That's exactly what I'm looking for. Thanks Trish.
Joy
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Trish David
Sent: Thursday, 9 September 1999 16:23
To: [EMAIL PROTECTED]
Subject: funding for births
Dear Joy,
I haven't thought this through very well, but I would like to see all
births funded through normal channels, but the choice of where to birth
would be the woman's. How I see this happening might be that midwives are
employed by government bodies (such as hospitals or health departments) to
be the lead maternity carer regardless of place. S/he then follows the
woman wherever she goes. The salary of the midwife thus is guaranteed, and
the woman has a funded choice of either public, private, birth centre, home
or the highway in between.
Any extra above the medicare rebate is a matter for the woman and her
private health insurer. An obstetrician is a separate entity, separately
contracted by the woman after referral from the midwife. We will still
need obstetricians for the pathological contingencies, and they should be
remunerated accordingly. And after all, no matter who she goes to as a
doctor, she will still need her midwife.
A small pool of midwives are maintained on a shift work basis in hospitals
for the obvious reasons, and antenatal care and the bulk of postnatal care
takes place in the woman's home by her LMC midwife (and her partners).
Does this make sense? This would then open the gates to either fully
employed by agency midwives or privately practicing midwives to work in all
sorts of ways but the woman chooses. What do you think?
Thus we do away with the bulk of shiftwork, the bulk of infrasturcture
costs, the bulk of on costs, etc. We put these midwives on a salary.
Create a separate award, register and Act of Parliament. We put them into
their own community to serve their neighbours within teams of midwives who
integrate with other services and use their underused buildings (eg Family
and child health clinics, gp offices, school buildings, etc) anything to
get them out of the big centres and out to where the women are.
Well, that's all probably more than you asked for. Cheers, Trish
Trish
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