Midwife indemnity plan may spark GP obstetrician exodus

For further information, contact Melissa Maimann at Essential Birth Consulting. Link

GP obstetricians could ‘down tools’ as a result of Federal Government plans to allow midwives to practise independently with subsidised indemnity insurance.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has warned the move could drive up doctors’ insurance premiums and force them to quit practice.

“Obstetricians may be called in too late to manage an obstetric emergency and have to face the blame for a poor outcome, when an earlier referral may have averted a crisis,” the college said.

“[If] premiums rise, that could be a considerable driver for doctors [to exit] the obstetric workforce, and we are already on... a knife edge with workforce,” RANZCOG president Dr Ted Weaver said.

The college warning comes as three pieces of legislation were introduced to Federal Parliament that would expand MBS and PBS rights for midwives and nurse practitioners, and provide the former with federally subsidised indemnity cover.

In submissions to a Senate inquiry into the legislation, doctor groups have called for clearer detail on the proposed collaborative models of care, amid fears the legislation will lead to fragmented and lower standards of care (MO, 31 July).

There's no reason for doctors to believe that their premiums will be affected by this legislation. Midwives will have their own indemnity. If a woman or baby needs to sue, they will sue the midwife for her part in what has happened, if negligence can be proved. Instances of unsatisfactory professional conduct or professional misconduct will be dealt with through disciplinary processes, as is the case currently. What the legislation does is to extend to midwives and the women they care for, the professional right to insurance that is shared by all health professionals. It places midwives on par with other professionals who are responsible for their practice.

If RANZCOG / AMA believe that insurance makes a profession safer, as they have previously stated, they ought to be happy that midwives will now have insurance. They ought to be especially pleased if insurance would be extended to cover home births, which they see as high risk and dangerous. Medical groups have been heard to say that doctors are often left to "pick up the pieces" from home birth that have "gone wrong". Well, if midwives are insured, they would not be sued in place of the midwife. So why aren't RANZCOG, the AMA and other medical groups right behind our demand for insurance to be extended to cover home birth?

Melissa Maimann, Essential Birth Consulting 0400 418 448