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Legislative Assembly for the ACT: 2001 Week 8 Hansard (8 August) . . Page.. 2547 ..

MR MOORE (continuing):

Omit "necessary", substitute "appropriate".

We recognise what Ms Tucker is trying to achieve, and we agree with that. We disagree with the method of going about it. Solutions do need to be found to the home birthing issue, but a knee-jerk reaction to subsidise professional indemnity insurance for self-employed midwives is not the answer. It will create many more problems than it solves.

Ms Tucker has no solid evidence that the indemnity insurance is not still available to independent midwives. While Guild Insurance has made a decision to withdraw, they are not the only insurers available in the market. For example, Victorian midwives are not insured with Guild but through the ANF with MCA Insurance. I have received advice that other insurers have also not ruled out providing cover. It seems to be a beat-up to get government to intervene in a knee-jerk fashion.

I understand that the Victorian Labor government-John Thwaites is a very competent health minister-has demanded proof that no insurer is available in the market. I am surprised that we have not seen the same demand here.

A responsible approach to this issue must also consider the impact on other providers of birthing services. There are two independent midwives in the ACT and about seven VMO obstetricians, as well as four staff specialists who provide a great many more birthing services to ACT residents in our public hospitals as well as in the private sector.

These VMO obstetricians are experiencing increases in their indemnity premiums. You may recall that there were concerns that they would not continue their services in our public hospital last Christmas. A great deal of negotiation has gone on to come up with some arrangements to keep these doctors in our public hospitals. If the Assembly intervenes to subsidise self-employed midwives, you can expect further demands from this group regarding their premiums. We will not be subsidising just two independent midwives; we will also be subsidising the VMO obstetricians. Then no doubt we will be subsidising the GP obstetricians who will line up.

But it does not stop there. I have with me a letter I wrote only yesterday or the day before in reply to the Psychologists Board. The Psychologists Board are also trying to find assistance with professional indemnity insurance for psychologists. So before long the psychologists will also line up. Every private practitioner contracting to government will be looking to government to pay their professional indemnity insurance. This is not the appropriate way to deal with this issue.

We have to find solutions. I met with the midwives and sought to find solutions. They put out a press release not so long after saying I was doing nothing. I have to say that it was offensive and entirely inappropriate. Let me give you an indication of why it was offensive and tell you some of the things that have been done. When health ministers met in Adelaide last Wednesday, they discussed this issue at length. I put it on the table, the same as I had put medical indemnity insurance on the table some time ago. On my motion, they referred the issue to the national working group looking at changes to existing medical indemnity arrangements to provide a sustainable way forward. The working group, which is chaired by the chief executive of the ACT Department of Health, Housing and Community Care, is particularly looking at better ways of managing the long-term care costs, the key factor driving premiums up.

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