Rural and Remote Families - the Ones to Suffer
That will allow doctors, who do not have to have obstetric training, to claim Medicare when nurses, who do not have midwifery training, provide antenatal care on their behalf. This would apply even though both may not be in the same town.
These changes to Medicare Item 16400 will only occur in rural and remote areas and were introduced despite a consensus statement from eight nursing and midwifery organisations and the Australian and New Zealand College of Obstetricians and Gynaecologists highlighting the risks.
“It’s simply outrageous” states Associate Professor Sue Kildea, Vice President of CRANAplus “they wouldn’t do it in the cities — once again we are diluting the provision of health care to Australians in remote areas, particularly Aboriginal and Torres Strait Islander Australians; a far greater proportion are living in these areas with more mothers and babies dying in childbirth”.
“It’s simply not appropriate to provide an antenatal training package for nurses in rural and remote areas and presume that this is enough. Not only is it against international recommendations, but it is in these areas that we should be providing increased midwifery resources not piecemeal solutions” Kildea states. It flies in the face of World Health Organisation recommendations regarding the provision of antenatal care, the protection of the public and accreditation of courses. “We have higher rates of mothers and babies dying in the bush and instead of sitting down and looking at how we can increase the midwives working in these areas, we have gone for this ill-conceived idea”.
Countries around the globe are striving to make pregnancy safer to reduce the maternal and perinatal mortality rate by ensuring midwives are located in the furthest reaches of the world. If this strategy really was about increasing antenatal care out in the bush, then midwives would be able to claim Medicare in their own right. This might encourage them to stay in rural and remote areas, and would bring more funding into these starved communities.
Remote area nurses do not want this responsibility; they want midwives working side by side with Aboriginal health workers to provide antenatal care. It is a safety and quality issue. “To be honest, I am surprised that the insurers are allowing this to occur when midwives are unable to gain insurance to perform the skills, and use the knowledge, that they have been trained in accredited programs to do. Do the Australian public realise the implications of this? We can only assume they do not”.
Urgent action is required to ensure that skilled care is available for all women in this developed country of ours, this must be seen as a non-negotiable national priority.
Associate Professor Sue Kildea
Vice President Council of Remote Areas Nurses of Australia
0418 289 199