Fiona Martin (Reid, Liberal Party) Share this | Hansard source

I rise to speak on the Medical and Midwife Indemnity Legislation Amendment Bill 2021. Having had four children, I can tell you midwives matter. Midwives matter because they assist with the health care of pregnant women and babies, and help bring new life into the world. Midwives matter because every pregnancy and birth is unique and different. Midwives matter because there are real risks in childbirth. Even in an advanced country like ours, maternal deaths still occur. Birth trauma, unfortunately, is quite common, and sometimes babies are born needing immediate assistance to stay alive. Midwives matter because a healthy mother-child attachment is the foundation for a healthy relationship. We know that perinatal depression and anxiety are a frightening reality for many parents and can get in the way of forming a healthy bond early on.

In Australia, there are approximately 33,500 registered midwives. In 2019, approximately 306,000 babies were born. The Medical and Midwife Indemnity Legislation Amendment Bill 2021 contains important measures that will ensure privately practising midwives have coverage under the Commonwealth's medical and midwife indemnity schemes. The Midwife Professional Indemnity Scheme commenced in 2010 and enables Commonwealth contributions to be paid to eligible insurers for the cost of claims against eligible midwives. Under the Midwife Professional Indemnity Scheme, the government assists in providing affordable cover for eligible midwives through a contracted insurer by covering 80 per cent of the costs of indemnity payouts over $100,000 and 100 per cent of payouts over $2 million.

The first measure will broaden eligibility to the Midwife Professional Indemnity Scheme and the Midwife Professional Indemnity Run-Off Cover Scheme to all eligible midwives in private practice, regardless of how they are covered under insurance policies—for example, their own insurance policy or that of their employers. Currently, these schemes are limited to privately practising midwives endorsed by the Nursing and Midwifery Board of Australia to prescribe scheduled medicines covered under their own insurance policy.

All midwives who are endorsed by the Nursing and Midwifery Board of Australia to prescribe scheduled medicines will have access under the Midwife Professional Indemnity Scheme and the midwife professional indemnity run-off cover scheme if they enter into an appropriate insurance contract with the eligible insurer under the scheme. This expansion in eligibility will enable the current provider of the Midwife Professional Indemnity Scheme to provide for critical Aboriginal community controlled health services. This will include a choice to take up appropriate indemnity insurance for their employed midwifes who are endorsed by the Nursing and Midwifery Board of Australia to provide scheduled medicines.

This bill will close an eligibility gap that has resulted in the exclusion of all registered midwives indemnified from liability through their own insurance contract from the allied health schemes. The second measure in this bill will rectify this exclusion. Without change, any claims lodged by insurers relating to the affected midwives will not be eligible to receive the Commonwealth subsidy. These practitioners had eligibility under the Commonwealth high-cost claim scheme and the exceptional claims scheme before 1 July 2020. It was always intended that registered midwifes would have coverage under the newly formed allied health schemes from the 1 July 2020 implementation, and this bill rectifies this anomaly.

A bill like this does not come about easily, and there was much consultation before the government arrived at this point. The Commonwealth consulted with the Australian College of Midwives, medical indemnity insurers currently participating in the indemnity schemes and three Aboriginal community controlled health services who were seeking an indemnity solution for their midwives. The federal government also assisted in preparing thousands of additional nurses to ensure our healthcare system had the workforce, depth and capacity to respond to challenges during the pandemic.

In March 2020 the Australian government funded 3,000 scholarships for registered nurses to undertake online education to enable them to refresh their clinical skills. Over 5,000 nurses registered interest in taking part in this program, and all 3,000 scholarships were awarded. This was all about taking the action required to ensure our healthcare system was properly supported in the wake of a one-in-100-year event.

The Commonwealth's medical and midwife indemnity legislation does not preclude home births. However, the insurance product offered by Medical Insurance Australia under the Midwife Professional Indemnity Scheme does not cover this type of practice. Under the current arrangements, there is nothing preventing a midwife from approaching a medical indemnity insurer to request cover for home births under the Allied health schemes; however, it will be a matter for an insurer to determine whether they will provide this coverage, and this is because the Commonwealth cannot compel an insurer to cover this type of midwifery practice.

The Commonwealth currently only maintains an insurance contract with one eligible insurer under the Midwife Professional Indemnity Scheme to ensure eligible midwives have access to affordable professional indemnity insurance. There is no comparable arrangement under the allied high cost claims. Rather, this is a claims reimbursement scheme whereby the Commonwealth subsidises eligible insurers for 50 per cent of their costs of the claim above a threshold of $500,000.

The amendments in this bill will also support key Aboriginal community controlled health services to consider accessing appropriate professional indemnity insurance for their employed midwives who have been endorsed by the Nursing and Midwifery Board of Australia to provide scheduled medicines. The Aboriginal community controlled health services sought remedy from the government for access to an insurance product for their employed midwives. Through this bill, the Midwife Professional Indemnity Scheme will be opened up to all endorsed midwives irrespective of their employment status to support the current provider of the midwife professional indemnity scheme to provide insurance policy to these employed midwives under these arrangements should they wish to.

These legislative amendments will broaden the type of insurance arrangements that are eligible under the Midwife Professional Indemnity Scheme and enable appropriate insurance products to be provided to these health services. Without these amendments, no insurer has been willing to offer indemnity insurance to cover the scope of midwifery practice required by these services.

Following royal assent, these changes in schedule 1 of the bill to ensure all registered-only midwives have eligibility under the allied health service schemes will take effect retrospectively from 1 July 2020, while measures in schedule 2 of the bill, to remove all employment limitations in the Midwife Professional Indemnity Scheme, will commence on 1 July 2021. I commend this bill to the House.

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