Melissa Price (Durack, Liberal Party) Share this | Link to this | Hansard source

The Midwife Professional Indemnity (Commonwealth Contribution) Scheme Amendment Bill 2024 will address the gap in the professional indemnity insurance market. This gap has prevented eligible midwives from accessing insurance when attending homebirths for Australian mothers. The uncertainty that this has created with regard to the exemptions to professional indemnity insurance for privately practising midwives has acted as a barrier for Australian women who wish to have a homebirth and uncertainty for the midwives who would like to provide these services.

In response, this bill expands the MPIS to ensure professional indemnity insurance coverage for eligible midwives providing homebirth services and intrapartum care outside of a hospital and at birth centres. The coalition supports this legislation as it provides Australian women with the option to make their own supported and informed choices when it comes to homebirth.

By expanding access to professional indemnity insurance, the bill supports eligible midwives in delivering safe and accessible care, including homebirths and intrapartum care outside of hospitals for non-complicated births. This will support greater choice for Australian women and families in their pregnancy journey and, particularly, assist mothers in rural and remote Australia, who face additional challenges in accessing maternity services within a hospital setting. It will allow Australian women greater choice to birth at home with their chosen midwife, with the security of knowing professional indemnity insurance is available in the case of an adverse event.

In the midst of a serious workforce crisis which is impacting almost all facets of our healthcare system, supporting healthcare professionals to work to their full scope of practice is integral to ensuring Australians have access to the healthcare services they need. This bill places trust on eligible midwives to practise to their full scope by allowing them to provide homebirth and intrapartum care outside of hospital within the safety net of professional indemnity insurance.

The coalition understands that Australian women need to be supported to be able to make choices about how they want to live their lives, and that starts with making sure governments are supporting women with their health. The coalition wants to ensure that women across Australia can access care and that we understand their needs and their experiences. Supporting the health and wellbeing of Australian women and girls is an absolute priority for the coalition, which is why we will be supporting this legislation.

A division having been called in the House of Representatives—

Sitting suspended from 17 : 08 to 17 : 14

Shayne Neumann (Blair, Australian Labor Party) Share this | Link to this | Hansard source

I'm pleased to speak on the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Amendment Bill 2024. The background to this is that the role of midwives and the issue of health funding and insurance became very obvious back in 2002—indeed, probably prior to that, after the insurance market collapsed after 9/11. The landmark obstetric birth injury case which resulted in a payout of about $11 million initiated a crisis of confidence in the industry with respect to midwives around the country. At that time there were around 200 privately practising midwives, and they were paying about $800 a year in insurance. That's simply not a big enough pool of funds to contemplate a payout of that magnitude, and obviously insurance for midwives was a longstanding issue.

The coalition—then in government, by the way—had another six or seven years to resolve the issues but simply did nothing. In 2008 we directed the Commonwealth Chief Nurse and Midwifery Officer, Rosemary Bryant, to conduct a review of midwifery services in Australia. I and a number of my colleagues met with midwives and lobbied the government to resolve this issue. I met with midwives across Queensland and spoke at a number of events, including a forum that was held by a maternity coalition in the state of Queensland. There are a number of local advocates across South-East Queensland who push this issue. We brought three bills before the House in 2009 to support Australian midwives.

Some anomalies emerged after this legislation. The purpose of the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010 and the associated Midwife Professional Indemnity (Runoff Cover Support Payment) Act 2010 was to support MBS and PBS arrangements enabling the establishment of a government supported professional indemnity scheme for eligible midwives by 1 July 2010. There was an unintended consequence in that the insurance seemed to cover in particular those who were dealing with private hospitals and large private obstetric practices as employers. But it didn't really cover midwives who were self-employed in private practice and in one-on-one settings or small settings.

There were also some tax anomalies that weren't covered. So we brought forward a piece of legislation back in 2011, the Midwife Professional Indemnity Legislation Amendment Bill 2011, to fix some of those anomalies that had created a higher tax on insurers of eligible midwives. We fixed a lot of those problems, but this issue really continued for another decade. Despite meeting with midwives across my electorate and elsewhere in South-East Queensland, this continued.

