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Legislative Assembly for the ACT: 2001 Week 8 Hansard (8 August) . . Page.. 2544 ..

MS TUCKER (continuing):

There are approximately 200 independent midwives in Australia. Eighty of these midwives, including two in the ACT, have policies for professional indemnity cover with Guild Insurance. On review of their policies, Guild has decided not to cover independent midwives as their policies become due for renewal.

The two ACT midwives face losing their indemnity insurance, by the end of August for one and mid-September for the other. They have stated they will not practise without professional indemnity insurance. The need for government intervention is therefore urgent.

These midwives are contracted to provide comprehensive one-on-one care for pregnant women. This care includes all prenatal visits, the birth, and care postnatally for up to six weeks. These midwives work collaboratively with other specialist maternity care providers in the ACT. The cost of the entire package of care is considerably less than a caesarean section alone. Twenty-two women have already approached these midwives to provide their care and will be forced to take on publicly funded care if the midwives are not insured.

Currently, women who choose the care of an independent midwife bear the entire cost themselves. Independent midwives are not recognised by Medicare. Women who contract the services of an independent midwife are saving the government thousands of dollars. If the 22 women previously referred to that have chosen to be cared for by an independent midwife return to the public system, it will cost the public purse an extra $88,000, conservatively. Over an entire year, with each of the two midwives taking on 40 women, the government can save $260,000.

The alternative is for these savings to be lost and further economic pressure placed on an already stressed public health budget. These figures are based on the Australia's Mothers and Babies 1998 report produced by the Australian Institute for Health and Welfare and, if anything, are a little conservative in their estimation.

Childbirth is a very significant part of the health system. It is the single most important reason for hospitalisation, and accounts for the greatest number of hospital bed days. If this government is interested in providing appropriate and cost-effective care that does not rely on acute services, then they will take action to support this motion.

In Setting the Agenda the government outlines directions for health and community care. A number of these directions will be disregarded if independent midwives are forced to cease practice. One need go no further then the introduction:

We need to promote and improve health... This requires ... a shift from a narrow focus on illness treatment to a broad focus on health and wellbeing and on improving partnerships.

In relation to improving costs, the government said in Setting the Agenda:

The Government has made a commitment to reduce ACT health costs ... This can be achieved ... by finding new, innovative and more efficient ways of providing health services.

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