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Legislative Assembly for the ACT: 2001 Week 8 Hansard (8 August) . . Page.. 2548 ..

MR MOORE (continuing):

There is nothing to suggest that there is more litigation associated with home births. But when something does go wrong and the practitioner is shown to be at fault, the settlements, particularly in birthing, can be massively expensive. We have already seen settlements of over $10 million with regard to birthing.

Those settlements include a case where a judge said that he was not sure whether it was the medical practitioner who was at fault, but since the particular situation required money for the child he was going to award it anyway. This is one of the difficulties we have to work through.

The working group is looking at fundamental structural change and the best solution to the vexed medical indemnity issue. It is an extraordinarily complex issue that is not simply resolved in this way. It is appropriate that you call on us to do the work. It is appropriate that we do the work, but it is appropriate that we do it in the most effective possible way. The work is going on.

In the meantime, the government intends to explore the prospect of making home birth an option available within our public system. This is something I raised in Setting the Agenda, which I was pleased Ms Tucker quoted. Her speech was remarkably close to the argument put to me by those midwives who came to see me some time ago, so I presume she has used largely their information.

I have spoken to Professor Elwood. He has agreed with me. I spoke to him some three years ago about this issue. We will certainly look at extending the public program, which currently has a strong midwife element in it, to home birth. It is the appropriate time to do something that I have wanted to happen for some time.

Rather than knee-jerking about the costs of self-employed midwives, we want a model of care that is safe and that ensures that the woman and her family are well informed and that there is safe back-up available in hospital. Government must not close its eyes to quality and safety, nor must this Assembly. Quality and safety issues are fundamental to what is happening in Australia at the moment.

Government should not subsidise practitioners when it has no control over the safety of their practices or the way in which high-risk births are screened out of the home birth option. In the ACT we already have a team of midwives who provide continuity of care to women, with a midwife in attendance, at the birthing centre.

Having spoken to Professor Elwood, we intend to explore extending the program to allow a home birth option under safe, well-informed arrangements. I am not prepared to guarantee that I can do this very quickly. We will work on it, and we will work as quickly as we can, but we will do it in the proper way. We will make sure that the stakeholders who are involved have a say and have an opportunity to participate. But I will be requiring a report on progress shortly. I am happy to share that progress report with members of the Assembly in the Assembly or to distribute it when I receive it.

Ms Tucker referred to the only other model of home birthing being in Fremantle. I am certainly aware of the one in Fremantle. But a model very similar to the one we are planning for the ACT is in place in north Adelaide. The South Australian government

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