as she puts it.  She would know that midwives do consult with obstatricians or other doctors, and refer when appropropriate - AND that by all outcome measures we provide effective and safe primary maternity care.  What Roxon obviously does not understand is that, for many women, giving birth is a spontaneous, non-medicalised event.  It can happen in the privacy of their own home.  It is not an illness.  Only those who experience illness or complication need medical attention. 

In summary, it seems that midwives who agree to provide private midwifery services for planned homebirth will, after 1 July this year, be under a great deal of pressure to accept only those whose risk profile is totally uncomplicated.  The women who have had previous caeasarean, or grand multiparity, or multiple pregnancy, or too fat, too thin, ... - they will be expected to go straight to [hospital], do no pass go, do not [see a midwife].

[ADDED 24 Feb]
From the Hansard:

Senator McGAURAN
Rest assured that I know all about the incompetence of Minister Roxon, who has flown under the radar. It is not just this issue; a whole array of issues in her portfolio ought to be brought out.......

I was in Ballarat recently for the community cabinet—‘community cabinet’?; it was Mr Rudd’s sideshow. That was all it was. You should have seen the glum faces on all of the ministers who turned up. What a joke. In this portfolio is the midwives issue, denying women the choice to have home births. That was what dominated the community cabinet. I got a guernsey; I was there in the front row. I could not believe it. It was a sight to see the one ego on display. He really does have a big ego. You have to see it to believe it, and you are all compliant to it. It is a joke. When are you going to stand up and speak on an issue?

This Prime Minister is so frightened of the midwives issue he is not willing to meet the public outside of a controlled situation. When he had to unveil the Kevin Rudd bust in Ballarat—as many of you know, in the gardens there there are busts of every Prime Minister— he did not turn up. He left the council, the Mayor and everyone else standing
there waiting for him to appear at 11 am. He just did not turn up. He did not even ring ahead to say he was not going to turn up. Can you imagine the embarrassment and the frustration? Do you know why?
Because there were midwives protesting there waiting for him and wanting to speak to him. Of course, they have dubbed it as ‘cowardly’.
That is the portfolio I want to speak on.


Michelle said...

Great summary Joy, very interesting to see the gut reactions we had around the consultations to be clearly confirmed in the Minister's responses in the community cabinet. How ignorant of her not to understand (or admit) that home birth WILL go underground, a huge percentage of us do not fit the so called 'low risk' criteria that will be necessary to birth at home birth a private midwife come July 1st. I am just glad that the truth is getting out there and we can call her on her misleading statements and continue to educate people on the real consequences of these maternity reforms.

Joy Johnston said...

I have written to Senator McGauran at
I felt encouraged and refreshed to read the Hansard from your words in the Senate about the Ballarat community cabinet.
This government is imposing an extreme socialist health policy that is dictated by AMA to the publicly funded part of maternity care. It's a joke to call it reform. The refusal of the government to give any parity to privately practising midwives, requiring us to buy indemnity insurance that simply is not available, is stifling the only alternative choice that women have at present. The 'carrot' of Medicare and PBS is going to be so heavily regulated and restricted that one has to wonder if anyone (mothers, babies, or midwives) will be able to benefit from it.
Thankyou for listening to common sense.
Joy Johnston