Tuesday, March 5, 2013

Medicare review

The federal government health department has engaged consultants to review the incorporation of Medicare into midwifery practices.  Yesterday the MAMA practice was visited, and focus groups and interviews carried out with midwives and mothers.

I don't know if or when the public (you and I) will see any such reports, but this sort of review is expected a couple of years after major policy and funding changes by our government.

A midwife/maternal and child health nurse asked the reviewers to note that the maternity reform initiative, subsequent to the Maternity Services Review, is notable in its lack of public education or advertising.  The government's response to the Review was a  "$120.5 million Budget package Providing More Choice in Maternity Care – Access to Medicare and PBS for Midwives. This Budget package provides Australian women with more choice in maternity care whilst maintaining our strong record of safe, high quality maternity services."

More "choice in maternity care" is not accessible if women don't know about it.  Medicare rebate for midwife-attended births means nothing if midwives can't have visiting access to hospitals.  Yet the rationale for the reforms is more safety and better outcomes for mothers and babies: achieved through continuity of midwifery care.

Any other government health initiative, such as immunisation, or safe sleeping, or smoking cessation or ... is presented to the target audience public with the aid of professionally prepared TV and radio advertising, brochures, posters, and the like.

Midwife primary care with Medicare rebates is the best kept secret in the country. 

Why aren't there posters about continuity of care from a known midwife in places where women of childbearing age will see them? Why haven't we seen letters sent to doctors explaining how they can collaborate with midwives? Why are hospitals working harder than ever to actively prevent midwives from achieving visiting access? 

Your comments are, of course, welcome.

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