The Morrison, Abbott and Turnbull governments simply did nothing, frankly. It was a Labor government that attended to this issue previously, with prime ministers Rudd and Gillard. Then: crickets, under Abbott, Turnbull and Morrison. Now we've come in here, and I want to pay tribute to the fine work of the Assistant Minister for Health and Aged Care, the member for Cooper, who's driven this inside our government. It might have had something to do with her previous vocation as a nurse and her advocacy in terms of her leadership at the ACTU as well. But I want to pay tribute to Ged. Thank you very much for the work you've done, Member for Cooper.

At the outset, I want to say that we're committed to making sure midwives are empowered. We want to make sure we have a health workforce that is satisfied and retained. We want to enhance maternity care and ensure better health outcomes for Australian women and their families. And we want to improve choice. It's not all just about the medicalisation. Midwives have been around for millennia helping women, and we want to make sure women have the opportunity of choice. But we want to make sure those midwives are properly covered. If they're privately practising with the insurance system, if they're providing home births and intrapartum care outside of a hospital, they've got to have proper insurance coverage in today's world.

So, we're acting to cover this gap by providing privately practising midwives with a temporary exemption from the Health Practitioner Regulation National Law of 2009 to ensure that they continue to provide these services and give expectant mothers choice in how they want the birth of their child to occur. The 2024-25 budget then provided a permanent solution to the Commonwealth covering the costs of professional negligence claims for eligible midwives providing home-birth services, eligible midwives providing intrapartum care outside of a hospital and eligible entities, including birth centres, employing or engaging eligible midwives to provide intrapartum care outside of hospital as part of the birthing-on-country models of care. It's my hope that, after having spoken on this type of bill before on multiple occasions in parliament and outside, this bill fixes the problem that's been ongoing for decades.

This bill builds on the budget measures we have undertaken, amending the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010, which I referred to earlier in my speech. It ensures that eligible midwives practising outside of hospital settings have access to professional indemnity insurance. Tragically, there are some people in the medical profession and hospital administration that have an almost negative approach to midwives and who haven't understood that it should be up to women to choose. I believe it should be up to a woman to choose in relation to her pregnancy and the manner in which the birth should take place. The bill provides a framework under which the government will pay 100 per cent of eligible claims for relevant intrapartum services providers outside of hospital. The expansion of the act ensures the insurance coverage is there for home births and intrapartum care outside a hospital conducted in accordance with the Nursing and Midwifery Board of Australia's safety and quality guidelines for privately practising midwives. That's really important. The bill provides scope for rules to be made to specify the intrapartum services covered by the scheme.

It also extends 100 per cent coverage to eligible entities such as Aboriginal community controlled health organisations, or ACCHOs, that employ midwives as part of birthing-on-country models of care. That's particularly important and also very important in your electorate, Deputy Speaker Scrymgour. The bill will take effect from 1 July 2025 and provide a permanent solution to address gaps in professional indemnity insurance coverage for eligible midwives. The bill supports eligible midwives to practise their full scope of practice, giving women greater choice, and I think it's important, as I said, for that access to be done in culturally safe birthing-on-country services, which is not always the case. This approach supports the delivery of safe and accessible care and reflects consultation feedback that raises concerns in relation to previous proposals to develop a definition of 'low-risk home birth'.

The bill promotes the rights of individuals to enjoy the highest attainable standard of physical and mental health as it improves economic access to maternity services. The bill provides certainty to the current professional indemnity insurer of the Commonwealth's ongoing commitment to subsidise the costs associated with professional negligence claims against eligible midwives and helps them manage claims with the government as insurer of last resort for those expanded services. Tragically, when I was a practising lawyer in my younger days, I did quite a number of medical negligence cases, some associated with the birth of children, and they were far more often in a hospital than in a home birth situation.

The legislation addresses a clear market failure, as I alluded to before, and I think this is a very positive outcome for Australian women and their families. Women can choose to birth at home with their choice of midwife knowing that professional indemnity insurance is available in the case of an adverse event. Aboriginal and Torres Strait Islander women or women pregnant with Aboriginal and Torres Strait Islander babies will have access to continuous, culturally safe birthing-on-country services with insured midwife. Eligible midwives will be able to practise their full scope of practice, offering home births and intrapartum care outside of hospital with the safety net of professional indemnity insurance.

