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Hi all,
Here�s a copy of Aden Ridgeways
press release.
Justine
------ Forwarded Message
From:
"Willis, Liz (Sen A. Ridgeway)" <[EMAIL PROTECTED]>
Date:
Tue, 1 Jul 2003 11:38:31 +1000
To: "Justine Caines" <[EMAIL PROTECTED]>
Subject:
RE: NSW Developments on Midwifery
thanks justine.
jennifer is on to this. here is adens july 1
release.
liz
Calm Not Alarm Needed in Medical
Indemnity Debate
The Australian Democrats today called for call
for calm after obstetricians and other medical professionals threatened to
walk off the job after changes to the medical indemnity
regime.
Democrats� Consumer Affairs spokesperson, Senator Aden
Ridgeway, said it was important to remember those at risk here are patients �
especially expectant mothers.
�If the issue is affordability of medical
indemnity insurance these medical professionals should be directing their
anger at the insurance industry not their patients,� Senator Ridgeway
said.
�The industry has been so successful in their fear campaign about
out-of-control claims that medical professionals and governments believe tort
law reform is the only answer.
�Governments all over the country have
bent over backwards to accommodate doctors� concerns.
�However there is
still no real evidence that these measures will actually create lower
premiums.
�In the meantime the rights of patients and victims are being
slowly chipped away and the balance may tip in favour of the
negligent.
�If Governments are serious about safer and more effective
obstetric care they should be offering similar lifelines to casual and
contract midwives � many of whom are still unable to gain any indemnity
insurance cover at all.
�This crisis in professional indemnity
insurance is also still preventing some universities from being able to offer
clinical placements to their students � a compulsory part of midwifery
training.
�Availability of professional indemnity insurance for
midwives is one positive step governments can take to alleviate this
situation.
�More working midwives means less pressure on obstetricians
and GPs and it is the most appropriate and cost effective type of health care
for women in normal pregnancy and birth.
�Midwives continue their
valuable care until around 4-6 weeks after the birth of a child � the kind of
care that is not readily available from any doctor or obstetrician,� concluded
Senator Ridgeway.
-----Original
Message-----
From: Justine Caines
[mailto:[EMAIL PROTECTED]
Sent: Tuesday, 24 June 2003
11:48 AM
To: Willis, Liz (Sen A. Ridgeway); MarYoung, Jennifer
(Sen A. Ridgeway - Sydney)
Subject: NSW Developments on
Midwifery
Hi Liz and
Jennifer
Liz as discussed - below, SMH piece from yesterday and Seven
Sunrise Transcript from this morning
Any queries give me a
call
Many Thanks
Justine
�����������������������������������������
Justine
Caines
NSW President Maternity Coalition
PO Box 105
MERRIWA
NSW 2329
Ph: (02) 65482248
Mob: 0408 210273
E-Mail:
[EMAIL PROTECTED]
Midwives to deliver without
doctors
By Julie
Robotham, Medical Writer
June 23 2003
Midwives at a NSW hospital are expected
to get permission to deliver babies when there is no doctor on duty, in a
state first that may herald a shake-up of public maternity
services.
Deb Picone, NSW Health's deputy
director-general of policy, confirmed midwife-only births may begin
imminently at Shellharbour Hospital, following a staffing crisis. Women have
been transferred to Wollongong recently when there has been no obstetrician
to cover the roster.
Ms Picone said the service
would only be offered to women with low-risk pregnancies, and only to those
who wanted it. She said the main rationale was to give women choice about
their care. But state-wide shortages of obstetricians and of midwives also
meant the department needed to consider different models of maternity care.
All proposals for midwife-only services would
need approval from the Maternal and Perinatal Committee, the body that
monitors childbirth safety in NSW.
There would be
no government directive to area health services that they should offer
midwife-only care.
"It's really going to be
local solutions for local issues," Ms Picone said. "It does require proper
supervision and a very thoughtful roll-out."
The
development comes amid pressure to give midwives more responsibility for the
care of women throughout pregnancy, birth and the postnatal period.
Pat Brodie, president of the NSW Midwives
Association, said women wanted to know the midwife. "They want to know who's
going to be at the birth."
Midwives had left the
profession because they got little job satisfaction from working hospital
rosters, but many would return if they could be actively involved in
individual women's care, she said.
The advocacy
group Maternity Coalition last week presented to Cherie Burton,
parliamentary secretary to the Health Minister, Morris Iemma, a proposal to
allow midwives within the public hospital system to manage all the care for
about 40 women a year.
It is based on research
evidence that women prefer such models and are less likely to have a
caesarean when they are attended by someone they know well.
Justine Caines, the group's NSW president, said: "When
midwives have one-to-one care of women, their results are stunning."
Midwives could be employed by a hospital, or self-employed and contracted to
it.
Andrew Bisits, an obstetrician who was also
at the meeting, said there was "a lot of dissatisfaction" with current modes
of care.
Dr Bisits, a specialist in obstetrics at
John Hunter Hospital, said midwives or GPs could be trained to deal with
emergencies. "There has been far too much of a focus on the worst-case
scenario," he said. "Our thinking gets distorted and we lose sight of
normality."
Andrew Child, president of the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists, said
he supported wider midwifery care, but there were dangers in midwives
working without medical back-up.
"It's a
fall-back position when things are really desperate - and there are major
workforce issues," Dr Child said. "People have to work out whether they're
happy to accept that from a safety point of view or prefer to travel.
Prediction of risk is pretty difficult. Things can happen so
quickly."
Midwife plan
ill-conceived: critics
>
> Midwives have cheered a NSW Health
Department proposal
> to allow them to deliver babies when there is
no
> doctor on duty.
>
> But the plan has drawn ire from
the Australian Medical
> Association (AMA).
>
> In
response to a doctor shortage on the state's south
> coast, Illawarra
Area Health proposed that midwives be
> given permission to deliver
babies without a doctor on
> call.
>
> NSW Midwives'
Association president Pat Brodie said
> midwives across Australia
already frequently handled
> births without a doctor present, and
doing so without
> an obstetrician on call would not mean a big
change.
>
> "This will be provided to women who are low-risk
and
> have had a healthy pregnancy, and midwives providing
>
care in this way will be skilled and trained in how to
> handle
emergencies," Ms Brodie said.
>
> "Women that require caesareans
are going to be
> transferred out way before they go into labour and
if
> anything untoward happens they will be transferred to
> a
unit that can handle that.
>
> "This system works effectively
across the United
> Kingdom and there's no reason why it can't work
like
> that here."
>
> AMA president Dr Bill Glasson,
however, called the
> plan "a sad day for obstetrics".
>
>
"We've been forewarning the government that this
> crisis in
obstetrics is on our doorstep, and here we
> are now trying to solve
the problem by bringing in
> obstetric midwives," Dr Glasson told
radio 2SM.
>
> "Midwives ... are highly skilled and highly
trained,
> but they are not doctors."
>
> In any group of
low-risk mothers, Dr Glasson said five
> to 10 per cent would need an
urgent caesarean.
>
> "If you haven't got an obstetrician at
your bedside,
> then you're putting the mother and baby at
terrible
> risk," he said.
>
> "The obstetrician may not
necessarily have to be
> standing beside the mother, but needs to be
just
> outside the door ... because things go wrong very
>
quickly in obstetrics."
>
>
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