I’m a little late getting to this due to my weekend adventures. I can’t help but wonder if Nicola Roxon and the government will put their money where their mouth is or will go the way of so many other government reviews?

I would like to see the College of midwives get on top of this along with consumer group,uncle Tom Cobley and all. However, part of me thinks it’s a done deal. It is either going to happen and is on the way or the submissions are just us being tapped on the head yet again and it’ll just peter out as the voice of the AMA shouts louder and louder.

Now is the time to move and I for one am rallying the troops. Watch this space.

Doctors do not have monopoly on care: Roxon
Date: September 20 2008
Mark Metherell

DOCTORS face pay cuts if they insist on doing work that nurses could perform just as easily. The message, to be delivered tonight in a speech by the Health Minister, Nicola Roxon, is likely to anger the medical profession.

Her remarks indicate the Government is thinking of using financial disincentives to drive doctors to relinquish their monopoly on procedures which can be done safely by other professionals, such as delivering babies, issuing repeat prescriptions and wound management.

The speech, to be made in Bathurst tonight at the “Light on the Hill” oration, will call for an end to the “historical anomaly” of doctor-dominated health care. The annual event commemorates Prime Minister Ben Chifley, who fought an intense campaign by doctors against the Pharmaceutical Benefits Scheme, established in 1948.

Ms Roxon, who said Labor also had to overcome entrenched resistance from doctors to introduce Medibank, then Medicare, already has a combative relationship with the president of the Australian Medical Association, Rosanna apolingua.

“Doctors must and will remain central to our health system. But to date, professional resistance and government funding have prevented the development of a health sector in which services are delivered not only by doctors, but by other health professionals who are safe, potentially cheaper and, most importantly, available,” Ms Roxon says in notes for the speech.

But change would be likely to require “pricing signals”, she says. “Doctors will need to be prepared to let go of some work that others can safely do.”To ensure this transition, there needs to be an incentive for doctors to eschew less complex work, and focus on the work that does require their high-level skills and expertise. “Or if doctors do not want to let go of it, to accept being paid less for devoting their highly skilled and heavily trained selves to less complex tasks then they might.”

Ms Roxon points to the need for big changes to Medicare and the way doctors are paid, pointing out that general practitioners are paid for the number of patients they see, not for any health impact they might deliver. “The current Medicare structure means a GP will receive more money for seeing 10 patients in an hour then they will for seeing three patients, each for longer periods.”

This meant there was a financial disincentive for GPs to provide longer, intensive visits that preventive approaches demanded, including showing patients how to lose weight, keep fit and avoid diabetes. For GPs to be required to undertake prescribing a repeat for the birth control pill was “an extremely economically inefficient proposition”. “There is a longstanding historical anomaly here. Our health system, including funding for health services is organised almost entirely around doctors.” By implementing these reforms, Australia would not only be “redressing the historical bias towards medical intervention and acute care, we will be redressing the historical bias against the traditionally female nursing workforce”.

“A few good Labor principles all tied up in one set of reforms.”

This article is so demeaning to the role of the midwife. Never mind about downgrading doctors, what about rewarding midwives for their skill and specialist knowledge.

Here is what Dr Crapolingua sorry Capolingua had to say on behalf of the AMA (I think that stands for Anti Midwives Association LMFAO)

AMA President, Dr Rosanna Capolingua, said the AMA recognises that women like to have options and choice in relation to maternity services but it was critical that those options were safe and medically supervised.

If and when women choose to access antenatal care and delivery without access to medical supervision and back up, then they must be fully informed about what that choice means to them and their babies.

“We’re pleased to see that the Federal Government’s Maternity Services discussion paper released today already recognises that ‘unless such services can be developed in collaboration with GPs and obstetricians, there are potential safety risks’,” she said. The paper states that “today Australia is one of the safest in the countries in the world in which to give birth or be born.”

“Australia has seen a 35 per cent decrease in perinatal deaths over the past 35 years as a result of the excellent maternity care provided in this country under medical supervision.

“It is important that these good health outcomes are not compromised as a result of any changes to maternity services in Australia.”

Dr Capolingua said midwifery services operating independently and away from comprehensive medical care actually remove patient choice in complex or emergency situations.

“Women in these situations may not be able to get access to specialist obstetric, anaesthetic and paediatric care that they and their baby require.

“Many previous surveys have confirmed that women want to deliver at a location where they have access to a doctor. This makes them feel safe and secure in what are often unpredictable circumstances.”

I would like to take this opportunity to quote Dr Rant, one of the anonymous UK doctor conglomerate blogs – “What a load of wank!”

Related posts:

1. Latest Maternity Review News
2. Maternity Review – Push For Midwifery
3. Maternity Review – Part One
4. Maternity Services Advisory Committee
5. Maternity Coalition Update.