Division Description Changes — Bills — Medical and Midwife Indemnity Legislation Amendment Bill 2019; Second Reading — 16th Oct 2019

Change	Division
representatives vote 2019-10-16#1 Edited by mackay staff on 2019-10-18 17:06:21	Title Bills — Medical and Midwife Indemnity Legislation Amendment Bill 2019; Second Reading Medical and Midwife Indemnity Legislation Amendment Bill 2019 - Second Reading - Indemnity insurance Description ~~<p class="speaker">Chris Bowen</p>~~ <p>The Labor Party will be supporting the Medical and Midwife Indemnity Legislation Amendment Bill 2019, which seeks to improve the operation of indemnity insurance following a first principles review. This is a very important item and I note that this bill does go some way—but only some way—to addressing some problems in the current environment for Australia's midwives. The requirement that all indemnity insurers must provide cover to all providers who need it is a particularly useful provision in this bill. At present this universal cover obligation only applies to the four insurers who have contracts with the Commonwealth. This is a sensible extension which will help.</p> <p>I want to place on record my thanks to all the doctors, midwives, pharmacists and others who've contributed to the review process that has led to this legislation. We do support this legislation but I need to note that this will be an ongoing problem. This legislation does not fix some of the fundamental issues facing Australia's midwives. There are big gaps in indemnity insurance for Australia's midwives, and this legislation does not even attempt to deal with those. There are two major issues with midwifery indemnity insurance that it does not address: the lack of cover for homebirths and the lack of competition and choice in other midwifery cover.</p> The majority voted against an amendment to the usual [second reading motion](https://www.peo.gov.au/understand-our-parliament/how-parliament-works/bills-and-laws/making-a-law-in-the-australian-parliament/) that "this bill be read for a second time", which is parliamentary jargon for agreeing with the main idea of the bill. ### Amend*ment text > That all words after “That” be omitted with a view to substituting the following words:* > *> “whilst not declining to give the bill a second reading, the House calls on the Government to address the lack of indemnity insurance for midwives who attend** home births, as well as the lack of competition and choice in other midwifery cover”.* <p>There's only one provider for indemnity insurance for midwives, which means there is absolutely no competition in the market. The lack of competition—I freely acknowledge—is not an easy issue for the government to fix, but it is one the government should pay some attention to and should be trying to think of creative solutions for. The other issue is that there is no indemnity insurance for all homebirths. While there's an exemption for holding that insurance, it is set to expire, which, of course, creates massive uncertainty for midwives in relation to homebirths. This is not a sustainable situation, and the minister does need to be turning his attention to this issue. Ultimately, it could jeopardise the ability of midwives to attend homebirths. Parents should have a range of choices when considering their birthing options. One of those choices is to have a midwife attend a homebirth, but that may not be the case if the exemption is not extended or if there's not a solution found for the lack of indemnity insurance, because then midwives will have to respond accordingly to the risk.</p> <p>Our concerns about these issues are consistent with our longstanding support for midwives. It's important to remember that the last Labor government added midwives to the national registration scheme, which was a very important initiative in recognition of their professionalism and their importance in the health system. We ensured that regulations are on par with other medical professionals, as they should be. It also gave midwives access to a range of Medicare and PBS items for the first time.</p> <p>I was very pleased to attend the conference of the College of Midwives a few weeks ago and to address some of these issues at their important conference in Canberra and to express my support for midwifery and the roles they play in supporting new parents across the country.</p> ~~<p>I now move:</p>~~ ~~<p class="italic">That all words after “That” be omitted with a view to substituting the following words:</p>~~ <p class="italic">“whilst not declining to give the bill a second reading, the House calls on the Government to address the lack of indemnity insurance for midwives who attend home births, as well as the lack of competition and choice in other midwifery cover”.</p> <p>This amendment will give the House an opportunity to express its concerns about these issues. We don't pretend they're easy. This has been an ongoing issue for Australian midwives since 2002, when a major provider went bankrupt. Midwives deserve the support of the government of the day, and they deserve the attention of this House. So we call on the government to provide more attention to these issues.