There's been so much consultation in relation to this. As I say, this is about choice and control. It's about empowering women. It's about making sure they can choose their birthing environment. It aligns to our broader goal of gender equality and fosters an inclusive healthcare environment where women can have access to continuous, culturally safe care. It aligns with Woman-centred care: strategic directions for Australian maternity services. Of particular importance to Australian families is the fact that they need that high-quality, respectful maternity care. It recognises the need for women to make those choices.

We've made a number of reforms in this area to improve the space, to attract more people into midwifery and improve the financial viability of independent midwives. From 1 November this year, we removed the red tape that prevents endorsed midwives and nurse practitioners from operating their full scope of practice. Legislating to remove collaborative arrangements has meant that nursing and endorsed midwives will now be eligible to independently provide the full range of Medicare services and prescribe certain pharmaceutical benefits medications. This change empowers midwives to work to their full scope of practice, improving access to quality care, particularly in rural, regional and remote communities.

We've invested in the Australian health workforce by upskilling the nation's nurses and midwives through a $50.2 million scholarship. And the Primary Care Nursing And Midwifery Scholarship Program provides 1,850 postgraduate scholarships over four years for registered midwives and nurses to become nurse practitioners and endorsed midwives in primary and aged care. That program strengthens the health workforce, particularly in rural areas.

On top of this, the eligible students have access to $319.50 per week as part of the Albanese Labor government's establishment of a new Commonwealth prac payment for students to help them manage the costs associated with the undertaking of mandatory placements. This will support midwifery students to undertake their studies and, of course, address the cost of living.

We have provided additional supports, but I've got to tell you, I am very pleased about this. This is a longstanding issue that I have been involved in for a long time and advocated for, along with some of my colleagues, some of whom are not still here in this parliament. This is about the Albanese Labor government improving women's health outcomes by listening to women and addressing systemic biases in the health system against women and taking important steps to build women's health into the foundation of a stronger Medicare system.

I'm pleased to support this legislation. It's the culmination of a lot of work by a lot of advocates—too many to name. I think of the meetings I've had in my office and I think of the four that I've gone to. I want to thank all these advocates for what they've done. Know that this will help women who are fighting for greater choice in control of their bodies.

Helen Haines (Indi, Independent) Share this | Link to this | Hansard source

I want to acknowledge the words from the member for Blair. Thank you so much for stepping us through what has been a long and at times complicated labour in the birth of this incredibly important legislation. As many members of this House know, I am still a registered midwife but no longer a practising midwife. Time honours the brave. Many of us worked long and hard and fought for reforms such as this right back to the 1990s. I remember what the member for Blair was telling us about those reforms that started in 2002 and then legislative changes in 2011. I remember them all and I thank him for his contribution to making those changes then. He also acknowledged Rosemary Bryant, and I remember the work of Rosemary very well.

I am just so pleased—thrilled, actually—to rise to speak to the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Amendment Bill 2024. If that young midwife, back in the nineties, could have possibly thought that she would end up in the parliament on the day when this legislation was being debated, she certainly would not have believed it. Those lovely things that happen from time to time about writing a letter to your younger self—well, this is a letter I don't think I ever would have written.

This is important. This bill will provide a framework which will allow the government to pay 100 per cent of eligible claims for relevant intrapartum services provided outside of a hospital. This aims to ensure professional indemnity insurance coverage for eligible midwives providing home birth services, eligible midwives providing intrapartum care outside of a hospital and eligible entities employing or engaging eligible midwives to provide intrapartum care outside of a hospital, including birth centres, as part of Birthing on Country models of care. These are fantastic models of care that are women centred, parent focused, baby friendly and evidence based.

What that means in practice is that eligible midwives will have access to the financial protection they need to confidently practise the full scope of their skills, to exercise their work away from hospitals in places where women choose to birth and to do that safely and confidently with the full protection of indemnity insurance. Equally, mothers—parents—will now have full confidence in knowing that, in exercising their choice to give birth at home under the professional care of an eligible midwife, they have this insurance coverage. This is really important.

