RE: [ozmidwifery] Request for information on current models of midwifery led care

[B & G]

Title: Message

Helen, From my limited knowledge as an ex-kiwi there is no opportunity to sue. I hope others will correct me if I have got it wrong. If an adverse event occurs the injured person have the right to be supported or as long as it takes for recovery or for comfort by the ACC. This was set up in the early '70's people pay for this from their taxes. Effectively this is a universal insurance scheme, no lawyers (boy did they scream loud then) and no fault access. Things were further refined about 5 years ago. I made a claim about 1978 when I was belted by a cow I was milking smashed glasses and crook back. I was paid ACC instead of a wage, had my glasses replaced and all was right. I can reactivate my claim if anything further happens although I think this aspect was changed recently. Cheers Barb -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Graham and Helen Sent: Monday, 2 August 2004 4:52 PM To: ozmidwifery Subject: [ozmidwifery] Request for information on current models of midwifery led care Seeking a bit of information please...   In the process of MOs arguing against midwives working as primary carers in normal healthy low risk pregnancies, I have known them to come out with comments such as:    "What if they (the midwives) don't act on a problem and the doctor only becomes involved when the s...t hits the fan........then who's fault is it???" "Midwives aren't qualified to make the decision about when things are outside the normal" "Medical indemnity insurers will stop insuring hospitals if a doctor is not in charge" "The perinatal mortality rates would increase!"     I know that midwives act as primary carers in NZ, Holland and even in WA.  They are also primary care givers in various midwifery models throughout Australia.   But I don't have knowledge of the intricacies about truly midwifery-led models to use as ammunition.   I do know that midwives are quite able to distinguish between the normal and abnormal  and if they don't refer someone on as necessary, they should be and are held responsible as part of their registration requirements/code of ethical behaviour.    When responding to such criticisms against midwives, I also like to make comparisons between GPs and Specialists.  Just because a GP misses something or behaves negligently, we don't say "that's it" everyone has to go straight to see a specialist as GPs can't be trusted!!!!!  But this seems to be the case when comparing midwives to doctors/specialists.    For my own knowledge and to assist me in my future responses to such criticisms, can anyone tell me the following:   1.  Medical indemnity status of midwives working in New Zealand - my understanding of it is that they work under the control of the health department and   2.  If anyone gets sued it is the hospital/health service.  Is this correct?   3.  If the hospital is successfully sued, where does the money come from if a huge payout is granted.  My understanding is that taxpayers all contribute somehow to a government fund for such purposes.    4.  Do all the women see a doctor at the beginning of pregnancy to be screened as low or high risk or does the midwife screen them and refer them on if needed.   5.  Do all women see a doctor in labour on admission or do the midwives totally provide the support/care with medicos only being called if there is a problem.   6.  What are the comparisons between perinatal mortality and caesarian rates between countries with midwifery led care and Australia - I've heard they are lower but don't have any research to back my claims.    I know I could search the net all day to find out the above answers but as we have so much combined knowledge on this list I decided to try here first.   Thanks in advance     Helen Cahill