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

Thank you. I have been a member of the health and ageing committee, as I mentioned, for some period of time. I was deputy chair when we brought down the report The blame game: report on the inquiry into health funding. When we did that inquiry, we looked extensively into the role of midwives and nurse practitioners. It has been my long-held belief that legislation like the bill we are discussing and debating here in this House today was needed. I did not see any moves from the then Howard government to act on those recommendations or to address that need.

In 2007 I was a member of the committee and we did an inquiry into the health benefits of breastfeeding, called The best start: report on the inquiry into the health benefits of breastfeeding. That inquiry really emphasised to me the vital role that midwives play, how their role needs to be expanded and how they need to have the rights that are being given to them in the legislation that we are debating here in the House today. It is a midwife who provides the support to a mother during pregnancy. Obviously, there is a very important role for obstetricians, but some women choose to have only a midwife’s support. After the birth is when a midwife provides the particular support that is needed in relation to breastfeeding. To hear those on the other side of this House sanctimoniously stand up and make the case that they support choice, they support midwives and they support women really turns my stomach.

I will get back to the legislation. This bill will support the inclusion of nurse practitioners and midwives under the Medicare Benefits Scheme and the Pharmaceutical Benefits Scheme, which is particularly important for those midwives who work in remote locations like Saibai Island and Thursday Island, as I mentioned earlier. These measures will help improve the efficiency, capacity and productivity of Australia’s health workforce, particularly in rural and remote areas, and it will make it so much easier for those nurse practitioners and midwives working in remote communities. When I was at Saibai Island last week, the nurse practitioner midwife there said that within the last month she had been required to assist in the birth of three babies whose mothers had come across from the Western Province of Papua New Guinea. Those births can be extremely difficult, and in those cases the excellent, highly qualified midwife can provide the assistance that is needed until the medical assistance of an obstetrician can be brought in.

These measures are vitally important for improving primary and maternal care. This legislation will allow nurse practitioners and advanced midwives to work in collaboration with doctors. I use Saibai Island in the Torres Strait as a very good example of where the skills of these midwives will be utilised. The new Medicare items covering these services will also be introduced, effective 2010. Specific Medicare items as well as PBS formulas specifying midwives and nurse practitioners will be managed through the minister’s determination. At this stage the government is not supporting funding of homebirthing. I have already referred to the communique that was released, and I can also refer to the transcript of the minister’s press conference on Friday, where she highlighted that there had been a breakthrough in the national registration and accreditation program. This has led to the resolution of the homebirthing issue. I hear people like the member for Mayo getting up and saying it is a backflip. It is not; it is the result of a lot of hard effort put in by the minister, who has worked constructively with the state health ministers to bring about a situation where this can take place. The Commonwealth signing on to the registration of the accreditation of 10 professions is about lifting standards, as the minister said. That is what it is all about.

I think this legislation has the ability to change the way nurse practitioners work. I should emphasise that, though I have talked a lot about those nurse practitioners working on Saibai Island, to a large extent it refers to nurse practitioners and midwives working in private practice. I felt the example of Saibai Island really showed how effective it was on the ground. In many areas throughout Australia there are no doctors on the ground. The simple fact that there are qualified midwives in those locations can really provide support that is needed. These midwives will need to meet advanced practice requirements and have collaborative arrangements with doctors. This is all about providing and ensuring the safety of those women who are giving birth and of their babies.

The reforms initiative supported by this legislation will allow for incremental reform with a strong framework of quality and safety. Quality, safety and being able to choose to have midwives and nurse practitioners when the time is right are what the Australian people should expect. It is expected that about 700 eligible midwives will participate in the measure over the next four years, so that will significantly expand the workforce and provide a lot of support to women throughout Australia. I have to emphasise that none of these bills have ever sought to make homebirthing unlawful—

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