Under current insurance arrangements, there's a significant gap in insurance coverage for midwives to provide intrapartum care outside a hospital, severely limiting access to homebirth and models of care so critical in our First Nations communities, such as the birthing-on-country models of care. The member for Blair outlined very clearly why that was the case: such small numbers of midwives would be unable to collectively contribute to the pool that would be required to get a commercially available insurance product.

This has been a problem for a very long time. Basically, no insurers have been willing to provide the cover for intrapartum care outside a hospital, in part because of the small pool of resources but also because they are unable to accurately quantify risks. This is because homebirth in Australia is very small because of the barriers that we've had to exercising and offering that model of care to women.

This situation has created a very real barrier for women who wish to homebirth and real uncertainty for those midwives who wish to respond to the choices of women. And that's what midwives want to do. They want to provide care that is evidence based, that fulfils their full scope of practice and that is what a woman wants, because if we combine those two things together we know we can get great outcomes. As a result, women were at risk of being transferred to hospital much earlier if they were in a homebirth setting—often much earlier than clinically necessary—and the continuation of culturally safe care and essential birthing on country, because of that, was in jeopardy as well. So we had some unintended consequences, with women having to enter the hospital system much earlier than ever they would have needed to had this insurance been available.

The bill provides scope for rules to be made to specify the intrapartum services covered under the expanded Midwife Professional Indemnity Scheme, the MPIS. The government's broad intent is to cover out-of-hospital intrapartum services where they're provided in compliance with the Nursing and Midwifery Board of Australia's Safety and quality guidelines for privately practising midwives. This bit is really important, because sometimes labours start to get a bit tricky right at the end, right before the baby is born.

There has been some toing and froing in trying to work out the criteria for a homebirth that would be covered by this insurance, and I'm just so pleased that the government have decided to embrace the Nursing and Midwifery Board's safety and quality guidelines, because they lay out very clearly the criteria that are important for a homebirth. It is tried and true and evidence based, and that's what we want. So I'm absolutely delighted about that.

Make no mistake: this change will allow more women and birthing parents greater choice to birth at home with their choice of midwife—and not only at home but with the person they want to have at home. I can't overstate how important this continuity of care is. It is really important that they can do this with the full confidence of knowing that, if on the rare occasion there is an adverse event, they're covered.

All women pregnant with an Aboriginal and Torres Strait Islander baby will have access to culturally safe birthing-on-country services. Deputy Speaker Sharkie, I know you know about this. I know you know what this means to First Nations women in Australia. Eligible midwives will be able to practice, as I said, to their full scope of practice, offering homebirths within the safety net of professional indemnity insurance. As I said, this legislation hasn't been an easy birth, and I want to acknowledge the decades of dedicated work from midwives, consumers, parents across Australia and the fantastic Australian College of Midwives to develop a fit-for-purpose private indemnity insurance product for individually practising midwives.

The Australian College of Midwives has engaged for many years with government and with the Department of Health and Aged Care to seek to contribute to the planning for an insurance solution. They've done this in good faith, they've done it consistently, and they've done it successfully.

I want to acknowledge the efforts of the Chief Nursing and Midwifery Officer, Alison McMillan, for her work in delivering this solution, which ensures public safety without imposing unnecessary restrictions. This is so important.

Of course, I absolutely applaud assistant minister Ged Kearney, the member for Cooper, and I see her fantastic staff over here. I know how much work you've put into this. I know the way that you engage with the people at the centre of the decisions this government is making when it comes to evidence based, safe, affordable, high-quality maternal care. So, thank you so much for your work. You have championed this bill and then shepherded the bill into the House. Women all over Australia, at all stages of their lives—through access to long-acting contraception, to birth, to menopause—benefit from so much of the work of Minister Kearney in this short term of parliament. So, thank you very much to the member of Cooper, the Assistant Minister for Health.

The current insurance exemption will be extended one final time to 31 December 2026, and I know how often midwives hang on this last extension, as we have been doing this for years. Any of them listening, please know: this is the final time, and this is to allow sufficient time to transition to these new arrangements and for regulation and policies to be amended and implemented.

