House debates

Monday, 7 September 2009

Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009; Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009; Midwife Professional Indemnity (Run-Off Cover Support Payment) Bill 2009

Second Reading

8:01 pm

Photo of Michael JohnsonMichael Johnson (Ryan, Liberal Party) Share this | Hansard source

As the federal member for Ryan it is a great pleasure to speak in the House of Representatives, this great chamber of democracy, on the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and related legislation. At the outset, let me extend my very warm congratulations to my colleague from the Labor government Craig Thomson MP, the member for Dobell, on becoming a father. It is a wonderful gift of life that we men have the opportunity of becoming fathers. One of the joys of my life is my little three-year-old and I know that as the member for Dobell’s son grows up he will bring him immense joy, immense pleasure and, I hope, immense pride as well. On behalf of my wife, I extend my congratulations to him and his partner.

Being a father is my great joy and to some extent this collection of bills has relevance to fathers as well. I know on the surface of it, it seems it is all about mothers but I want to put on the record straightaway that I think this is not just about mothers exclusively or fathers exclusively; it is about parenthood. Fundamentally, it is about how those who are about to become parents choose to become parents.

Very briefly: the legislation introduced here in the parliament provides MBS and PBS access for nurse practitioners and midwives, to commence in November 2010, and Commonwealth subsidised indemnity insurance for midwives working in a collaborative setting. The legislation is in response to recommendations of the maternity services review. The indemnity insurance provisions will not cover midwives providing birthing services outside of a clinical setting. That is the starting point.

I was going to speak on this legislation with substantial anger, substantial frustration and substantial disappointment but I am going to now speak with measured anger, measured frustration and measured disappointment. It is measured because the Minister for Health and Ageing from the Rudd government has, I understand, in the last few days done a triple somersault and backflipped because of the pressure from the public, the pressure from all those wonderful women throughout Australia who have urged the government to see common sense. I will come to that in a moment because in my presentation in the parliament I want to talk about the larger issue that this legislation goes to.

Initially, a very significant part of these bills goes to midwives in the context of their registration and how they practise, whether they practise within the health system or external to the health system. On the face of it, those who practised as midwives without registration would have faced a maximum penalty of $30,000 had they not been exempted by the health minister’s backflip. Currently we know that insurers do not consider it viable to offer independent midwives indemnity insurance due to their small numbers and their lack of a risk profile. Women who have a homebirth privately contract with midwives without indemnity insurance, and this goes to the heart of the contention in this legislation. Some jurisdictions provide publicly funded homebirthing services, in a very limited number of locations, which should not be affected by this measure.

Of grave concern to me and to the hundreds and hundreds of women who have contacted me by phone, email and fax and the dozens of women who I have had the opportunity of meeting—and I want to thank them for taking valuable time out of their day to come and see me—is that this legislation seems to take away the choice for women. It seems to take away their right to choose to have their child at home with the professional care and skill of a midwife, forcing them to be part of the hospital system. Had this legislation gone through without that backflip, midwives would effectively have been forced to practise their skill underground. They would have been breaking the law, because this legislation would have put them in a category which would not be covered with insurance, and clearly that is just untenable.

I want to draw the House’s attention to the larger aspects of this bill, to its philosophical heart. The key aspect for the coalition in relation to the heart of this bill, as I touched on earlier, is the idea of choice for women. When Prime Minister Rudd gave his maiden speech on Wednesday, 11 November 1988, the very first lines were the following words:

Politics is about power. It is about the power of the state. It is about the power of the state as applied to individuals, the society in which they live and the economy in which they work.

I want to say to Mr Rudd, to all my colleagues in the House of Representatives—and, indeed, to my colleagues in the parliament—and certainly to all the constituents of Ryan: politics is not about power; politics is about empowerment. It is about empowering young people. It is about empowering individuals. It is about empowering businesspeople. It is about empowering entrepreneurs. It is about empowering women to make choices. That is what politics is about, and that is the fundamental divide between the government party and the opposition parties. We believe strongly, robustly, fervently and vigorously in choice. We believe that politics has a capacity to empower people.

