« The Japan Birthing Association | Main | Term Breech Trial discredited »

Some Midwives to be given Medicare numbers

It’s been a while since I posted to My Diary – holidays and writing a huge project (more of this later) have kept me busy. There is a lot happening, and a number of things to tell you about, so I will start with the latest news about midwifery in Australia.

There has been a campaign running for many years to have midwifery included as part of our free health care system.

All our maternity hospitals are staffed by midwives, and women giving birth in the public system will have midwifery care for free. However, midwives don’t have “provider numbers” as do the doctors, which means that women can’t engage a midwife privately and be reimbursed through our public health system (Medicare). Women who do pursue this option will have to pay from their own pocket for independent midwifery care, and this has been a major disincentive for some to seek a homebirth. It also means that midwives have no official recognition as health care practitioners in their own right, as they do in many other countries.

The inequities in this situation have been trumpeted for years by Aussie midwives. There have been almost 40 Government reports and enquiries over the years that have concluded that midwifery care is safe, affordable and practical. Finally, we are seeing s glimmer of hope – the current Federal Government is being forced to act, due to a shortage of doctors, midwives and nurses especially in our rural and remote areas (which is most of the landmass of this huge place!).

Last week, the Minister for Health announced that he will give midwives in some rural areas Medicare Provider Numbers so that they can provide pregnancy care for women who might otherwise have to travel long distances to see a doctor, or worse, have no care at all. It’s a start. The upside is that it is a foot in the door, and the downside is that nurses have also been given the green light to perform pregnancy checks. There will be much debate about whether a nurse is qualified for this role, but I suspect that in the end common sense will prevail and midwives will be the primary care givers for country women.

One problem that will need to be overcome is that the new arrangement will only be available when a doctor has made the referral to the midwife, which in effect means that a doctor will be supervising the professional practice of the midwives – this is clearly unacceptable. However, once the system is in place, it can grow from there and changes can be made.

The Shadow Minister for Health (a woman) has already publicly supported the call for Medicare numbers for midwives and is fully supportive of the widespread use of midwives as primary care givers. If we get a change of Government (fingers crossed) we should see a rapid expansion of the system which will have been in place for some while by the time the next election is due.

One interesting side light has been the indication that this new use of midwives as primary care givers will add $5 million to the annual cost of Medicare. Given that there have been widespread reports in the press this week about the rorting of Medibank by the doctors to the tune of tens of millions of dollars, introducing this simple measure has the potential to save money, as midwives traditionally prescribe fewer medicines and services than doctors (especially private obstetricians). We could have had this system in place years ago……

Posted by andrea at January 15, 2006 01:32 PM