Let me just reflect a little on why this matters. Planned homebirth involves care from midwives, who are registered experts in childbirth, and they want to do so in a woman's home. These registered midwives working privately are often there from conception right through to six weeks postpartum. That familiar face and not having to retell your story are absolutely critical to a birthing woman.

The research is absolutely clear on this. For women with low-risk pregnancies, planned homebirths attended by qualified midwives are safe and satisfying. They set people up for a positive experience of parenting. The research is absolutely clear, and we know that homebirths, when cared for by a highly qualified midwife, do result in less intervention than hospital births. Of course, there are a whole lot of parameters around that, if you want to understand the research in more detail. But it's really clear there's less intervention, and, equally as importantly, the women perceive their experience much more positively.

Midwives provide safe and well-regulated homebirth care, and, as a former midwife, I really welcome this approach by the government to underwrite this insurance. I know this is being celebrated right around Australia, because many women, consumers, dads and midwives have contacted me about this legislation; I've sat down with a lot of them. Many of the mothers actually have shared with me, and we saw this in the New South Wales inquiry into birth trauma, some very deep, personal trauma that they have experienced through previous births. For them, the only way that they can truly feel in control and have a real say in their next birth is to have a homebirth. It empowers them, and it sets them up in a situation that they want to be in.

One woman said, 'Being from a rural area with very limited continuity of care midwifery options, homebirth offers me the right to choose my place of birth and my care provider.' Another one said, 'My home is where I feel safe to give birth.'

I was really pleased to meet with Louise Thornton, a registered midwife with more than 18 years experience—Louise is from Yackandandah in my electorate—along with Rhi from Your Birth Photography and others to talk about how important the reform is to them and so many. I was able to say to them, 'Don't you worry; I'm batting for this big time.'

I want to acknowledge that there is a lot of fear associated with giving birth, and we can mitigate much of it by giving women control over the decisions that affect their bodies. And we know that much of the move of some women to taking choices around freebirth—where there is no professional care—is because of the issues they've had in accessing homebirth. This, again, is a fantastic remedy to address the trauma that many women have experienced and help them to utilise homebirth with a qualified midwife.

In the few minutes I've got left, I also want to recognise the other significant reforms in the roll back of collaborative arrangements and the increased access to PBS listed medicines for endorsed midwives. This is a package that, again, Assistant Minister Kearney has worked so hard on, to make sure that we truly acknowledge that midwives are primary maternity care providers. With the reforms that we're seeing in this legislation and other legislation, we are finally recognising the essential role of the midwife and the need to remove the barriers which stand between the midwife, with their professional expertise, and the women they care for.

As I said, a very long time ago, I worked as a midwife and set up a midwifery group practice with continuity of care under a known midwife. These reforms were part of our fight for achieving choice, control and evidence based care where the woman was at the centre. Back then, many women would have loved to have accessed a homebirth, but they could not—but maybe their grandchildren will be born at home, thanks to this fantastic legislation. It's deeply joyful to now be a member of parliament and speak on this bill.

Finally, I want to acknowledge my Parliamentary Friends of Maternal Health co-chairs, the member for Canberra and the member for Wide Bay, and the work that they do alongside me and alongside many consumers across Australia in continuing to put forward the absolute essential that we get the care of women right—through pregnancy, birth and postpartum—because that's how we set up our nation to be healthy and to live the best possible lives that they can. Start early, start right—this bill really helps us achieve that.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Amendment Bill 2024—an important piece of legislation because it extends the existing Midwife Professional Indemnity Scheme, a scheme that supports midwives to do their vital work with confidence. I chose to speak on this legislation for two reasons: because my mum started studying midwifery but didn't finish it—instead, she had 10 children—and because my neighbour Rachel is a midwife.

In a nutshell, this legislation means that eligible midwives who work in out-of-hospital settings can access the same professional indemnity insurance as their colleagues who practise in hospitals. This underpins Labor's belief that women should be able to choose where they give birth and, wherever it is, be able to do so safely. If they choose not to deliver in a hospital, women should be able to trust that they will receive equally safe, high-quality, respectful and woman centred care.

