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Maternity services framework to be redrafted

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Work has been terminated on a controversial new framework for maternity services that was drawn up with no input from obstetricians or GPs.

The Australian Health Ministers’ Advisory Council (AHMAC) agreed to start afresh on a new draft following a hostile stakeholder consultation meeting on 23 June at which not a single stakeholder voiced support for the project.

Both the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the National Association of Specialist Obstetricians and Gynaecologists (NASOG) boycotted the meeting in protest.

AMA Federal Councillor Dr Gino Pecoraro, who represented the AMA at the meeting, said that the stakeholders – doctors, nurses, midwives and health consumers – were united in their opposition to the proposals.

“The decision to scrap the National Framework for Maternity Services (NFMS) is a win for the women and children of Australia,” Dr Pecoraro said.

“What has happened has been a monumental missed opportunity to achieve the best possible maternity care for mothers and babies.”

The NFMS was designed as a guide for future maternity care policy in Australia. Following an agreement at the April 2016 COAG Health Council, the Queensland Government was tasked with leading the project, under the auspices of AHMAC.

The AMA first became aware of the NFMS project in December 2016 – eight months after it commenced, and without any direct contact from AHMAC’s 12-member Maternity Care Policy Working Group (MCPWG) or consultants Deloitte.

AMA President Dr Michael Gannon raised the AMA’s concerns with federal Health Minister Greg Hunt and Queensland Health Minister Cameron Dick.

“If it was an episode of Yes Minister or Fawlty Towers, you could have a bit of a laugh,” Dr Gannon told Medical Republic.

“Even if you had a predicted outcome in mind, you could at least window-dress it with one obstetrician or one GP.”

AMA Vice President, Dr Tony Bartone, said that obstetricians and GPs share the bulk of the care for women throughout their pregnancies, and leaving them out of the process was a critical misjudgement.

“The AMA has consistently warned that without genuine engagement with the medical profession, the review would be doomed to fail – which is exactly what has happened,” Dr Bartone said.

“The AMA remains committed to working with Government and all stakeholders to see a strong and safe framework.”

Following the stakeholder meeting, Queensland Health representatives recommended to AHMAC that the current process be terminated, replaced with a more substantial consultation phase, and a complete redrafting of the Framework.

The Australian College of Rural and Remote Medicine (ACRRM) and the Rural Doctors Association of Australia (RDAA) said the decision to start again was the right one.

“RDAA and ACRRM were very concerned there had been no specific consultation with rural clinicians, no recognition of the role of procedural GPs in rural maternity services, nor any mention of the guidelines developed by RANZCOG, the organisation that trains the procedural GPs and specialists in this field,” RDAA Vice President Dr John Hall said.

“With over 34,000 babies born each year in locations classified as outer regional, remote and very remote, it is essential that rural maternity service models are supported as part of the NMSF – and that the doctors who provide care as part of these services are closely consulted in its development.”

Maria Hawthorne

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