Sounds like Westmead and other hospitals will have to rethink their medical birthing practices as there will not be enough doctors to intervene when the routine CTG strips say they should. I trust the midwives at Westmead are making the most of this opportunity to introduce real midwifery care a la NMAP?? Denise Hynd ----- Original Message ----- From: "Andrea Robertson" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Thursday, August 14, 2003 7:38 PM Subject: [ozmidwifery] Another article on the doctor's crisis
> Hi, > > Yet another article: Sydney Morning Herald, Aug 12, 2003 - Page 1 with big > pic. The doctors bleating again about their insurance. I note that the > doctor in Moree (featured in the huge pic, with a baby) says she still > works at the hospital, so women aren't really missing out on obstetric > care, just private medicine. > > ---------------------- > > Doctors at a premium in the litigation era > Ruth Pollard and Ben Wyld report. > August 12, 2003 > > > Sixteen months after Australia's largest medical defence organisation > collapsed, the true cost is > only now emerging. > > At Westmead Hospital, obstetrician Andrew Pesce is worried. "Ten years > ago," he says, "there were 15 of us providing obstetrics and gynecological > services at Westmead to people in the area. There are now seven. > > "I now turn away more patients . . . than I look after. Our specialty is > dying - the way that we practise has been corrupted by the expense of the > litigation and the psychological impact that it has on the practitioners." > > General surgeons, neurosurgeons and others paint the same bleak picture. > Doctors will keep quitting the > profession because their insurance way too high - despite Federal > Government subsidies, significant state law reform and Canberra's action to > prop up United Medical Protection since the insurer went into provisional > liquidation last year. > > W ithout Government subsidies, obstetricians face annual premiums of up to > $140,000. Dr Pesce, spokesman for the National Association of Specialist > Obstetricians and Gynecologists, says 45 of the nation's 700 practising > obstetricians left obstetric practice in 2001. > > "That is about six to seven per cent of the workforce. Last year it was > even higher than that, and there is no indication it is going to get any > better." > > One casualty of the crisis is Moree obstetrician and general practitioner > Maxine Percival, who stopped doing private procedural obstetrics in May > last year. Dr Percival, who would have faced a premium of $20,000 this year > if she had maintained her procedural insurance, now only practises > obstetrics for the local public hospital. She said a loss of confidence in > UMP forced her to give up her procedural work. > > "In obstetrics, litigation can be launched 25 years after the procedure," > Dr Percival said. "I don't know if UMP or their subsidiary will be around > next year, let alone in 25 years' time." > > The Government stepped into the indemnity crisis after UMP went into > provisional liquidation with unfunded liabilities of $460 million. UMP had > about 30,000 members, or two-thirds of the country's doctors. The > Government rescue package is estimated to be worth $260 million over four > years. > > Dr Percival says that for women in Moree, who don't want to be admitted to > the district hospital as a public patient, the alternative is a three-hour > trip to the nearest obstetrician in Tamworth. > > "For towns that are relatively isolated, you can't put pregnant women in > the back of an ambulance and transfer them three hours away, hoping they > get there without having their baby." > > Dr Pesce said Federal Government subsidies had helped to make medical > indemnity more affordable for obstetricians but the pressures, both > financial and legal, continued to bite. > > The president of the NSW Neurosurgical Association, Dr Warwick Stening, had > warned last year that 10 of the state's 30 neurosurgeons would resign if > the medical indemnity crisis continued. In a move to reduce medical > misadventure, cut premiums and thereby halt the exodus, neurosurgeons > launched a project to identify and measure risk in the hospital system and > to manage better the risk of neurosurgical procedures. Working with NSW > Health, the risk-management model will be rolled out in the next year. > > "We are still a long way from solving the problem, but this is a positive > step that we have taken which will allow us to identify problems before an > unfavourable outcome occurs," Dr Stening said. "All we can do is to start > to reduce the number of claims by reducing the number of adverse incidents." > > Dr Stening said the NSW Government's Health Care Liability Act of 2001 and > the Civil Liability Act of 2002, along with Federal Government subsidies, > had helped ease the financial pressure on neurosurgeons. > > But that was not to say, he said, that a special new levy - imposed on > doctors in case of a claim against them - would not hurt the rest of the > medical profession. A recent survey of 750 general surgeons aged over 55 > has found that one in five intends to retire in the near future. Nearly 100 > per cent of them nominate medical indemnity as the reason. > > Many experts are placing their hopes on the establishment of a federally > administered fund for the catastrophically injured. This would help cut > medical indemnity premiums. Yet after 10 months of meetings, progress on > achieving such a fund is no closer. > > Dr Pesce said: "The Government has made great effort to improve the > situation . . . we now need substantial reform of the remaining uncapped > liabilities that doctors face, and that is for the long-term care costs for > the catastrophically injured." > > The Assistant Treasurer, Helen Coonan, said the long-term scheme was > definitely on the national agenda. "You cannot contemplate a proper system > of professional standards for doctors . . . without having regard for the > long-term care needs of those catastrophically injured by medical negligence." > > It was November 2001 when a court handed down a decision that would send > shockwaves through the medical fraternity. Sydney woman Calandre Simpson, > who suffers from cerebral palsy, was awarded $14.2 million after she > successfully sued the doctor who botched her delivery. > > It was almost twice the previous highest award, and it highlighted the > vulnerability of both the country's medical insurance industry, and > individual doctors. The payout has since been reduced to just under $11 > million on appeal. > > The tort law reforms put in place by the federal and state governments > since the collapse of UMP, six months after the Simpson decision, have hit > consumers hard, according to the senior health policy officer for the > Australian Consumers Association, Martyn Goddard. > > They would simply deliver increasing wealth to insurance companies and do > nothing to lower the cost of premiums, Mr Goddard said. "The real cause of > the bulk of indemnity rises wasn't a sudden increase in litigation - there > has been no such increase - it was changes to the structure of the > global reinsurance market." > > The Federal Government clearly needed to intervene in the medical > reinsurance market, he said. "They are doing the opposite, which is trying > to reduce premiums by subsidies and by limiting patients' rights." > > --------------------------------- > > ----- > Andrea Robertson > Birth International * ACE Graphics * Associates in Childbirth Education > > e-mail: [EMAIL PROTECTED] > web: www.birthinternational.com > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