The Australian College of Midwives describes the role of midwife as a maternity care specialist with the knowledge and capability to ensure the best health outcomes for mother and baby; they are the mother's advocate, helping the mother to achieve the experience she wants. Midwives are acknowledged to be a critical part of our health system, and they are highly valued for their care, compassion and expertise.

This bill amends the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010. Specifically, it develops a framework for the Commonwealth government to pay 100 per cent of eligible claims for intrapartum care outside of hospital. Intrapartum refers to the time period from the onset of labour until the delivery of the placenta, the critical period where the child is born. It is a crucial time of care for both the mother and the child, and the midwife is there for it all, using their expertise to support the mother and literally guide the child into the world. The framework stipulates that the homebirths and intrapartum care outside of hospital must be conducted in accordance with the best practice guidelines, namely, the Nursing and Midwifery Board of Australia's Safety and quality guidelines for privately practising midwives.

The bill includes 100 per cent coverage for eligible entities which employ midwives for birthing on country, such as the Aboriginal community controlled health organisations. For numerous reasons, including maternal and community wellbeing, it is vital to safeguard access to culturally safe birthing-on-country rights for Aboriginal and Torres Strait Islander women, and this bill makes this possible.

The legislation will come into effect on 1 July 2025 and will resolve the existing issues of gaps in coverage. It will also give the professional indemnity insurer ongoing certainty of the Commonwealth's responsibility for the costs pertaining to professional negligence claims. As the amazing assistant minister said, this bill is about empowering Australia's hardworking midwives, supporting women and mothers and ensuring equitable access to continuous, culturally safe maternity care. It is a testament to our commitment to strengthening Australia's healthcare system.

It is that aspect that I would like to touch on now—the Albanese Labor government's extensive measures to improve the Australian healthcare system, especially for women. This year, the Women's Budget Statement highlighted the reality that girls and women experience gender bias in the health system. Unsurprisingly, this leads to poorer outcomes, such as delayed diagnoses and subsequent treatment and higher out-of-pocket costs. Girls and women may also be adversely affected by a lack of understanding and, unfortunately, sometimes even a stigma around women's health issues, such as menstruation, miscarriage and menopause.

This is just one of the reasons behind Working for women: astrategy for gender equality, and the government has committed to the aims of that report. These include not only the recognition of gendered health issues but responsiveness to them with fewer barriers to information, diagnosis, treatment and services. The strategy ties in with the bill we're discussing today, with the commitment to women having choice and access to safe and affordable maternal, sexual and reproductive health care.

This was the background to this year's budget announcement of nearly $50 million to not only enhance but revolutionise health services for women with complex gynaecological conditions. What this means is an additional 430,000 more services so affected women can receive longer consultations of 45 minutes or more. Medicare now pays the same fee to a gynaecologist for a long and complex consultation as it does for appointments for other specialities, such as cardiology and gastroenterology. This directly addresses the structural inequality that girls and women have endured for years.

At the same time, this year's budget provided over $58 million of funding to establish endometriosis and pelvic pain clinics across Australia. The clinics provide expert multidisciplinary care, enabling more appropriate and more timely diagnosis and management. Endometriosis is a debilitating chronic condition that affects one in nine girls and women in Australia. These clinics are ensuring improved pain management for sufferers, as well as building an expert primary care workforce. We're also adding longer Medicare consultations for patients with suspected endometriosis and pelvic pain.

Further measures announced in the budget include support for women who have suffered miscarriages and free period products via national Aboriginal community controlled health organisations, or NACCHOs. The budget also directed $57 million over four years from 2024-25 to promote high-quality and tailored maternity care. This applies to recommendations from the MBS Review taskforce for participating midwives. It increases the time for antenatal and postnatal consultations, more adequately reflecting the time that expert care actually takes—and then you set kids up for life. The funding covers the introduction of a six-week check-up after birth to help identify any mental health issues and ensures the all-important continuity of care with midwives.

