Media Release  -  Tuesday October 8 2002

No solution on indemnity crisis,
until appropriate practices are used.

In the words of David Molloy of the National Association of Specialist Obstetricians and Gynaecologists there is "no point pouring money into a bottomless pit" The Australian, 8/10/02. "This is what the Federal Government is doing, a band-aid approach costing the taxpayer so unnecessarily," said Dr Barbara Vernon, President of the Maternity Coalition.

The over-servicing by specialist obstetricians in the public and private maternity systems means that unlike any other area of the health system, healthy women access specialist care without any known medical problem. Millions of dollars more funding than is necessary, is being spent on this system, to provide safe and effective childbirth services.

For example, in 2000-01, Medicare paid for 1,457,473 non-referred consultations by an obstetric specialist¹. The cost of this service all up was $120.1million², and the cost to the public purse in Medicare rebates was $62,534,107. This amounts to approximately $250 for every woman who gave birth in Australia in the year 2000.³, or at least five visits for every pregnant woman in that year.

"In order to reduce the liability we need to reduce the risk. Using specialist obstetric staff for normal healthy women is like taking a cardiologist along with you while jogging, over the top, and unnecessary" said Dr Vernon "Yet in this case, taxpayers are footing the bill. Maternity Services in Australia need an overhaul."

Since 1985 there have been 30 public reports that have recommended greater use of midwives to provide maternity care to healthy women. Yet few if any recommendations have been acted upon.

International research confirms that primary care by a known midwife reduces the interventions used to achieve a safe birth. "Every intervention carries risks. The fewer the interventions used, the lower the risk" Dr Vernon said. "That's why we're saying to the federal government that they have to look seriously at providing access to primary midwifery services across Australia as part of solving the professional indemnity problem".

In New Zealand, the majority of women choose a midwife as their primary carer. In Australia less than 1 percent of Australian women are able to choose the care of a known midwife. In New Zealand the changes made to maternity services has resulted in

• 80% of women choosing a midwife (A turnaround from 14% 10 years ago)
• A strong alternate dispute resolution process based on mediation, where women and their families' grievances are aired resulting in far less litigation
• Savings to the Maternity Services budget of millions of dollars each year that are being channelled back into the health budget. The maternity budget has actually fallen each year since 1997.
• Professional indemnity cover for New Zealand midwives gained for the longest term of any health professional worldwide.

Media Contact: Dr Barbara Vernon 02 6230 2107, Justine Caines (02) 6247017

References:
HIC Annual Report 2000-01 www.hic.gov.au/annualreport/statistics/medicare_table16.htm 
AIHW Australia's health 2002, Canberra 2002 p 407
HIC Annual Report 2000-01 ibid table 7

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