We believe that women should be empowered to choose to have their births at home if they so wish. They know all the risks. They are informed. They are educated. It is not something, surely, that they would have taken on board lightly. Women have the right to choose to have homebirths and with the protection, the skill and the professionalism of midwives, who have trained for it. That is their role. No less so than a surgeon or a gynaecologist, they ought to be respected for their craft. They ought to be respected as an important profession that caters to a need in the community.

I certainly know that all the women of the Ryan electorate who came to see me, the dozens of them, and, I understand, the hundreds and hundreds who were here in cold, rainy Canberra today came to voice their statement of choice, to voice their preference for the right to choose. Why should a government say to these people, ‘You are criminals if you decide to have a midwife at home when you give birth’? Why should that midwife be classed as a criminal? Surely the government of Australia has bigger fish to fry. Surely the Commonwealth of Australia has greater priorities. Let us go out and catch the murderers, the rapists, those who destroy our society, the drug pushers. Let us go out and catch those people. They are the criminals. They are the ones who destroy our lives. They are the ones who destroy the fabric of Australian society. They are the ones that we should be pursuing with every national resource available to the Commonwealth government. Midwives are not criminals. But effectively, in two years time, when the provisions of this bill come up for review, when there is a reconsideration of the status of midwives, what will happen then?

I want to state very strongly on the record for the benefit of the people of Ryan, for the benefit of the women of Ryan and for the benefit of those who believe in their right to choose: I am for your choice, I am for your empowerment and I will continue to make public and to raise at every opportunity that the Rudd government is about the power of the state. It is about the power of the government, not about the empowerment of women and of individuals.

I went back to my maiden speech, just to compare it with what Mr Rudd had said in his maiden speech. This is what I said, for the benefit of the women of Ryan and for the women who believe in choice. This is what I said in my maiden speech, and it is very relevant:

Australia must always be a land of … abundance—one that is rich in opportunities for our people to pursue their hopes and dreams. ‘Equal opportunity, not equal outcomes’ is a description that sits at the heart of my Liberal political views. It is in this context that my philosophical view of the role of government takes shape. It must be the role of government to do all in its capacity to ensure that its citizens have the greatest opportunity of pursuing their life’s dreams. There must never be powerful state hindrance or cruel institutional barriers to individuals wanting to fulfil personal or professional goals.

‘There must never be powerful state hindrance’—well, this is state hindrance. This is the power of the state hindering those women. This is ‘cruel institutional barriers’. This is the barrier of legislation, a barrier to individuals who want to fulfil their personal choice to have their children at home.

I think a presentation like this would be remiss without me referring to the heartfelt thoughts of many women who came to see me to express their absolute anxiety, their absolute dismay, that a Labor government could go down this path, that a Labor government with, perhaps, a feminist minister would choose to close the door to women who wish to have their children at home, something which happens all around the world, where midwives are protected by law—whether or not they are protected with insurance. It absolutely astounded them. I want to make a reference to Hazel from Bellbowrie, who wrote to me:

Women will continue to exercise their right to choose where they give birth. By removing their option to be attended by a registered, skilled and competent Midwife, they will have no choice but to ‘free-birth’ (with no birth attendant at all) or employ a doula (an excellent supporter during childbirth, but not a practitioner trained and skilled in management of complications which may occur). This will lead to a totally unnecessary greater risk for mothers and babies, with potential for both neonatal and maternal morbidity and mortality.

I want to thank Hazel for her views there, going to the issue of the health and safety of those babies who would be born at home where mothers chose to exercise their fundamental right to have their baby at home.

This is from Carolyn of Kenmore Hills, a beautiful part of the Ryan electorate:

I … cannot fathom the reality that my beautiful birthing experiences will be lost to legislation and politics.

What I am saying is that the existence of CHOICE allowed me to choose the best birthing option for me. Hence allowing me to have the birthing experiences I had. Today I look into my daughter’s eyes and know I need to fight now for her right to CHOOSE her preferred place to birth. I will not take for granted the CHOICE I had and those who made it possible for me to choose.

