Dear List,

The new federal health minister announced just prior to Xmas that she would
be holding a national summit on the PI crisis for medical specialists early
in the new year.  It is imperative that midwives be considered in any
discussion of subsidy/assistance whatever to obstetric specialists.

I have sent the following letter on behalf of the Maternity Coalition to the
Minister.  It would be helpful for other organizations to send their own
letters on this issue to as a matter of urgency.

regards Barb.  



The Hon. Senator Kay Patterson
Minister for Health & Ageing
Parliament House
CANBERRA  ACT  2600

7 January 2002

Dear Minister,

Re National summit on professional indemnity insurance

Congratulations on your appointment as the Minister for Health and Ageing.

I am writing in response to your recent announcement of your intention to
hold a national summit on the issue of professional indemnity insurance for
health professionals.

The Maternity Coalition is a national non-profit umbrella organization of
groups and individuals committed to improving maternity care for women
during pregnancy, birth and the postnatal period.   One of the key
objectives of the Maternity Coalition is to work with governments and all
relevant professionals to expand women�s access to a midwife-led model of
care in which midwives, as autonomous professionals, provide primary care
and support to women throughout pregnancy, birth and the newborn period.

Midwife-led care has been recommended by the World Health Organization as
the most cost effective and appropriate model of care for pregnant and
birthing women.  Research evidence in both Australia and overseas
demonstrates that midwife-led care, where a woman receives true continuity
of care from a midwife, lessens the need for costly interventions and
improves outcomes. Yet in Australia, fewer than 10% of women have access to
one on one care from a known midwife.

The crisis in professional indemnity insurance has affected midwives as much
as other health professionals offering maternity services.  A majority of
Australia�s independent midwives are being forced to cease practice due to
the lack of affordable PI insurance.

This contraction in midwifery services is occurring at a time when there is
a pressing need for major expansion in midwifery services.  Greater use of
suitably qualified midwives to provide competitive best-practice care for
healthy women would make a significant contribution to lessening the
pressure on health budgets.  As the Rocking the Cradle report found,
maternity occupies the largest number of hospital bed days each year, let
alone the escalating costs of unwarranted obstetric interventions.

The Maternity Coalition is particularly concerned about the recent NHMRC
Report on Maternal Deaths in Australia which showed a 70% increase in
preventable maternal deaths in 1994-96.  These deaths represent a dramatic
reversal in the trend of declining mortality rates.  Increases over recent
years in the rate of caesarean sections (now around 20% nationally) was
mooted by the NHMRC report as a contributing factor.   Midwifery care of
normal healthy women has been proven to result in fewer women needing
caesarean sections.

Midwives are experts in caring for women experiencing normal healthy
pregnancies�the majority of women.  The lack of access to PI insurance for
midwives threatens to further undermine their ability to compete with
specialists in the care of healthy women.  This lack of competition is not
in the interests of consumers and nor is it in the interests of government
health funding agencies.

The Maternity Coalition strongly urges you to include access for midwives to
affordable Professional Indemnity insurance on the agenda for the national
PI summit you have announced.  The AHMAC has acknowledged the importance of
this issue when it referred the problem of PI insurance for midwives to the
Medical Indemnity Working Group.  Any solution for addressing the
professional indemnity crisis affecting obstetric specialists should be also
be applied to midwives, to ensure that national competition policy
imperatives are honoured.

Considering the urgency of this matter and the proposed timeframe for the
summit we request a response from you prior to the summit.   We look forward
to hearing of your thinking on this matter.

Yours sincerely,




Dr Barbara Vernon
President
The Maternity Coalition

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