David Gillespie (Lyne, National Party) Share this | Hansard source

I rise to support the Medical and Midwife Indemnity Legislation Amendment Bill 2021. As we all know, in the last 20 or more years there have been a couple of insurance crises. First of all, in public liability in the late nineties, a lot of huge claims went through and bankrupted many entities, not in the health system but councils and the like, that had accidents on their public spaces. It stopped a lot of stuff from happening in Australia—and finally it was sorted out. Then came the medical indemnity crisis, where some of the claims were exceptionally high, leading to premiums of a couple of hundred thousand dollars per year in obstetrics in particular—and we fixed that too. And then there was a problem with that same sector of the health market: one couldn't afford to retire because your premiums in your run-off cover were higher than what you were earning or winding down. Obviously, when markets fail, the government has to step in—so they did that.

In 2010 this parliament introduced two schemes to cover a similar situation with privately practising midwives. There are two existing midwife schemes—the run-off cover one, which is similar to medical indemnity, and the Midwife Professional Indemnity Scheme. The government basically assists the nominated eligible entity—Medical Insurance Group Australia are the nominated provider of the indemnity product—and this covers exceptionally high claims. Eligible midwives who are insured through them—if they make a claim, their insurer will obviously deal with the matter. For a very high-cost claim—above $100,000—the scheme supports 80 per cent of it. But some of the claims are absolutely astounding. Some of them are in the millions of dollars. Clearly, if you don't have insurance it would be a really bad outcome for the healthcare system, for the midwife and for the people taking the action. So, if there's a claim above $2 million, the scheme picks up 100 per cent of it.

There were changes in 2019 where we were strengthening primary care and guaranteeing Medicare. And there was an anomaly when they created the Allied Health High Cost Claim Scheme and the Allied Health Exceptional Claims Scheme in a similar vein. In all these changes, Aboriginal Community Controlled Health Services were left in a bit of a limbo, and some employed midwives were similarly in a bit of a limbo. These amendments correct those anomalies so that, whether you're an employed endorsed midwife or a privately practising midwife, you will be covered by this scheme. Employed or privately practising, there will be a scheme that will cover you.

The one thing it won't cover, at this stage, is homebirths. They have looked at the reasons why they don't. The insurers think the risks don't add up. But that is a very select part of the obstetric services market. The main people that were being hampered by this were some of the more remote Aboriginal Community Controlled Health Services that deliver obstetric services in remote and regional Australia. We want good health outcomes across the nation. Hence the initiative to correct the anomalies.

There's a lot of machinery in this bill, but it's very important. All of us have been brought into this world by a midwife. It's a very well-trained profession, and they deserve the support that everyone else gets from the government through the Medicare system. We want everyone to be able to have good, safe obstetric care, wherever you are in Australia. I support the amendments in this bill.

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