midwifery and insurance update...

Urgent Reading For All Women and Midwives....the future of childbirth

There are important changes coming that will affect ALL midwives. On October the 25th 2013 legislation will become enforced that will result in choice being taken away from women and midwives.  Please do not think that the new insurance laws only affect independent midwives just because they are making the most noise about it. The legislation the government is consulting on at present, and hoping to pass after May, is to make insurance a condition of health care professionals registration.  No insurance means no registration.  How does this affect you?
Newly Qualified Midwives.
No choice how you work employed or self- employed. As a NQM, having worked hard to meet the standards of registration, you will no longer be able to go onto the register until you have a job and are therefore insured by your new employer. The difficulties at the NMC of this will result in a delay before you can start paid employment.

Employed Midwives
No choice as how you work employed or self-employed. No choice but to spend £239 per year to join the RCM (or another union) or open yourself up to losing your PIN number. During the time you are not employed by the NHS, even if you are a union member, you will not be insured eg when you are between jobs you will have to come off the register and re -join when you have secured new employment. And what about if you take extended maternity leave? Do the NMC have time and procedure in place for this massive change? This will result in an admin nightmare and delay in payments, as well as losing your right to call yourself a midwife during this period. Also, who will pay for the extra admin and time? 

Recently the NMC tried to increase registration fees dramatically to cover the cost of a back log of work clearing negligence claims.  Midwives coming on and off the register will incur more expenses and time which will inevitably be passed to you.
It will be imperative to find out when your trusts insurance starts and finishes.  Will they cover you in uncontract hours or unpaid time when shifts over run?  If not you will be practising illegally.  Will they cover you when asked a question in the street by a friend or woman and not in paid time?  If not you will be practising illegally.  Will they cover you to care for a friend outside of their trust area?  If not you will be practising illegally.
The NHS will have a monopoly on maternity care but there are women who will never use the NHS for whatever reasons they have. If women want midwives then there will be midwives who choose to work illegally. Illegal midwives will not be governed by any regulations, rules or standards and will not be subject to supervision. That is a backward step for a country that has always been proud of its midwifery profession. 

The UK Government is saying that the new law will improve patient safety. There is no evidence to support this. Insurance does not make Midwifery safe, good standards do.  All midwives are currently heavily regulated in the UK with supervisory meetings and NMC registration, which ensures regular updating of practice.  These contribute to safe maternity standards.  The new laws may limit practice and result in practice policies written and implemented to be cost effective.  Many women each year choose to opt out of the NHS for various reasons.  These women are already stating they would free birth rather than enter into the NHS system next time.  As we all know, this will not improve patient safety and we need to ensure there is a safe option for women outside of the NHS.
What does this mean for women? Firstly it means that all midwifery care delivered is governed by insurance companies. (At the present time the insurance offered by the RCM will cover midwives to provide autonomous care for women who are refusing treatment or care plans that are set out by hospital protocol). This could change. In other countries Home birth is only insured with very strict criteria that effectively makes it illegal. This could happen here too. Insurance companies can put any restrictions they like on midwifery care and increase premiums to price more open policies out. This may drastically affect choices for birth.  
Currently Independent Midwives cannot obtain insurance to practice outside the NHS.  Unless an affordable solution is found you will not have any choice but to opt into the NHS system for maternity care, or free birth without assistance, or use a midwife who is willing to break the law.  Women deserve real choice.
With political will the government could find a solution to this problem but so far have decided to ignore the recommendations of the Finley Scot report, and instead have stated that this legislation will have minor effects on the midwifery profession and birthing women.  They have also ignored the impact this legislation will have on all midwives autonomy.
The Finlay Scott report states:
141. It is important to stress that the impediment to a market solution is not quality of care. The impediment is that the number of individuals is too small to enable the risk to be pooled and spread in a way that produces an affordable premium
143. Nevertheless, the position of such groups is relevant to the acceptability of making insurance or indemnity a condition of registration and to securing confidence and support. It will not help if some self-employed registered healthcare professionals, who are providing good quality and valued services, are unable to continue to practice because they cannot, through no fault of their own, meet a condition of registration despite their willingness to do so.
144. It is a well-established principle that governments may need to intervene when the functioning of the market does not, or cannot, provide an affordable solution.
Recommendation 20:
 In relation to groups for whom the market does not provide affordable insurance or indemnity, the four health departments should consider. Whether it is necessary to enable the continued availability of the services provided by those groups; and, if so, the health departments should seek to facilitate a solution.
Midwives and women and all who value choice and midwifery both independent and NHS please do not let this happen.  Show support now.  Protect your profession.  Retain your right to be an autonomous practitioner.  Let the government know you do not want insurance to be a condition of your registration.
Come and show your support on 25th March at 11am outside Parliament. See Facebook page
CHOOSE YOUR MIDWIFE CHOOSE YOUR BIRTH   For all further details and updates.