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With respect, Stretcher Bearer, I think you fail to understand some of the politics behind the decision to make indemnity insurance a requirement to practice as a midwife.
The politics is the problem. The battle between Midwife and Obstetrician has been going for years. Nurses from most significant specialties have battled with their Medical counter parts. Midwives until recently have been the only real independent practitioners though. With Nurse Practitioners, the playing field has been broadened.
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But surely you understand that, without that adequate insurance cover and therefore, under the new legislation, the right to practice, the choice of women in Australia IS limited? What do you think would happen, in 2009, if the last of the southern hemisphere medical insurers withdrew cover for OBs in private practice? Do you think the government would simply say "tough luck, no more private obstetrics?" Do you think obstetricians in private practice would accept that decision?
It's not just the choice of women, it's the choice of parents (reagrdless of Gender) for starters. Everything requires insurance to operate from Body Corporates to tradespeople. The insurance is required so the argument needs to be affordability and adequate coverage as the impetace for challenge.
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Originally Posted by Stretcher Bearer
Every one is happy until something sadly goes wrong and a poor midwife is sent into financial ruin because of inadequate insurance covering legal action.
That is a risk to no one - NO ONE - but the midwife concerned. It does not impact on her practice, or her ability to provide safe and competent care.
Unfortunately is does impact on everyone. Insurance prices drive fees. Insurers in the indeminty field base their coverage on risk. The midwifery profession (including the male midwives) needs to establish in their argument that the ability to provide safe practice is worthy of risk and subsequently reaosnable fees and coverage. Litigation unfortunately does affect practice in health care.
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Answer me this. Do you stop being a paramedic when you leave your workplace? Are you still a paramedic at home? Do you suddenly switch off your knowledge and skills outside of the workplace because you are no longer covered by insurance?
To suggest that midwives cannot call themselves midwives and acknowledge their years of training simply because outside of the hospital system they are not insured is insulting to midwives.
And another question - if you, as a paramedic, come upon someone in medical distress in public, when you are not on duty, are you ethically bound to offer assistance to the best of your skills and abilities? If so, is that as a paramedic, or as an untrained bystander?
You don't just stop being what you are trained to be because you are not insured.
The argument isn't about switching off knowledge. When I am not at work in a hosptial as a Critically Care Trained RN or in Ambulance service, I have NO legislative coverage to practice outside the boundaries of a member of the public. At a prang, I am a first aider, and only receive coverage for my actions if my employer reinstates me to duty.
I have no ethical compliance to provide care as either a Registered Nurse or Paramedic, off duty. Particlularly if I can be sued for my actions and I don't have personal indemity insurance.
I never said that Midwives can't call themselves Midwives outside the hospital system. When you work in a hopsital, even independently in a birthing centre, your employer pays the insurance and wears the liability. If you are in your own business you wear the liability, then you pay the insurance.
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Does anyone know the last time a homebirth midwife, in Australia, was succesfully sued by a client? This statement alone is indicative that you share the position of the government - that homebirth is in some way riskier than hospital birth or birth with a private obstetrician, and that therefore midwives need to be prevented from putting themselves at financial risk. That completely ignores that facts that a) independently practicing midwives are happy to take that financial risk because they are passionate about providing Australian women a safer alternative to birthing in hospitals, and b) that there is any increase in risk, when in fact, if appropriate screening and admission criteria are in place, the opposite is true.
Im talking about risk. Insurers make the assessment. If the government is still deciding that the risk is too high then, the arguments perhaps haven't been made the right way. Again, NO LAW HAS BEEN PASSED. I don't share alleged view of the Governement. What I am opposed to is over emotive campaigns the bury any real facts to acheive an outcome. The aim isn't about a safer alternative (an emotive caption on it's own) but simply another alternative. That implies that because we choosing to have our child in hospital things are less safe for us. However I guess we are safer because we will be in a family birthing centre ruh by Midwives.
There have been enough cases of apparent malpractice and negative outcomes form homebirths. It's all about suing, it's about risk. Home births despite being biologically sound (we've been doing them for millions of years) the aren't risk free.
I don't want this thread to degrade any further so my apologies to all, I've worked in the health care system for 20+ years in boith my qualfications so have seen a bit, hence my view. I just think that standing around beating chests isn't necessarily the best way forward.
[B]So all the best for the rallies. Hope to see Midwives out their doing what they do best.[/B]
