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Further Maternity Changes To Reduce Women’s Choice

Further Maternity Changes Will Reduce Women’s Choice – GPs

Further changes to the structure of maternity services proposed by the Ministry of Health will “drive out” the few remaining GP obstetricians and thus eliminate that option as a choice for pregnant women according to the Royal NZ College of General Practitioners.

Deputy Chairperson Dr Helen Rodenburg explained that the Ministry had written to twenty maternity care providers who were not operating under a standard payment system indicating its intention to force them into such an arrangement by July next year. Those who don’t agree will have their existing contracts terminated.

Because the standard contract will reduce the ability of GPs to be compensated for the services they provide to pregnant women, those who remain as GP Obstetricians working within organisations such as Wellington’s Matpro, Southlink Health, Pegasus in Christchurch and similar services would probably cease any involvement in pregnancy care, Dr Rodenburg predicted.

“This flies in the face not only of the preferences of a clear majority of women – as expressed, for instance, in the National Council of Women survey in 1999 – but also goes against the recommendations of the National Health Committee report which stressed the importance of ‘networks of care’,” Dr Rodenburg said. “That is exactly what these organisations are providing – networks of GPOs, midwives, nurses and other professionals all working together in the best interests of the patient rather than worrying about who pays what to whom as happens under the Ministry’s preferred model.

“The Ministry’s justification for wanting the change is that they are not getting the quality of data they want from non-standard providers. But the data they collect is not, primarily, about quality of care, it’s about claiming… about money. Clinicians think in terms of quality issues, and need to be able to see the data enhancing the quality of care they can provide. If the Ministry was unhappy with the data they’ve been getting they’ve had four years to address the issue through the existing contracts,” Dr Rodenburg pointed out.

“Some of the contracts affected also have funding for quality assurance and socioeconomic need, it appears this funding will be lost. The College considers this a backward step, as provider involvement in quality assurance is essential. There is a need to support systems that encourage quality assurance and reduce the isolation of practitioners.

“Ironically, the best existing examples of teamwork between midwives and GPs are in the areas served by contracts which are outside the standard system favoured by the Ministry. By canceling these ‘non standard’ contracts the Ministry is driving a wedge between GPs and midwives. Not only will this drive the remaining GPs out of obstetric care it will also destroy that collaborative teamwork and remove choice for women, who will no longer be able to choose a shared care arrangement where they can see their own GP for some of their antenatal care,” Dr Rodenburg said.


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