Wednesday, October 27, 2010

Minister Roxon's advice: "suck it and see"

Women’s Right to bodily autonomy and a midwife’s right to practice: We’ll just have to “suck it and see”

Writer: Anonymous

Historic times yet I get the distinct feeling they won’t want to be remembered. Julia Gillard, a declared feminist and yet we are on the cusp of the most draconian midwifery regulation dressed up as reform. From November 1 midwives will be able to claim Medicare funding but only when controlled by a doctor. Midwives are educated and registered to provide complete care for healthy women. Despite common misconception midwives are not handmaidens to doctors, but professionals in their own right.

Naturally it is appropriate for midwives to have established links to a range of other health professionals, this enables a woman to receive timely advice and care. When a midwife and obstetrician are respected for their role and a woman is recognised as the primary decision maker, best practice care is possible. This does not happen in Australia. Many women have been led to believe that their bodies are revolting, faulty with birth a barbaric process that should be managed. Couple this with a system that has financially rewarded huge increases in surgery with little scrutiny, indeed one that saw the likes of Graeme Reeves [NSW the 'Butcher of Bega'] continue to practice. It’s easy to see why obstetrics controls childbirth’s billion-dollar industry.

Maternity reform was the first cab off the health reform rank. Considering it’s the highest volume area, accounting for the greatest number of bed stays, that seemed appropriate to reform advocates. Perhaps this was Minister Roxon’s first mistake, she was overheard saying ‘I want to get maternity over with first and then move onto chronic disease’. I am sure she understood the turf war and passionate consumer advocates it seems she had little understanding of how political (read profitable) pregnant woman are.

Allegedly the AMA threatened a $7 million anti-government campaign pre election if midwives were able to claim Medicare in their own right. Their deal that individual doctors controlled midwives access to funding and the decisions of the birthing woman. If a woman makes a decision not supported by an individual doctor access to funding and midwifery care is likely to be withdrawn.

It is possible that the Gillard Government is contravening its responsibilities under the Convention of the Elimination of all forms of Discrimination Against Women (CEDAW). If international convention is too abstract then perhaps the plight of rural and remote women is more convincing. In rural areas, GP’s control maternity care, even when a GP has ceased obstetric practice the establishment of midwifery models has been vigorously opposed.

Women are forced to relocate or risk travel in labour rather than access local midwifery models. The cultural damage for Aboriginal women is considerable. If Medicare funding was not shackled to the permission of an individual medical practitioner midwives could establish rural clinics. This could have enhanced safety and removed the financial and emotional burden of many rural families.

These and many other issues were formally raised. The Maternity Services Review received 950 submissions, nearly double that of the National Health and Hospitals Reform Commission. The consumer led juggernaut then continued to achieve the nigh impossible, 2 Senate enquires into the same bill (something only seen a handful of times) coupled with a Senate record number of submissions, 2507. Over three thousand gathered outside Parliament House to protest the way the reform in September 2009.

The political cost has been high with Minister Roxon embarrassed by poor advice. It is unclear why but a senior bureaucrat and ministerial adviser both with carriage of maternity reform have both ‘moved on’.

Last week ‘reform representatives’ met with the Minister, the meeting was only achieved after the same women ran in ultra marginal seats in the recent federal election. While seemingly having an open door policy to the AMA, maternity consumers have been repeatedly refused access.

Many criticised the Rudd/Roxon health reform citing it was rather hospital reform, with little focus on health, wellness or consumer engagement. Perhaps that can be explained with yet another medical practitioner appointed by the Minister. Dr Judy Searle, an Obstetrician, seemed unmoved by the participants pleas regarding rural maternity services citing it as ‘a hard area’ but the quote of the meeting must go to the Minister herself who is reported to have responded to the participants comments regarding women’s rights to self determination rather than proposed medical control by saying we will just have to “suck it and see”. So that’s how Labor feminists do women’s rights.

Note:  This essay was sent anonymously to APMA.