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Monday, 7 September 2009
Page: 8628


Mr IAN MACFARLANE (12:39 PM) —I listened carefully to the member for Shortland, but I must admit that at the end of the allocated time I was none the wiser as to whether she is actually a supporter of homebirths or not. What has been lacking in this debate all along—


Ms Hall interjecting


Mr IAN MACFARLANE —The member for Shortland interjects. She says she is. Well, why didn’t she say so in her speech? Why didn’t she come out and say to the midwives—


Ms Hall interjecting


The DEPUTY SPEAKER (Ms AE Burke)—The member for Shortland has had her time, and the member for Groom will not provoke interjections.


Mr IAN MACFARLANE —I will not provoke, Madam Deputy Speaker, but I was interested in the answer because the member for Shortland claims now, after she has delivered her speech, that she is a supporter of homebirths. She said in her speech that she went to a rally a few years ago. If that is so, why was she so silent when the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and related bills were introduced to the House? Why didn’t she, and every other member of the government sitting over there who say they support homebirths, speak up and say there is a flaw in this legislation, which couples homebirths to state registration requirements?

This government was on the verge of banning midwives attending homebirths, committing women to a situation where if they ask a registered midwife to attend then that midwife could not only face a massive fine but in fact be deregistered and lose her right to her livelihood. So where were all these people six weeks ago, before the minister did a massive backflip on Friday, before the minister changed her position to where she should have been? Where were all those people? Where have they been for the last six weeks? Why weren’t they speaking up? All those people who support choice, all those people on the government side who speak up for women’s rights—where were they on this issue? They were nowhere. They were silent.

The Minister for Health and Ageing changed her position last Friday because of the pressure that came from this side of the chamber, because of the pressure that came from those thousands of midwives who are standing out there in the rain as we speak. They went quietly to the minister for health. They said: ‘There is a flaw in what you are proposing. Because of the link to registration at a state level, there is going to be a problem in a registered midwife attending a homebirth.’ And what did we get from that side? Silence. They thought they could bluff it out. They thought it would not be an issue.

They should have been on the planes this morning, when babies and mothers—pregnant mothers, in some cases—were flying down here because the only time this government, this Prime Minister and that minister listen is when women go and stand in the rain, supported by their partners, to get a voice in this House. That should never be so. We need to see a more understanding government. We need to see a more compassionate government. We need to see a government that understands the detail of its own legislation. It took the minister nearly two months to realise the problem that was explained to her in words of single syllables by the midwives of Australia. They immediately knew that there were clauses in this legislation that were going to be a massive problem for midwives who operate in Australia.

Can I say categorically that every woman has the right to choose where she has her baby. It may not be the choice that my family makes. The birth of our two daughters is not something I would want to go through again. I know they say it is a wonderful experience, but the birth of our first daughter lasted 16 hours. It was not what you would call a quick delivery, and that daughter has been late most of the time ever since! Our second daughter was a little quicker, but it is not something that I would like to go through again. It was a wonderful experience and something that certainly leaves a memory, but whether my wife had decided to have those babies in hospital or whether she wanted to have them at home was, in the end, her choice. Whether my daughters make that choice, again, is their choice. But there are women now who are making that choice.

In my electorate, one birth in 15 is a homebirth. That is a staggeringly high statistic, for a whole range of reasons—lifestyle; experiences, perhaps with one birth in a hospital; personal beliefs. Whatever the reason, women need the right to have that choice. They need to be confident that if they make that choice they will then have access to the best care possible. As it originally stood, this legislation removed that right. It took away options that would have allowed women to make that decision or, more dangerously, to put them in a position where they would have to have a baby without a registered midwife. Imagine a government that says they care about the rights of individuals forcing women underground to have babies in seclusion, away from all the medical help. And do not think that they would not. There are some women who will do what it takes, as they say, to have their babies the way they want. In that situation the mother’s life, and the baby’s life, are being put in danger.

I am grateful for what the minister did on Friday. She has taken, as the member for Shortland said, an incremental step, but she has not come up with the solution. She has provided two years breathing space. That is not a solution. That smacks to me a little bit of, ‘Let us get this on the other side of the next election before we make a decision.’ That could be a cynical comment. I hope it is, because I hope the minister is committed to fixing this problem because she has not fixed it yet. She has said that you do not have to have indemnity insurance if you are a registered midwife attending homebirths. That is no solution. Everyone knows—and the Howard government started this process—that indemnity insurance is critical to protecting the professionals who operate not only in the medical area but everywhere. We as a government recognised that there would have to be assistance in some cases in paying those premiums. That is just the way the world is. No-one likes it, no-one believes that it should be this way, but that is the reality. A civil case now can amount to millions of dollars of damages and for a midwife often—in fact, in virtually every case—that would mean the complete destruction of her or his business.

As we move forward, firstly dealing with the whole area of obstetrics, the Howard government took steps to ensure that we filled the first major holes of assisting in indemnity insurance. I am not going to stand here and say that we got it all right. What we did we got all right. We did not make a mistake. We did not exclude anything. We did not say to doctors, ‘If we provide assistance to you for your indemnity insurance you cannot do this or you cannot do that.’ We are not into specifying to professionals who know better what they should and should not do. There are other mechanisms for that. I do accept that we needed to go further, and in the fullness of time we would have. That baton has now been passed to the Labor government. As I say, I acknowledge that in this area, particularly for midwives and nurse practitioners, the government has introduced a number of very important pieces to this legislation: for instance, the right to request certain diagnostic imaging and pathology services, the right to prescribe certain medicines under the PBS, a new Medicare item and referrals under the Medicare benefits schedule for midwives and nurse practitioners working in collaborative arrangements with doctors. The bill goes on to cover a range of areas in regard to assisting with insurance and providing a tender process for indemnity insurance. There are within this legislation that we are talking on today provisions for the imposition of run-off cover support payments as a levy on insurers’ midwife professional indemnity insurance premium income—all good things that this side of the House supports. We support midwives. We support the work that they do. We see them as incredibly important.