</p> ~~<p class="speaker">Rob Mitchell</p>~~ ~~<p>Is the amendment seconded?</p>~~ ~~<p class="speaker">Catherine King</p>~~ ~~<p>I second the amendment.</p>~~ ~~<p class="speaker">Susan Templeman</p>~~ <p>I rise to support the Medical and Midwife Indemnity Legislation Amendment Bill 2019 and the amendment moved by the shadow health minister. This issue did have its start in the major market failure that occurred in 2002 and which impacted midwifery indemnity insurance. Since then, various reviews have determined a way forward. I note the involvement of stakeholders like the College of Midwives, the Australian Nursing and Midwifery Federation and the Australian Medical Association, who are all supporting the fact that there is now action on this issue. I thank them for engaging in the process; I know it has been a long one.</p> <p>There are two unresolved issues in the midwifery indemnity insurance area. They both have an impact on midwives and, therefore, on women who seek to had a midwife at their birth and in particular at a homebirth. In my electorate of Macquarie a significant number of families choose to have a homebirth. That is their preferred option. The first unresolved issue is the lack of indemnity insurance for midwives who are doing homebirths. Midwives delivered both of my children. I didn't choose to have a homebirth, but we need to respect the right of women who want to go down that path and ensure that they have the support they need to do that, and that means having access to midwives. When midwives can't access insurance, the process becomes harder and riskier. That may well happen if the current exemption expires and there is no further action on it.</p> <p>In Australia about 0.3 per cent of births are planned homebirths. That compares with two or three per cent in Britain, up to five per cent in New Zealand and around 13 per cent in the Netherlands. That shows that, where there is support, there are women who choose this option—women like Aimee Sing, a consumer advocate with Homebirth Access Sydney and a part of the Blue Mountains homebirth community. She is a fierce advocate for this matter. She is keen to see any barriers to women choosing a homebirth—if that is their preference—come down.</p> <p>I also note that there have been calls recently from midwives and homebirthing groups for a Medicare rebate to be applied to homebirths. The minister has advised that the Medicare Benefits Schedule Review Taskforce will submit its findings on that matter before the end of the year. I look forward to that.</p> <p>I also note that this bill doesn't provide for any choice of insurer for midwifery cover. There is a monopoly; there is just one provider. Again, we are really limiting the choices for midwives. My concern with that is that it flows through to the choices that women have. They need to make decisions that are in their best interests, their family's best interests and their unborn child's best interests.</p> <p>I urge the government to address those issues. This really is about women having the ability to make choices about where and with whom they give birth. It's a very individual decision. What determines that decision shouldn't be insurance considerations.</p> ~~<p class='motion-notice motion-notice-truncated'>Long debate text truncated.</p>~~

~~Chris Bowen~~
The Labor Party will be supporting the Medical and Midwife Indemnity Legislation Amendment Bill 2019, which seeks to improve the operation of indemnity insurance following a first principles review. This is a very important item and I note that this bill does go some way—but only some way—to addressing some problems in the current environment for Australia's midwives. The requirement that all indemnity insurers must provide cover to all providers who need it is a particularly useful provision in this bill. At present this universal cover obligation only applies to the four insurers who have contracts with the Commonwealth. This is a sensible extension which will help.
I want to place on record my thanks to all the doctors, midwives, pharmacists and others who've contributed to the review process that has led to this legislation. We do support this legislation but I need to note that this will be an ongoing problem. This legislation does not fix some of the fundamental issues facing Australia's midwives. There are big gaps in indemnity insurance for Australia's midwives, and this legislation does not even attempt to deal with those. There are two major issues with midwifery indemnity insurance that it does not address: the lack of cover for homebirths and the lack of competition and choice in other midwifery cover.
The majority voted against an amendment to the usual [second reading motion](https://www.peo.gov.au/understand-our-parliament/how-parliament-works/bills-and-laws/making-a-law-in-the-australian-parliament/) that "*this bill be read for a second time*", which is parliamentary jargon for agreeing with the main idea of the bill.
