The 11 June issue of Australian Doctor carries a story … that is truely gob-smacking.
… the NHMRC has been trying to organise a meeting between the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australian College of Midwives to develop an agreement on referral guidelines in relation to midwives being able to access the Medicare Benefits Schedule … provided they work “collaboratively” with doctors.
… RANZCOG has … refused to attend the meeting because community representatives who support homebirths have been invited.
If you were ever in doubt about the need for reform of maternity services, then look no further.
If you were ever in doubt about why reform in this area is so excruciatingly difficult, then look no further.
And if you were ever in doubt that professional interests rule in the health sector, then look no further.
This really is pathetic. Absurd and childish are other adjectives that come to mind….
It's simply business. Midwives and obstetricians essentially compete for the same low risk women. Every low-risk woman who sees a midwife is one less woman seeing an obstetrician. Most women are low risk. Obstetricians cannot afford to lose the bulk of their "business" to midwives and unfortunately, collaborative agreements favour obstetricians in several ways: - There is no onus on the obstetrician to collaborate, and for every midwife who cannot get a signed collaborative agreement, that's one less midwife in private practice and therefore more women woo will see private obstetricians. - There is no onus on the obstetrician to return the woman to midwifery care once the indication for referral no longer exists. Indeed, there is a great incentive for the obstetrician to "keep" the woman: $$$.