Hi Marina
Can I add a few thoughts on funding for maternity services. Our private
practice group in Newcastle managed very successfully because most of the
women were in private health funds which provided a rebate for midwifery
care on the basis that it usually meant less intervention and shorter
in-hospital stay and therefore costs for the insurer. The public health
system may benefit in the same way with shorter hospital stay (short term
cost benefit) but more importantly for long term benefits and therefore
decreased costs since women in this model of care are more likely to breast
feed therefore have healthier children etc etc.
The proposal that midwives be able to gain a bulk funding contract with a
health service for providing midwifery care for a certain number of women
is one which needs to be further explored as i think it has the greatest
potential for a way forward. (Medicare rebates for midwives will be
strongly resisted for all sorts of reasons.) It is the way Nicky Leap's
practice was funded in London and it is the way many groups are funded in
New Zealand...population based bulk funding. In effect this means you would
say something like...If there are 300 women seeking a homebirth in my
district in a year then the midwives would be paid a lump sum of 2,000
dollars per woman. Or the Homebirth association would be paid the lump sum
and would hire midwives and provide all care from that budget.
Funding issues are complex but have to be grappled with since the dollar is
the bottom line.
cheers Maralyn
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