Dear all
You may recall that I asked recently for comments on how we can change the
current system to allow midwives to provide woman centred care within the
mainstream health system.
The following comment came from Jan Robinson, and I wonder if anyone would
like to discuss this proposal. It sounds excellent to me. I would be
interested in contracting a caseload of say 2 per month at a local hospital,
and retaining my own private caseload. The 'contracted' bookings would be
for planned birth in hospital, and I would expect the hospital to encourage
a midwife or student midwife who wanted to be mentored into independent
practice to work alongside me in some way through the care. I envisage that
some women who accessed this service would actually decide that they wanted
to give birth at home, and that would be OK by me.
I now have 'shared care' provider status for antenatal care with Birralee
Maternity Service, Box Hill, and my first client who was booked there
birthed at home last Monday. Of course this arrangement does not have any
funding linked to it - the next step, which fits in very well with Jan's
proposal:
QUOTE
Re your request for ideas on the ozmidwifery chat line... I feel the way
forward is for all midwives capable of providing a comprehensive service to
women be offered a redundancy package by their employers and then invited to
tender for contracts with the Area Health Authority to independently
contract to service a set number of healthy women each year. The midwives
would provide and maintain their own vehicles and communication equipment as
well as insurance and contract to take a permanent student load to enable
them to experience caseload working conditions. There would be benefits to
all parties but the most benefit to the women who would now have their own
midwife and hopefully offered a choice of birth venue within the program.
The women would not have to pay any midwife contracted with the area health
authority.
It all seems so simple to me but I'm sure all parties would see complexities
superimposed on each aspect of this suggestion.
Hilary and I have submitted such proposals to one of our local health areas
on numerous occasions and although the CEO is interested the buck stops when
the nursing administration tells him 'we don't have the budget for this'.
What they really mean is that they don't have the midwives with the skills
or inclination. Hillary and I offered to skill-up their midwives so that we
could bow out of the scheme after one year and their midwives could take
over. No way!
There must be some employed midwives with the skills and enthusiasm
somewhere in Australia who would like to privatise and start working as
autonomous, professional business women. The Kalgoorlie midwives surely
would go for something like this. Once one hospital does it, others see the
advantages and go for it.
END QUOTE
Any comments will be recorded in the file I have started on funding and
visiting access for midwifery services.
Many thanks
Joy Johnston
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