Midwives attack new 'veto'

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448. Link

MIDWIVES are aggrieved about new rules that might curb their access to Medicare rebates and prescribing rights ...

Last year Ms Roxon announced that from November this year midwives would for the first time be able to use the Pharmaceutical Benefits Scheme and Medicare rebates for their clients.

At the time, Ms Roxon said the historic move would boost a midwife's ability to work independently and increase options for pregnant women ...

But in a long-awaited change to the legislation ... midwives will now have to work collaboratively with a doctor, who must endorse their practice before their clients can access financial benefits.

The requirement for collaboration was always planned to be in place, but the detail of collaboration requires that a midwife has a written agreement with an obstetrician to access medicare benefits. This is problematic: more than one obstetrician must sign an agreement because no obstetrician provides 24/7 cover, so there'd need to be at least 2 obstetricians signing the agreement. What happens if one obstetrician leaves the local area? Is sick? Goes on leave? In these situations, the collaborative agreement is very vulnerable. Not only the agreement, but the midwife's ability to provide ongoing care to her private clients.

After eight months of debate between doctors and midwives, government records show that Ms Roxon signed a determination on the matter two weeks ago, when Parliament was out of session.

Doctors' groups who say home birth is unsafe are believed to have lobbied the government for the changes.

Yesterday, midwives and home-birth advocates accused Ms Roxon of trying to hide what will be an unpopular decision with midwives and mothers.

Australian College of Midwives president Hannah Dahlen said the change would effectively give doctors the ability to veto their access to Medicare and the PBS.

While midwives working inside hospitals would not be disadvantaged, she said private midwives would find it difficult to find a doctor to endorse them, especially if the doctor did not support home birth.

In fact, doctors have refused to sign agreements with any midwife who attends homebirths. Is this collaboration or control?

Melissa Maimann, Essential Birth Consulting 0400 418 448