Well???!!!!! I'm speechless...........Liz
----- Original Message -----
From: "Knowles, Susan (Senator)" <[EMAIL PROTECTED]>
To: "'Elizabeth McAlpine'" <[EMAIL PROTECTED]>
Sent: Tuesday, July 31, 2001 9:24 AM
Subject: Midwifery
> Dear Ms McAlpine,
> Thank you for your recent email concerning adoption of the Recommendations
> of the 'Rocking the Cradle' Senate Community Affairs References Committee
> Inquiry conducted in 1999. I would like to take this opportunity to focus
on
> some of those Recommendations.
> However, from the outset I would like to say that the most relevant point
I
> can make is that this matter is by and large a State's issue and one over
> which the Federal Government has no jurisdiction. I expressed that concern
> repeatedly to the Labor Chairman prior to the start of the inquiry but she
> was still determined to delve into this area of State responsibility. It
is
> not the Senate's (or the Federal Government's) responsibility or right to
> dictate to the State's how to run services which are primarily their areas
> of authority.
> The issue of indemnity insurance for midwives which you also raise, is
like
> most other aspects of this issue, an area of State Government
> responsibility. I would urge you to contact them in order to canvass
opinion
> and responsiveness to such an outcome.
> This inquiry was opposed by the Federal Government for a number of
reasons,
> to which you may already be privy, however, the issue of Childbirth
> procedures has been tackled before and with the same conclusions being
drawn
> on each occasion. As I mentioned earlier, not only does it fall outside
the
> jurisdiction of the Federal Government, it is not always entirely a
State's
> concern either. These decisions are clinical ones to be made by doctors
and
> patients directly involved in individual circumstances and not by Senators
> and other Parliamentarians in Canberra.
> The role of Parliament is not to decree what procedures should be
> undertaken, or what tests should be prescribed. Neither do we seek to
> interfere with medical or surgical procedures deemed necessary by treating
> physicians. In the case of childbirth procedure, this is no different.
> Along with the rest of this Committee, I found that there is satisfaction
> with the quality of birthing services available in this country. I can
also
> say that the Coalition Government is funding and driving health system
> improvements on a scale not seen previously. As you too suggest, of course
> childbirth procedures for all Australians are not perfect and this
> Government is making particular efforts to improve outcomes for certain
> population groups, such as indigenous peoples, and those living in rural
and
> remote areas.
> The Government is currently working with the States and Territories to
> provide better integration of care through provisions in the Australian
> Health Care Agreements for patients using public hospital services and
> through other mechanisms to ensure integrated approaches to population
> health and primary care. The Government draws on the National Health and
> Medical Research Council guidelines as part of its evidence base for
> national strategic planning across the range of health care, including
> obstetrics.
> As I mentioned previously, responsibility for delivery of population
health
> measures rests primarily with State and Territory Governments, Divisions
of
> General Practice and individual GP's. The Commonwealth has a broad policy
> leadership and financing role in promoting health action including
> integration of population health in the wider health system. The Public
> Health Outcome Funding Agreements set out in a single agreement the
ongoing
> Commonwealth funding provisions for a number of programs including the
> National Women's Health Program and the Alternative Birthing Services
> Program.
> The recommendation that Commonwealth and State governments work together
to
> ensure the annual publication of a list of all its hospitals where births
> take place, coupled with statistics on each birth-related intervention
> performed and insurance status of women involved, the Australian Institute
> of Health and Welfare is an independent health and welfare agency within
the
> Health and Aged Care portfolio.
> They have, in conjunction with the Australian Bureau of Statistics the
> responsibility for collection and publication of such statistics. They
feel
> that if appropriate funding were available, a national report on birth
> related interventions could be produced.
> The continuation and expansion of hospital birthing centres is a matter
for
> State and Territory governments to determine in the context of their own
> budgets.
> Finally, with regard to the recommendation that the Health Insurance
> Commission monitor the new Medicare rebate for complex births to ensure
that
> it does not lead to overservicing, the Department is monitoring the use of
> this item on an ongoing basis using Health Insurance Commission data. It
> always has monitored such information.
> Furthermore, while this Committee found that Australia has a high rate of
> obstetric intervention compared to other developed countries, we found
that
> in spite of this satisfaction with the quality of birthing services
> available was high. One can't dispute that having a baby in this country
is
> generally a safe event for most women, and in recent decades Australia has
> made great strides in improving maternal and infant mortality rates. As a
> result, we now compare favourably with other first world countries.
> I believe the Government's reform agenda is consistent with the main
thrust,
> and many of the recommendations of "Rocking the Cradle" in that it aims to
> enhance continuity of care for consumers, remove artificial barriers, and
to
> encourage collaborative arrangements between health care providers at the
> community level.
> I might also add that these recommendations on the whole neglect to
> recognise many things, such as the fact that there is no organisation or
> person/s to execute some requests, statistics on procedures are currently
> readily available and most astonishingly, they overlook initiatives the
> Coalition Government has implemented.
> Ms McAlpine, your comments have been noted. The recommendations of the
> report essentially exist as a 'wish list', and moreover few of them are
> within the complete sphere of influence of the Federal Government. The
> Federal Government has no desire to encroach upon the State's
> responsibilities in this area.
> Thank you for writing to me with your concerns, I hope that I have made
some
> sense of some of the recommendations made by the Inquiry. Please do not
> hesitate to contact my office if you have any further questions.
> Yours sincerely,
> SUE KNOWLES
> SENATOR FOR WESTERN AUSTRALIA
>
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