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Maternity Review Spells The Demise Of GPOs

In the Maternity Review, released today, the National Health Committee (NHC) has accepted the demise of general practitioner obstetrics in this country and done nothing to reverse the situation, the New Zealand Medical Association says.

NZMA Chairman Dr Pippa MacKay said the Review had several major negative features. It also has positive aspects, but, even in these, it focuses on outlining the problems rather than providing viable solutions.

"The NHC has accepted that general practitioner obstetricians (GPOs) have left the service in large numbers, but has said that nothing can be done about it. This means that most New Zealand women will now have even less choice about involving a GPO in their maternity care," Dr MacKay said.

"It also means that a key clinical component of community health will effectively be permanently lost. In the long term, rural women will be particularly affected by the Review's recommendations."

The Review also emphasises teamwork and co-operation, yet the recommendations it makes will do little to bring this about. In any case, it is extremely unlikely that many GPOs will be available to contribute to the "team".

Dr MacKay said the Review completely failed to address the serious issues facing secondary maternity services, particularly the increasing pressure on specialist obstetricians.

There is one major positive in the Review, Dr MacKay said. It acknowledges that the existing system places substantial barriers in the way of pregnant women who wish to consult their family GP during pregnancy, which results in fragmentation of care. The Review attempts to improve this situation. The NZMA strongly supports this initiative and will be happy to work with the HFA to bring it about.

The NHC made much of the high level of satisfaction with the present maternity system among women who were surveyed. Most of those surveyed were self-selected, and the NZMA has already raised concerns about the quality of the surveys. Satisfaction levels of 80 to 90 percent still mean thousands of women were not satisfied with their maternity experience, and it is the experiences and needs of these women that the Review should have addressed, Dr MacKay concluded.

The NZMA will be commenting in more detail on other aspects of the report over the coming week.


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