The ‘low-risk’ definition scrapped

 

The Department of Health and Aged Care has advised the outcome of the recent stakeholder consultation on a ‘low-risk’ definition for professional indemnity insurance for privately practising midwives.  The department thanks you for your considered, thoughtful, and helpful feedback during the consultation process.

We have now reviewed all stakeholder feedback, in summary:

The department invited all state and territory Chief Nursing and Midwifery Officers, Chief Nursing Officers and Chief Midwife Officers, current insurance provider Medical Insurance Group Australia (MIGA) and 15 stakeholder organisations to submit responses to the consultation. A total of 227 responses were received from organisations, midwives, obstetricians, and consumers. The feedback highlighted concerns about the broad definition of ‘low-risk’, the exclusion of midwives’ continued role in care after referral or transfer, and the need for culturally safe care for Aboriginal and Torres Strait Islander women.

An alternative solution submitted by the Nursing and Midwifery Board of Australia (NMBA) and other stakeholder groups comprised utilising the current regulation framework, the NMBA Safety and Quality Guidelines for Privately Practising Midwives (SQG). This approach already provides a robust regulatory framework, that midwives must adhere to as part of their mandatory registration and regulation requirements and has a proven track record of safety to the public since its introduction to midwifery regulation in 2017.

Government has approved this approach to link indemnity for homebirth under the Midwives Professional Indemnity Schemes to compliance with the SQG, so a definition of ‘low-risk’ will no longer form part of the Bill. Instead, amendments to the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010 will provide scope for Rules to be made that specify the intrapartum services covered under the expanded Midwife Professional Indemnity Scheme. The Government’s broad intent is that out-of-hospital intrapartum services will be covered where they are provided in compliance with the NMBA’s SQG. This approach supports the delivery of safe and accessible care and reflects consultation feedback that raised concerns in relation to the original alternative proposal to instead develop a definition of “low-risk homebirth”. Government agrees that by trusting midwives’ clinical judgment within their scope of practice, and leveraging these robust existing guidelines, we can effectively support homebirth care in a way that ensures public safety while avoiding the potential pitfalls of a restrictive definition.

Government believes this change in approach, informed by extensive consultation and a thorough understanding of the complexities involved, represents the best possible outcome for all stakeholders. 

Additionally, to allow sufficient time to transition to these new arrangements, government is also seeking a final extension to the current National Law exemption for midwives to 31 December 2026. The exemption is currently due to expire on 30 June 2025. Extending the exemption to the National Law will provide reassurance to women and midwives that homebirth plans may continue without disruption during the transition and allow time for regulation and policies to be amended and implemented. We will advise the outcome of this in the new year once it has proceeded through government approvals.

Thank you for your continued support.