Sharman Stone (Murray, Liberal Party) Share this | Hansard source

The Midwife Professional Indemnity Legislation Amendment Bill 2011 is a very important piece of legislation. It aims to correct two serious flaws in the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010. Once amended, and the coalition supports this amendment, this will ensure self-employed midwives can access the insurance scheme—what an absurd omission that was at the time.

The amendments also aim to fix up the Midwife Professional Indemnity (Run-off Cover Support Payment) Act 2010. The error in the latter act was a miscalculation which imposed a far higher tax on the premium income of insurers of midwives. The insurer would have paid more in tax than the entirety of the net premium. This has been passed off by the government as a typographical error, but it really is another example of sloppy policymaking that has had enormous implications for the profession of midwifery. It is a profession that has been under strain and stress for generations in this country as the competition continues between the so-called rights of doctors—mostly male doctors—to deliver babies compared to the rights of women and families to have choice, and to have that choice include midwives who are properly and appropriately insured.

Obviously, we the coalition support the amendments to the act. We want to allow self-employed midwives into the scheme which gives a Commonwealth contribution to the insurer for the cost of eligible midwife claims. We support the correction of the so-called typographical error which imposed the wrong tax calculation on the insurer. But midwives continue to wonder what this government has against highly qualified and experienced midwives being able to take out government supported insurance for home births. Particularly for many in rural and regional Australia, a home birth can be not only a preferred way to have the joy of new baby come into the home but also the safest and best option when you are many kilometres away from a hospital or when the travelling conditions are difficult. In some sort of emergency, like our recent floods, a lot of our women are better off by being assured that a home birth is an option if a professionally qualified woman is nearby.

Under this government's policy, midwives assisting with home births are still not able to be insured. They have a two-year exemption for insurance cover, which will run out in June 2012. Why can't these women come under this Commonwealth assisted MIGA scheme right now? The lack of security about their futures and their insurance status is obviously very problematic. Meanwhile, the absurdity is that all midwives—whether they are assisting in home births or not—must have insurance for the ante- and post-natal consultations, which are invariably part of a home birth program. So the whole thing is absolutely absurd. Midwives cannot get insurance for the home delivery, but they must have insurance for their support visits before and after the birth. This system can make for a serious problem, obviously, if a midwife wants to work with a team of other professional midwives but they do not have the special insurance that is required to cover home births and post- and pre-natal consultations.

There is another very serious problem with this legislation and the government's policy, and it again particularly affects rural communities. It is a fact that the Commonwealth insurance program, which uses the Medical Insurance Group Australia, will not insure midwives who are called to assist in fewer than 30 baby deliveries per year. It might be fine in metropolitan Australia for a midwife to give assistance in more than 30 deliveries a year—they may assist in 30, 50 or 80 deliveries a year—but in regional Australia many midwives are very busy and fully employed in doing a range of post- and pre-natal support, but do not assist in more than 30 deliveries a year. Under this scheme they are not insurable because they do not have the magic 30 deliveries a year that make them eligible for this MIGA scheme. I ask this government to immediately address this problem because it is a serious issue for highly professional midwives in rural and regional areas, who often have even more years of midwifery experience than their sisters in metropolitan Australia.

Under this government's policy and the MIGA involvement in the insurance for midwives you need to have at least three years professional post-graduation experience before you are eligible to access the insurance scheme. That is absurd. So a young midwife who has just completed her training, who has graduated and who is a professional midwife cannot access this government supported insurance scheme for three years. What other profession has that sort of constraint? What does that do to a young woman planning to become a midwife when she realises that for the first three years she is going to have exceptionally higher costs in trying to find some insurance—if she can—to cover that three-year period? It is extremely difficult. I refer in particular to Ms Andrea Quanchi. She is a midwife with 25-plus years experience. Her daughter recently graduated and of course she is not eligible for insurance right now. She wants to join her mother as a midwife in private practice. Andrea is a brilliant, professional and highly respected midwife who is the only midwife in private practice serving a large part of southern New South Wales and all of northern Victoria. She is an extraordinary woman doing an extraordinary job. Her services are much sought after, but she is caught in this insurance trap whereby midwives must perform homebirths without insurance for two years. She is caught in the trap where she cannot bring on newly qualified midwives to assist her in homebirthing because of the three-year rule. She is also caught in the trap where she cannot get assistance from other midwives to do pre- and postnatal consultations with her homebirthing patients because those professional midwives must have the insurance to undertake pre- and postnatal visits.

There was an incident recently in my part of the world during the very serious flooding. Ms Quanchi had a patient who had given birth but, unfortunately, she was on the other side of the floodwaters. She asked a very competent local midwife to undertake the postnatal consultation for her but found that this midwife did not have the insurance. She then approached the local Wangaratta hospital and was told they could not support her because it had been a homebirth and, 'It was her problem.'

The member for Lyne praised homebirthing. In Australia, we should have the option to homebirth and with the birth of subsequent children enjoy the special additional support that is provided to women in the home. As our previous speaker highlighted, in Australia we have some of the highest levels of medical interventions in births in the developed world. An extraordinary number of caesareans are undertaken and too often it seems those caesareans are undertaken for the convenience of the medical profession rather than for the best health considerations of the women who are delivering.

As everybody knows, we have a chronic shortage of obstetricians and gynaecologists in rural Victoria, and indeed throughout rural Australia. That is why highly professional, competent midwives are so critical to the delivery of health services in rural Australia. It again highlights the problem with this government's refusal to amend its catastrophic independent youth allowance policy. The independent youth allowance enabled country students who had finished year 12 and been offered university places—for example, in nursing—to go somewhere else to train, typically in a capital city. Those would be future nurses cannot now access nursing training and midwifery training because too often their families cannot afford the $20,000 or more that it costs for country students to be supported in their studies while living away from home.

We have the absurd situation now from yesterday's budget where another 16,000 skilled migrants will be admitted into rural and regional areas under the regional skilled migration scheme. On the other hand, we have discrimination in the access to the independent youth allowance—

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