Senator Webber asked the Minister for Health and Ageing, upon notice, on 20 March 2003:

(1) Has the Government provided a response to the National Maternity Action Plan.

(2) Does the Government support the recommendations of the plan; if not, why not.

(3) Given that the World Health Organisation has determined that midwife-led births are the safest and most appropriate for healthy women, what is the Government doing to move towards this internationally-accepted best practice.

(4) What is the Government doing to reduce the rate of elective and emergency caesarean surgery.

(5) What is the Government doing to increase women's access to `continuity of carer' with a midwife through pregnancy, labour, birth and the postnatal period.

(6) What is the Government doing to increase access to midwifery care generally.

(7) What measures has the Government taken in the past, on either a pilot or permanent basis, to fund continuous one-on-one midwifery care for pregnant women.

Senator Patterson (Minister for Health and Ageing) —The answer to the honourable senator's question is as follows:

(1) No.

(2) Midwifery services are principally the responsibility of State and Territory Governments.

The Government has no plans to increase its role in relation to the provision of publicly funded community midwifery services, and does not support the extension of the Medicare arrangements to include allied health services.

The Government is working with the States and Territories to implement a range of measures, including to encourage insurers to make professional indemnity insurance available and affordable.

(3) Refer to Question 2 above.

The Government has provided assistance in areas where there is a need for national coordination. For example, the Government has provided funding of $4.3 million over five years for the Rural and Remote Midwifery Upskilling Program. This Program, which commenced in 1999, invests in the maintenance of midwifery skills in rural areas, allowing rural women to deliver their babies as close to their families as possible.

(4) There are a number of factors that affect caesarian rates including risks to the mother and baby, advancing maternal age, previous medical history, current complications and co-morbidities. Analysis of caesarian rates needs to take these factors into account and this in turn will be dependent on accurate information being available.

The Government provides funding to the Australian Institute of Health and Welfare to improve national reporting on reproductive health. The ability to provide clinically relevant comparisons of obstetric and gynaecological practice and outcomes across Australia is also currently under review.

(5) The Commonwealth Government makes a contribution to State and Territory Health Authorities for eight specific public health programs through the Public Health Outcome Funding Agreements. One of the eight programs is for alternative birthing services.

(6) Refer to question 5 above.

(7) Refer to question 5 above.