Jill Hall (Shortland, Australian Labor Party) Share this | Hansard source

I would like to commence my contribution to this debate on the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and related bills by providing the member for Mayo with some information that might help him, so that next time that he makes a speech he can actually put factually correct information to the House. I have in my hand a letter from one of my constituents who wrote to a local health fund. This constituent is a midwife and is a person who is very supportive of homebirthing and somebody I have had a long association with. She wrote to a health fund asking them why they had removed homebirthing from the schedule that they paid insurance rebates for. Oh, the member for Mayo has left the chamber. He did not want to learn or get the information that showed that what he presented to this House was factually incorrect. The letter reads:

Thank you for your response to my inquiry. You have stated that the removal of the homebirth benefit is due to the fact that midwives in private practice are unable to source professional indemnity insurance for the homebirth of a baby.

And this is the really key point—

This has been the case since 1 July 2001

Who was in government then? That has been the case since 1 July 2001, when those opposite were in government. Those on the other side argue that they have supported homebirths for a long period of time—so how could it be that it was removed from medical indemnity insurance when they were in government? I find it sickening to see those on the other side of this House standing up and advocating homebirthing when they were the ones who removed it from medical indemnity insurance. They have never supported choice for women. They have always adopted a very patriarchal approach to birthing and other women’s health issues, where they feel that they have the right to tell women what they need and what is best for them. I hear speaker after speaker after speaker stand up and advocate homebirth, and that is really out of character for those on the other side of the House.

I have been associated with midwives in my electorate for a very long time. I have attended picnics on the foreshore in Newcastle with midwives where they advocated homebirthing, and I stated my support for homebirthing in that environment. It was many, many years ago—around 2001, I believe—when the then government decided that they would not offer medical indemnity insurance for midwives.

Listeners to this debate could actually be confused as to what it is about. They could think that this was a debate about homebirthing; that is not true. This is an excellent piece of legislation that supports the inclusion of nurse practitioners and appropriately qualified midwives under the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme in line with the 2009-10 budget measures. This will enable these health professionals to request appropriate diagnostic imaging and pathology services for which Medicare benefits may be paid and to prescribe certain medicines under the PBS. The MBS and PBS benefits will be available from 2010.

The professional indemnity, which has been discussed at great length and which I will come back to in a moment, will commence on 1 July 2010. Medicare benefits and PBS subsidised medicines will not be approved for delivery outside of clinical settings. The Commonwealth subsidised professional indemnity cover will not respond to homebirthing but, as has already been said in the debate today, an agreement was reached at the COAG meeting on Friday.

I heard the previous speaker refer to ‘backflips’. I would like to refer him, and all those members on the other side of this House who are not in the House now, to statements made by the minister consistently through this debate that there were negotiations taking place between the states and the Commonwealth and that this matter would be resolved. I refer to the communique that was released on Friday, which says:

Health Ministers agreed to a transitional clause in the current draft National Registration and Accreditation Scheme legislation which provides a two year exemption until June 2012 from holding indemnity insurance for privately practising midwives who are unable to obtain professional indemnity insurance for attending a homebirth.

That is a far cry from what happened in 2001, when the Howard government removed that coverage from midwives. Professional indemnity insurance for midwives has always been quite an issue. I refer to the paper I have in my hand, from Australian and New Zealand Health Policy, which discusses the issue at great length—how Australian governments, particularly the Howard government, I have to say, appeared reluctant to protect the economic viability of the business of self-employed midwives. This legislation does give some protection to midwives, as does the agreement that was reached on Friday.

The government has committed $120.5 million over four years to maternity service reforms and $59.7 million over four years to expand the role of nurse practitioners. I might add that those on the other side of this House have always opposed the expansion of nurse practitioners. As a member of the House of Representatives Standing Committee on Health and Ageing over a very long period of time, I have seen many members on that side argue that nurse practitioners take away from the role of doctors. Last week I was in the Torres Strait Islands with the health and ageing committee and we visited Saibai, which is nearly the northernmost tip of Australia. There we saw firsthand just how vital the role of a nurse practitioner is, how essential it is for nurses working in very remote and rural locations to be able to work as nurse practitioners. They are delivering front-line services with doctors, hundreds or thousands of kilometres from where their health clinics are. That is the case in many areas throughout Australia. Mr Deputy Speaker—sorry, Mr Speaker; it is such an honour to have you in the chair.

See this speech in context