Australian Private Midwives Association: Examples of lack of collegiality by some doctors

Saturday, October 9, 2010

Examples of lack of collegiality by some doctors

In preparation for the implementation of Medicare reforms, commencing 1 November, midwives and maternity consumers have been asked to record evidence of any obstruction to collaboration.

The following message has been received from a midwife in Melbourne:

"A number of my clients have been advised by the GP, when going to their office requesting blood tests, ultrasounds etc, that if they are having a midwife attended home-birth then the GP does not want to be involved in their care beacuse of the lack of insurance for midwives in private practice. This is a major barrier to collaboration in my opinion. I have been searching RACGP websites for some confirmation of this issue and have found some. The attached document (the RACGP submission to government) states:
"What are the workforce barriers to integrated models of care?
• Insurance
As stated previously the RACGP finds the present unavailable of insurance for
privately employed midwives a deterrent. Some GPs want to access midwives on a
sessional basis as they do for other doctors, but find this not possible in the current
climate."
Link:

"Do any of the Midwives/clients have it in writing that GP's are refusing to collaborate already? I have personally found this to be a frustrating and potentially negilgent treatment of women. They [the women] ask for a simple test and the GP refuses - what if there IS an undetected problem because of the GP's refusal to provide care?"

NOTE:
The Australian Medical Association has published a document Collaborative Arrangements: What you need to know in preparation for the inclusion of eligible midwives and nurse practitioners in Medicare funding from 1 November 2010.
This guide is intended to provide you with guidance on important information to consider when entering into a collaborative arrangement with a midwife or nurse practitioner.
Contents:

The legislation
Effective collaboration is good for patients
What is a collaborative arrangement?
Does the midwife/nurse practitioner meet the relevant MBS/PBS requirements?
Indemnity insurance
Is there any obligation to participate in a collaborative arrangement?
Are there any restrictions on which medical practitioners can participate in a collaborative arrangement?
Can more than one medical practitioner be a party to a collaborative arrangement?
Is a collaborative arrangement required for every patient?
Do you have confidence in the midwife or nurse practitioner?
Remuneration
Should you insist on a written agreement?
Clinical settings where services will be provided
What matters should be included in a collaborative arrangement?
Best practice guidelines
What should you do when a patient does not want to follow agreed clinical guidelines?
What happens if things do not work out?
Where can you obtain more information about relevant MBS and PBS arrangements?

Link to Medicare information: Midwives and Nurse Practitioners

WHO ARE WE?

The Australian Private Midwives Association represents midwives in private practice. The association is focused on the safety of women, the ability of women to access quality midwifery care across Australia and the partnerships between women and midwives. APMA supports women’s choice in maternity options within a framework of quality and safety and believes in women being able to access midwives in all settings. APMA unites all midwives seeking to provide continuity of care for women.

APMA strives to provide midwives in private practice with information relevant to their practice and advocacy in the political process.

Enquiries:
Joy Johnston joy@aitex.com.au
Marie Heath NSW and National 0407 266004
Clare Lane (Vic) 0416 130219

APMA POSITION STATEMENT on PLANNED HOME BIRTHS WITH A MIDWIFE

1. We support home birth with a midwife in attendance for women who have uncomplicated labours. 2. We support and adopt the International Confederation of Midwives’ (ICM) Definition of the Midwife (2011), which is foundational to all midwifery practice, including homebirth. 3. We support the right of every woman to access a midwife as the primary maternity caregiver who works in partnership with the woman throughout the episode of care, who is able to be the responsible professional in attendance at the birth either at home or hospital, and who is able to make appropriate referral and transfer of care when required. 4. We support the right of a midwife to practise privately in a fee-for-service or funded relationship with the client, or to take up employment. 5. We support only those regulatory restrictions that are able to pass the ‘public interest’ test: “How does this promote health and wellbeing in the mother and baby?” 6. We support an expectation of equity, including equal pay for equal work throughout a midwife’s scope of practice. Midwives who provide primary maternity care are entitled to the same public funding, the same opportunity to charge a fee-for-service, the same access to hospital referral, and publicly supported indemnity insurance, as medical practitioners providing the same maternity services. 7. We support processes by which midwives are able to gain experience and mentoring in order to commence and demonstrate competence in homebirth practice. 8. We support seamless and reliable processes by which midwives are able to make hospital bookings for women planning homebirth, and arrange transfer to the hospital in a timely way when needed.