These wide-ranging reforms benefit girls and women in every community across Australia. The extension of the professional indemnity program for midwives working outside of hospital settings indicates Labor's commitment to women's health and women's choices. As the minister said, the Albanese government recognises that continuity of care in midwifery is incredibly important and has the best outcomes for women and babies and we will continue to work to make sure that it is accessible and supported. This was another failure of the former government in health care, but, as always, the Albanese government cleaned up the mess. Thank you to Ged Kearney for the great work that you do in this area, and I commend the bill to the House.

Zali Steggall (Warringah, Independent) Share this | Link to this | Hansard source

I rise to speak on the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Amendment Bill 2024. It sounds technical, but it is incredibly important to women in their birthing choices. Equitable access to midwifery services is an important step in ensuring Australia's maternal healthcare system meets the needs of expectant new mothers.

This bill represents an important step forward, addressing critical gaps in care and providing necessary support to the vital work of midwives, who are essential to achieving better outcomes for both mothers and babies. The current scheme provides indemnity coverage for antenatal and postnatal care, but excludes intrapartum services provided by privately practising midwives outside of a hospital setting. This bill closes that gap, ensuring that government will cover 100 per cent of eligible claims for these services, no matter where the birth takes place. This change is a win for midwives and mothers alike, enhancing the safety and accessibility of birthing options across the country.

I commend the minister for her commitment to improving maternal care and listening to community concerns. The decision to remove the term 'low risk' from this legislation is particularly significant. It ensures that all women, regardless of how their pregnancy or birth is classified, have access to the support they need. This change promotes equity, providing women with greater autonomy and choice in how and where they give birth, as well as recognising the role of midwifery care in all aspects of maternal health.

Midwives play an invaluable role in supporting women throughout their pregnancy, childbirth and postpartum period. In fact, research from the Australian College of Midwives consistently shows that continuity of care with a known midwife improves the outcomes for mothers and babies, including reducing the need for medical interventions. Midwives not only ensure safe and positive birthing experiences but also provide vital postnatal care, including screenings for mental health concerns and domestic violence. They have that access to new mothers and are able to discuss any concerns and identify problems.

Tragically—it's quite an incredible statistic—suicide remains one of the leading causes of death for postnatal mothers. It makes the ability of midwives to give that continuity of postpartum care so incredibly important. These services are critical for the wellbeing of new mothers. They put midwives in the position and with the ability, to identify and have discussions if there are concerns from a domestic violence point of view. We know statistically this is the time when women are often most at risk because there's been such change to the relationship, so it is vital for mothers to have access to that care.

I also very much want to thank the minister for her engagement on the issue. Earlier this year, Assistant Minister Kearney visited Warringah to announce additional funding to support midwives in providing longer postnatal consultations. Again, that is really important because the longer consultation allows for that discussion to identify all those risk factors around domestic violence or the mental health of mothers. Those consultations allow time for comprehensive birth debriefings and mental health screenings, which are so essential for early intervention.

These were key changes that I, like many others, advocated for alongside the Australian College of Midwives, who have worked tirelessly to bring about these changes. I commend them for their hard work. This bill presents the next step in improving accessibility to midwives for young mothers.

As we move forward, we must remain focused on addressing broader systemic challenges, though, particularly improving health outcomes for First Nations women. We know that unfortunately the statistics are not good and there is not equitable access to health care. This bill will help provided greater access to birthing-on-country programs which assist Aboriginal and Torres Strait Islander women to give birth in a more culturally safe way, surrounded by family and community. The research indicates that this is important. Birthing on country provides better mental health outcomes, strong connection to cultural heritage and improved physical outcomes for mothers and babies. Again, those longer consultation times mean those screening factors can be present all the more.

In fact, Charles Darwin University's Indigenous Birthing in an Urban Setting study, to help close the gap in Brisbane, found that birthing on country reduced First Nation preterm births from 14.3 per cent to 8.9 per cent. That is a significant improvement. It shows the importance of creating and maintaining a maternal care system where women have greater choice, respect and support. Women must be at the centre of the system. The absolute priority must be greater options and choices in where birth can take place, how it can take place and especially that it be culturally appropriate.

This bill brings us closer to achieving that vision. I commend the minister for her leadership in this area.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.

Ordered that this bill be reported to the House without amendment.