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Legislative Assembly for the ACT: 2103 Week 13 Hansard (29 October) . . Page.. 3894..


not seen as necessary for us to then consult locally with a whole range of other stakeholders on whether or not the plan that was agreed through health ministers and all the discussions that were had as part of that were to be re-agitated at a local level. Consultation in developing this has been undertaken with the following: senior clinicians within the Centenary Hospital for Women and Children, and it is believed that if credentialing of midwives is to occur it will occur in that facility: with the clinical director of obstetrics and gynaecology at Canberra Centenary Hospital for Women and Children; with the Acting Director of the Medical and Dental Professional Standards Unit; and with the Principal Medical Adviser. All of these officers indicate their support for the bill and the credentialing for which it provides.

Going back to the comments of Mr Hanson, I think he said that the local chapter of the college of obstetricians and gynaecologists alleges that it gives admitting rights to midwives for the first time. It does not do that. This allows a process to be put in place which could allow for the credentialing of midwives, but that is going to take—Mr Hanson, you raise your eyebrows at me. You read in that this gives midwives admitting rights. It does not. No-one can have admitting rights or credentialing rights until there is agreement with local medical practitioners. It has to be done in cooperation with them.

Some will say that we have got Buckley's of actually delivering that in the ACT because of the views of some of the local obstetricians about whether or not this is the right way to go. But in Queensland, for example, since these changes were put in place, I think there are now 60 credentialed midwives working in public hospitals. So women can choose a midwife and choose to have that midwife support them through their antenatal period and support them during their birth. As our VMOs have admitting rights in hospitals, midwives are able to do that.

In order to be an eligible midwife you have to have registration as a midwife; you have to have three years full-time post-registration experience as a midwife; you have to have evidence of current competence to provide pregnancy, labour, birth and postnatal care through professional practice review; and you have to hold an approved qualification or have completed a program of study substantially equivalent to approved qualification or made a formal undertaking to complete an approved qualification within 18 months to acquire the skills required to provide the scheduled care.

That is what subsection 38(2) of the ACT's Health Practitioner Regulation National Law sets out for an eligible midwife. This will allow eligible midwives who meet those requirements to potentially, if they can reach agreement to work in collaboration with medical practitioners, have the opportunity to provide midwife-led admission. That is what this change does. The concerns of obstetricians will be able to be well heard if an eligible midwife applies for credentialing to a local health facility. And if they do not support it, if there is no medical practitioner that supports that application, there will be no credentialing of that eligible midwife.

My understanding is that in other jurisdictions—and this is particularly useful in rural jurisdictions, where there are no specialist obstetricians and where you may have a general practitioner who has been doing all the obstetric care, and in small rural


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