The exemption

The next big hurdle for privately practising midwives (PPMs) is to ensure that we are able to access 'Exemption' from indemnity insurance for homebirth from 1 July 2010, until 2012. Without that exemption it will be unlawful to provide any midwifery services for homebirth. Midwives will be required to purchase indemnity insurance for the other parts of our practice - prenatal and postnatal. Exact definitions of what is prenatal and what is postnatal and what is 'birth' for the purposes of the exemption are yet to be found.

Does 'birth' start at the beginning of labour, and how is the beginning of labour to be defined for the purposes of the exemption? And does 'birth' end after the placenta has been birthed, or does it end at some other time?

The Federal and State/Territory Health Ministers decided at their meeting last September that midwives providing homebirth care would be given access to an exemption from the requirement to hold professional indemnity insurance for a period of 2 years subject to three conditions. The conditions are:
1. That PPMs report all homebirths according to the requirements of their jurisdiction
2. That women booking with a PPM receive written disclosure that the PPM is practising without insurance
3. That PPMs agree to a Quality and Safety Framework for midwifery care

Point .3 is the one receiving most attention, and is the focus of the face to face consultations that are being held, at which organisations are being invited to comment on the draft document.

MiPP has prepared a response which is to be presented to the consultation by several members. This response will also provide the basis for written submissions.  MiPP has gathered evidence to support our submission.

In summary, we urge the Consultation to recommend to the government

• that the only mandatory requirement for a midwife to engage in private practice be that the midwife is registered
• that all midwives who are currently in private practice should be eligible for the exemption
• that midwives who choose to commence private practice during the two-year exemption period be able to proceed with fair and reasonable processes
• that the two years of the exemption be used to review and record private midwifery practice so that any regulatory changes can be introduced in a systematic and evidence-based way 
• that midwives in private practice be treated equitably with other midwives, and with other regulated health professionals in their ability to practise their profession privately. 

Other groups whose draft submissions are being circulated amongst members for commment are those of the Australian College of Midwives, and the Australian Private Midwives Association.