June 2021

Medical and Midwife Indemnity Legislation Amendment Bill 2021

It's a privilege to talk on the Medical and Midwife Indemnity LegislationAmendment Bill 2021, which is fundamentally about giving mothers-to-be and parents-to-be choice and control.It's about supporting the principle that mothers-to-be should be at the centre of maternity care and the birthing process and that they should have access to a wide range of choices about how they give birth. The amendments made by this bill will mean that all privately practising midwives can access one of the Commonwealth's medical or midwife indemnity schemes.

The bill implements the 2021-22 budget measure in two distinct ways. Firstly, it expands the MidwifeProfessional Indemnity Scheme and the Midwife Professional Indemnity Run-off Cover Scheme to cover claims made against midwives in private practice whose registration has been endorsed by the Nursing and MidwiferyBoard of Australia to prescribe scheduled medicines—so-called eligible midwives—irrespective of whether the midwife is covered under a professional indemnity insurance policy as an employee or in an independent capacity.This addresses an anomaly that had arisen depending upon what sort of insurance policy midwives held, either as an employee or in an individual capacity, to make sure that both categories of midwife can nonetheless access the Midwife Professional Indemnity Scheme and the Midwife Professional Indemnity Run-off Cover Scheme.This was a particular request of the Aboriginal community-controlled health services, who sought government support to ensure access to an insurance product for their employed midwives, and this amendment will help ensure that. This cohort of midwives had been unable, up to this point, to obtain indemnity insurance to extend their services to intrapartum care under an indemnity insurer.

The second thing this bill does is amend the Medical Indemnity Act 2002 to ensure that claims made against midwives in private practice whose registration is not endorsed by the Nursing and Midwifery Board ofAustralia to prescribe scheduled medicines—so-called registered-only midwives—are nonetheless eligible under the Allied Health High Cost Claims Scheme and the Allied Health Exceptional Claims Scheme, where the claim relates to incidents that occurred on or from 1 July 2020. Previously, claims against some registered-only midwives were not eligible for the allied health schemes, based on whether the midwife could be expected to be covered by an employer's indemnity arrangements. What this does is create parity of arrangements for all other registered allied health professionals under the allied health schemes. It means that employed endorsed midwives currently not participating in the midwife schemes will have the choice to stay under their current arrangements, and if an eligible claim is made in these circumstances the allied health schemes will respond. This flexibility supports midwives to work in a variety of different arrangements without their indemnity insurance being a barrier. Amendments made by this bill will mean that claims against all privately practising midwives will be eligible under the Commonwealth's medical and midwife indemnity schemes if an eligible medical indemnity claim is made.

Continuity of midwifery care is the gold standard of maternity care because it leads to the best possible out comes for mothers and babies. As we know from research, care from the one midwife throughout pregnancy, birth and the postnatal period results in better satisfaction with the birth experience for mothers, greater likelihood of carrying the baby to term, reduced birthing trauma for the mother and the baby, an increased chance of breastfeeding successfully and better outcomes for babies. The end result is happier parents, happier babies and less cost to the health system. Fundamentally, that is what this bill is about.

I have been a partner to three births in my own family, all of which were facilitated by midwives. The first birth was done in the midwife's home, the second birth, in the United States, was done at home and the third birth was in a midwifery centre attached to a hospital here in Australia. My wife and I are both great supporters of and believers in the valuable services that midwives provide and the level of care and support they provide to parents-to-be, both mothers and fathers, and of course to the babies. I know personally—and certainly my wife does as well—that we would not have had the birthing experience we enjoyed with our three children without the care and support, the attention and the nurturing love and affection of the midwives with whom we worked, both in the United States and in Australia.

We had our first two children in the United States, where many people would know that the practice of obstetrics is a highly medicalised one. My wife and I, having our first child, were quite put off by the directness of the obstetricians we dealt with and their insistence that things would have to run a certain way and that the birth would occur on a certain day in a certain fashion. That's why we sought out other assistance. We found midwives who practised at a clinic in Alexandria, Virginia. That's where we had our first baby, Diana. That experience was immensely positive. The midwives were thoroughly professional, caring, attentive and nurturing. They did their job exceptionally well, with a high level of care and to a high standard of care. That experience led us on to having our second child at home in Washington DC, with midwives in attendance, and then in Australia, because that was not an option, having our third child at a birthing centre attached to the hospital just down herein Deakin in the ACT.

As I said, midwives deserve all the support they can get from us here in the parliament and us in Australia. This bill, by helping to give mothers-to-be and parents-to-be choice and control, supports the principle that women should be at the centre of maternity care and birthing choices and that they should have access to a wide range of birthing choices. The amendments made by this bill will go some way to addressing some anomalies and ensuring midwives continue to play an important role in our society, in the life of families and in the arrival of new children into the world. I commend this bill to the House.