Hospital doctors fear losses of staff

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MIDWIVES will not flee the state's chronically understaffed public hospitals, despite budget moves to allow them to set up private practices from the end of next year, the Australian College of Midwives said.

The Federal Government's overhaul of maternity services will allow some of the nation's 12,000 midwives to prescribe drugs subsidised by the Pharmaceutical Benefits Scheme and claim Medicare rebates for managing pregnancies, deliveries and postnatal care.

Independent midwives will also be granted indemnity insurance and visiting rights to hospitals, despite opposition from doctors' groups.

... "[These changes] potentially meet the needs of the majority of women … from the middle of our largest cities to remote communities. It is not about midwives being independent of the system. We have always worked with doctors and we always will. It is the safest and best way, but these changes will make it more financially viable for everyone."

But obstetricians are concerned that public and private hospitals could be stripped of experienced midwives, putting women at risk. "They are saying that won't happen but we just don't know yet," the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Dr Ted Weaver, said yesterday.

"There is every chance some of these models of care being examined will be very attractive to midwives and entice them away from their traditional places of employment, such as hospitals."

Ahem, what does that say about hospital employment, if this doctor fears that midwives will all leave if oddered an alternative way to practice?

Professor Dahlen said the changes would attract more midwives and retain those already in the system because they would be able to practise to the full scope of their abilities "rather than be frustrated by a medically-dominated model of care". She said that not all midwives would want to manage their own businesses.

Dr. Andrew Pesce ... said if the Government underwrote midwives' indemnity insurance that could disadvantage GPs who also deliver babies.

Under a current scheme, the Government already subsidises GP obstetricians' insurance premiums if these amount to more than 7.5 per cent of their fees for providing the service. Unless access to subsidised insurance was offered equally to both groups, doctors might be put at a "competitive disadvantage [compared to] midwives", Dr Pesce said.

The Rural Doctors Association of Australia welcomed the changes, saying it would free GPs in regional areas.

Interesting that the issue of competitive advantage comes into play. Hannah Dahlen makes a great point that not all midwives will want to leave the hospital system. I agree totally! being self-employed and managing a business is, in many ways, much harder and more demanding (also more rewarding) than working in a hospital where a stable and dependable amount of money appears in one's bank account every 2 weeks.

Melissa Maimann, Essential Birth Consulting 0400 418 448