### Amendment text
> *That all words after “That” be omitted with a view to substituting the following words:*
>
> *“whilst not declining to give the bill a second reading, the House calls on the Government to address the lack of indemnity insurance for midwives who attend home births, as well as the lack of competition and choice in other midwifery cover”.*
There's only one provider for indemnity insurance for midwives, which means there is absolutely no competition in the market. The lack of competition—I freely acknowledge—is not an easy issue for the government to fix, but it is one the government should pay some attention to and should be trying to think of creative solutions for. The other issue is that there is no indemnity insurance for all homebirths. While there's an exemption for holding that insurance, it is set to expire, which, of course, creates massive uncertainty for midwives in relation to homebirths. This is not a sustainable situation, and the minister does need to be turning his attention to this issue. Ultimately, it could jeopardise the ability of midwives to attend homebirths. Parents should have a range of choices when considering their birthing options. One of those choices is to have a midwife attend a homebirth, but that may not be the case if the exemption is not extended or if there's not a solution found for the lack of indemnity insurance, because then midwives will have to respond accordingly to the risk.
Our concerns about these issues are consistent with our longstanding support for midwives. It's important to remember that the last Labor government added midwives to the national registration scheme, which was a very important initiative in recognition of their professionalism and their importance in the health system. We ensured that regulations are on par with other medical professionals, as they should be. It also gave midwives access to a range of Medicare and PBS items for the first time.
I was very pleased to attend the conference of the College of Midwives a few weeks ago and to address some of these issues at their important conference in Canberra and to express my support for midwifery and the roles they play in supporting new parents across the country.
~~I now move:~~
~~That all words after “That” be omitted with a view to substituting the following words:~~
“whilst not declining to give the bill a second reading, the House calls on the Government to address the lack of indemnity insurance for midwives who attend home births, as well as the lack of competition and choice in other midwifery cover”.
This amendment will give the House an opportunity to express its concerns about these issues. We don't pretend they're easy. This has been an ongoing issue for Australian midwives since 2002, when a major provider went bankrupt. Midwives deserve the support of the government of the day, and they deserve the attention of this House. So we call on the government to provide more attention to these issues.
~~Rob Mitchell~~
~~Is the amendment seconded?~~
~~Catherine King~~
~~I second the amendment.~~
~~Susan Templeman~~
I rise to support the Medical and Midwife Indemnity Legislation Amendment Bill 2019 and the amendment moved by the shadow health minister. This issue did have its start in the major market failure that occurred in 2002 and which impacted midwifery indemnity insurance. Since then, various reviews have determined a way forward. I note the involvement of stakeholders like the College of Midwives, the Australian Nursing and Midwifery Federation and the Australian Medical Association, who are all supporting the fact that there is now action on this issue. I thank them for engaging in the process; I know it has been a long one.
There are two unresolved issues in the midwifery indemnity insurance area. They both have an impact on midwives and, therefore, on women who seek to had a midwife at their birth and in particular at a homebirth. In my electorate of Macquarie a significant number of families choose to have a homebirth. That is their preferred option. The first unresolved issue is the lack of indemnity insurance for midwives who are doing homebirths. Midwives delivered both of my children. I didn't choose to have a homebirth, but we need to respect the right of women who want to go down that path and ensure that they have the support they need to do that, and that means having access to midwives. When midwives can't access insurance, the process becomes harder and riskier. That may well happen if the current exemption expires and there is no further action on it.
In Australia about 0.3 per cent of births are planned homebirths. That compares with two or three per cent in Britain, up to five per cent in New Zealand and around 13 per cent in the Netherlands. That shows that, where there is support, there are women who choose this option—women like Aimee Sing, a consumer advocate with Homebirth Access Sydney and a part of the Blue Mountains homebirth community. She is a fierce advocate for this matter. She is keen to see any barriers to women choosing a homebirth—if that is their preference—come down.
I also note that there have been calls recently from midwives and homebirthing groups for a Medicare rebate to be applied to homebirths. The minister has advised that the Medicare Benefits Schedule Review Taskforce will submit its findings on that matter before the end of the year. I look forward to that.
I also note that this bill doesn't provide for any choice of insurer for midwifery cover. There is a monopoly; there is just one provider. Again, we are really limiting the choices for midwives. My concern with that is that it flows through to the choices that women have. They need to make decisions that are in their best interests, their family's best interests and their unborn child's best interests.
I urge the government to address those issues. This really is about women having the ability to make choices about where and with whom they give birth. It's a very individual decision. What determines that decision shouldn't be insurance considerations.
~~Long debate text truncated.~~