Nicole from Chapel Hill says to me:

As my elected representative, I urge you to take women’s rights to maintain personal liberty and choose their care provider during pregnancy, birth and the postpartum period seriously. Please do not allow the Labor government to restrict women’s access to home birth and midwives in private practice.

There is that phrase again, ‘personal liberty’. It goes to the core of those on this side of the parliament—liberty, choice, freedom. Why would we decide to take that liberty away from individual educated, informed, smart women? These are not women that go into this decision lightly. We ought to respect that. Of course there are risks in doing that but they are being cared for by professional midwives and they are making that decision with the best information and advice. Let me go on to Jane from Taringa in the Ryan electorate, who says:

However, as an academic at UQ, and a practising midwife, I am particularly concerned that her [Roxon] announcement excluded support for home birth midwives. In particular I am concerned that Home Birth will go ‘underground’ and that women will be forced to birth at home without the support of a midwife, if they exercise their right to make a choice to birth at home.

Thank you, Jane from Taringa, for that statement. Here is a dig in the ribs to a Labor government:

But now I find that my ability to hire a private midwife is in jeopardy, and frankly I am quite disgusted.

That was from Kara from The Gap. Thank you, Kara, for making your feelings very clear indeed. Here is another from another part of the electorate, from Mary in Karana Downs:

Medicare funding for midwifery is long overdue. It is not acceptable however to exclude homebirth from the funding and indemnity arrangement. By doing this Australia is totally out of step with nations such as the United Kingdom, Canada, the Netherlands and New Zealand.

If Australia makes homebirth unlawful, it will be on par with the US state of Alabama where home birth is unlawful and capital punishment still exists.

Thank you, Mary from Karana Downs, for your very insightful remarks. As I said, I was going to speak earlier on with substantial anger, frustration and disappointment, but this is now more measured because the government has backflipped again. It has backflipped on this issue as it has backflipped, done a triple pike and a triple somersault on a whole bunch of policy issues. We should be accustomed to that by now from this Labor government. In power for 18 months, they are really out of their depth. They are all spin and very little substance and are superficially telling the people of Australia that they know best. They are extremely arrogant, and there can be no better example of the arrogance and the philosophical core of the Labor DNA.

I remember during the election campaign we were told that Mr Rudd was very similar to Mr Howard, that a Rudd Labor government would be a safe pair of hands and that they would be doing things pretty much similar to the Howard government. It would be steady as usual with a few differences here and there. Well, of course, now we know, after 18 months, that this Labor government has nothing on the quality of the Hawke government, for instance. This Prime Minister has nothing on the prime ministership of Bob Hawke. Certainly, Prime Minister Hawke would not have said that politics is about power; he would have said that politics is about empowerment.

I say to all those in the Ryan electorate, as I end my remarks, that the fundamental difference between the Labor DNA and the Liberal DNA is choice. It is about liberty, it is about personal responsibility and it is about empowerment. We are the party of liberty, we are the party of the individual, we are the party of personal responsibility and we are the party of empowerment. On this side of the parliament, I say to my colleagues very loudly, very clearly and very passionately that we must not let the Labor Party conquer that philosophy. We must stand firm. We must be resolute.

Liberalism is about minimal state intervention and liberalism is about being the driver of opportunity and options, not about being dictated by them. This remains the fundamental divide between this side of the parliament and that side of the parliament. I say to all my colleagues that, if you ever needed any cause to doubt, this is one policy example where even with a feminist Labor health minister they will have no qualms at all about intervening and intruding into every corner of our lives and into our lounge rooms. I use the example of lounge rooms because another battle is looming in relation to censorship of the internet. That is another superb example of the different DNA between a Labor government and a coalition government. We are not for intruding into the bedrooms of Australians and we are not for intruding into the lounge rooms of Australians. Certainly, we are the party of choice.

We stand resolute in favour and in support of all those courageous women around Australia who have said, ‘Enough is enough: get out of our lives, get your bureaucracy out of our lives and get your government out of our lives.’ Remember, politics is about empowerment; it is about choice and it is about liberty. It is not about power, Mr Rudd.

Comments

No comments