I turn to my seat of Groom and my city of Toowoomba. Toowoomba is a very fertile place. In fact, in October last year it was shown to have 2.07 babies per woman over the preceding three years. The state average happened to be 1.92. I am sure it has got nothing to do with cold nights or anything else. We just see ourselves as living in a very fertile part of the world, both in growing crops and also babies. But, as I said, the interesting statistic that was not in that article and that has since surfaced is that one in 15 mothers chooses to have a homebirth. That is the principle that the coalition has forced this government to recognise: every woman has the right, whether they live in Toowoomba, in Canberra, in Nimbin or in the Riverina, to choose where they have their baby. Every woman has the right to choose whether or not they attend a hospital for the birth. This legislation, as it stood, undermined a woman’s right to choose how she would experience childbirth and limited her ability to decide what was in the best interests of her own body, her unborn child and her family. The minister knows that that is the case. That was proven by what she did on Friday. She accepts now that, through the link of state registration and the requirements of state legislation, she was taking away a right. She has not fixed it yet, and I guess our role between now and the next election is to ensure that she does not just prevaricate on this issue but actually gets down to doing something about it.

We need to ensure that women not only have the right to choose but have access to the very best of medical care when they do choose to have a baby at home. They need to have access to a fully registered indemnified midwife who can collaborate both with other midwives and with all the other doctors and obstetricians within the health service to ensure that that baby is born in absolute safety and is born in an environment to the choosing of the parents, particularly of the mother. If the mother decides to have the baby at home, then so be it. We as a parliament and we as a country should provide the support for a woman who makes that decision.

I must admit that when this debate about midwives started, around three years ago, I was not as passionate as I am now. I have always believed in the right of individuals to choose. That is a fundamental Liberal right. It used to be a fundamental Labor right, but they have stepped away from it. I believed that women could do what they chose to do—in fact, in my family they did anyway. I needed, though, to get my mind around the issue of homebirths. Coming from my background, slightly conservative, and from a family that, on my father’s side, has a history of birthing problems, I found the idea of homebirths certainly rang some alarm bells. That is when Liz Wilkes, who is not only a local midwife but also the national president of Australian Private Midwives Association, started coming to my office regularly to change my attitude towards homebirths. What she has done very successfully—not emotionally but very professionally—is to outline the facts relating to homebirths: the experiences in other countries, the process that takes place when a woman decides to have a baby at home, and the fact that, along with her right to choose homebirth, a woman should have the ability to make the right decision about every aspect of that birth—that is, that the baby be born not only in a home environment but in such a way that there is virtually no risk to both mother and child.

I acknowledge the work that Liz Wilkes has done, particularly in the last six months, to ensure that this legislation as it was originally framed did not pass this House and that concessions were gained from this government. Those concessions still have some distance to go, but people like Liz Wilkes and members of the midwives association right across Australia have brought this government to account and made it see the error of its ways. Just to make sure of that, the midwives association has also assembled the thousands of women out there in the rain today—women who will not be taken for granted on this issue.

This is not just about those women who want to have babies at home; it is about men and women who believe in the right of choice. They are the people being represented down there in front of Parliament House today: people who believe that women have the right to choose. We on this side believe that, but I sometimes wonder if those on the other side still do. It seems to me that their voices have become muted since they got into government. It seems to me that all the people who used to speak so freely when they were on this side of the chamber suddenly have been forced to toe the line. I will be interested to hear whether those who are left to speak in the debate speak up in support of the midwives who are assembled down there.

It seems odd to me that, with so many women and so many men who support the rights of women sitting on that side of the House, not one Labor member spoke to the midwives assembled on the lawn at the front of Parliament House. That says to me that perhaps they are not fair dinkum. I hope, as we go forward with this legislation, that I am wrong. The Senate will provide further information through its inquiry, which had over 2,000 submissions, a record number. Two thousand submissions should have been enough to tell the government that something was wrong, but they were not. It was not until those women prepared to assemble down there, started to book their flights and to travel to Canberra last week, that this government actually decided to do something about it.

The shame of all of this is not that a disaster almost occurred in the formation of this legislation; it is that professional men and women who are midwives have been distracted by the flaw in this legislation for the past six weeks. They have spent more time on this, in some cases, than they have on what they want to do, which is to deliver babies for Australians. This government needs to fix the problem. This government needs to ensure that women have not only choice but access to the full broad spectrum of birthing options when they deliver their babies. That is what this country is all about. It is what we who sit on this side of the House are all about. We believe in women having the right to choose. We do not believe in shutting off options that are safe. We believe that the government does not have to regulate everything to the point where it is impossible for people to deliver their babies in their own home.

I will be following this debate closely as we go forward from here. If those on that side of the House want to have any credibility in this matter they should be down there talking at the rally. They should be speaking up in this chamber. They should be saying to the people of Australia: ‘We realise there was a problem. We are going to fix it. We have not just deferred this for two years to get it on the other side of the election. Let’s fix it now. Let’s see the numbers from the health minister, see what it will cost and what we can do to fix the problem.’