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Improvements For Maternity Carers And Mums

19 April 2002

Midwives, general practitioners and specialists offering maternity care get a pay increase under a revised maternity contract announced by the Ministry of Health today.

"Our main objective with the updated contract is to ensure that all those practitioners offering maternity care are paid appropriately for the services they provide and pregnant women will continue to receive the best possible maternity care," said Maternity Manager Barbara Browne.

"We want to ensure women continue to have free access to maternity services wherever they live and are involved in the management of their care".

The revised contract, a Section 88 Maternity Notice, covers midwives, obstetricians, general practitioners, radiologists, anaesthetists and paediatricians.

Ms Browne said an extra $6.2 million has been set aside to pay for maternity services in 2002/3 in New Zealand - $3.7 million of which is new money announced in last year's Budget.

The money has been targeted at post natal care. There will be a 29% increase in payments to lead maternity carers for the post natal package of home visits to women, and a 40% increase to $350 as an additional fee to cover travel costs to remote rural areas.

"The Ministry of Health acknowledges there has been concern in the sector that maternity practitioners have not always been paid appropriately for the services they offer. We expect the increased pay will encourage those offering maternity care to keep doing so."

''The Ministry is aware that there are strong and divergent views held by practitioners delivering maternity care about both its funding and practice. The Ministry has tried to accommodate these views as well as possible in making the changes to the contract."

Altogether, there are around 60 differences in the new maternity contract compared to the old one.

Changes will see women able to hold their own clinical notes thereby encouraging involvement in their own care. There will be an increased number of free home visits available for women who have additional post natal needs such as mental health problems or breastfeeding difficulties, and more consultations available for women post miscarriage or post termination.

"Furthermore the new contract gives the Ministry of Health greater ability to audit maternity services and better definitions of what constitutes free maternity care."

The contract, which has yet to be gazetted, can be located on www.moh.govt.nz



How long has the current maternity notice been around? The Section 88 Maternity Notice was first implemented nationally in 1996. Relatively minor amendments were made in 1998. The notice covers midwives, obstetricians, general practitioners, radiologists, anaesthetists and paediatricians.

Aren't there some lead maternity care organisations not currently offering services under Section 88 At present 70% of primary maternity providers are currently working under a Section 88 Notice and offering specified lead maternity care and other primary maternity services. There are another 19 providers on non-standard contracts. They offer similar services but there are differences in prices, payment rules and reporting processes.

Last year the Ministry of Health moved to standardise the contracts in an effort to end price inequities and improve the quality of maternal and newborn information.

The change means all midwives, GPs and specialists operating under the contract will be expected to provide women with the same set of services to the same level of quality throughout New Zealand.

The non-Section 88 providers are currently in the process of moving over to the section 88 notice and all primary maternity providers will be offering services under the new contract by October this year.

How much money does the Ministry currently spend on maternity services each year? Some maternity services have been devolved to DHBs however the Ministry still retains a third of total maternity expenditure. The total expenditure from both DHB and the Ministry is around $356 million per annum. This includes specialist neonate services, maternity facilities, secondary/tertiary maternity services and LMC services.

Which payments for services will be increased for lead maternity carers? A 30% increase to $32.50 to be paid to GPs or midwives when a woman makes a one-off visit in her first trimester A 29% increase in payments to lead maternity carers for the post natal package of home visits to women A 40% increase to $350 as an additional fee to cover travel costs to remote rural areas.


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