Dear all
Have just returned from the Senate Select Committee hearing. I represented
the WA ACMI. There's no doubt the committee has read the submissions and are
thinking about issues. Most of my questions came from Sue Knowles and
Rosemary Crowley. I found it difficult at times to separate the me hat from
the ACMI hat. This was harder when some of the questions were What is your
opinion of... and the ACMI doesn't have a stock/united policy.
VERY IMPORTANT After the hearing it was suggested to me that we midwives
must present to the Senate models which show how Federal money can best be
used to fund services - sort of like the ABSP. I just can't do it at the
moment. Maybe we need a joint submission. I get the impression that the
Committee wants ideas about finding sources of money and then ways of using
it. Can this be done by the next hearing? The crux of it is that they want
us to do the work! We've done it all before so can we do it again?
The rest of this post is about my/ACMI (WA) submission.
In my five minute blurb I concentrated on the need for maternity services
that reflect womens' expressed needs etc etc. I used a primary health care
model to show that not all women have services that are equitable,
accessible, appropriate affordable etc etc. I then gave three examples of
this ie homebirth, only two birth centres in WA and none in the rural areas,
inadequate or even absent services for women in remote and rural areas.
Not all the Committee's questions were related to the submission so I had to
think a bit. They asked if DEM educ'n would improve relations with the
medical profession (my answer No)! I think they were a bit surprised at my
somewhat gloomy prognosis about positive relations with our medical
colleagues. I started hedging a bit and talked about my 'colleagues'. But,
RC said which ones? I answered.
There were quite a few questions about accreditation of midwives (visiting
privileges) costs of programs ie homebirths and other midwife managed
services. Another was why did I think the midwives were so old! I said that
I think (but as yet little evidence to support it in mid but if general is
anything to go with) that the midwives and nurses leave the profession in
droves because of dissatisfaction with their working conditions etc. I used
Kalgoorlie (hello Kal) to show that if the work is satisfying and they are
able to practice midwifery as they wuz taught they will stay. So it isn't a
matter of bringing in 'young students' but of finding ways to make 'em stay!
Other comments were about the 'routinisation' of technologies/services,
anti-competitive behaviours, lack of appropriate information on which to
make informed choices; too much money being spent on something to the
detriment of others ie antenatal care etc.
I tried to make the point that in some quarters midwife managed care is
considered an expensive luxury for an elite group. Midwife led services
should be 'instead of' rather than 'as well as' ie it is not an adjunct to
obstetric services but a model of care in its own right. I'm not sure if it
came out like that but that's what I meant!
That'll do for now. It is a bit scary but far from unpleasant. By the way
submissions are the property of the Senate and can't be published. We can
only comment on what is open to the public.
Thanks to those who gave up their time to listen and be supportive
afterwards!
Carol
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