Useful information for consumer representatives
- Overview of maternity reform
- Key documents for maternity consumer representatives
- QH useful websites
- Recommended reading list
Overview of maternity reform
Maternity services reforms in QLD – started in 2004
A QLD Health website that gives a quick overview of what the QLD Government has been doing since the independent review of maternity services in 2004 kicked off the current reform process. Also provides useful links to other parts of QLD Health.
History of maternity services reform in QLD
This article, Birth Politics in QLD: A brief, recent history, first appeared in Maternity Coalition’s newsletter Birth Matters in 2005 and provides a useful perspective of maternity services reform from 2000 to 2005.
Maternity services reform from the Australian Government – started in 2007
Department of Health and Ageing – Maternity Services Reform
In 2007, the Federal Government announced a review of maternity services across Australia. Since then they have committed money to the ‘maternity services reform package’ that includes access to the Medical Benefits Schedule (Medicare) and the Pharmaceutical Benefits Schedule for midwives. This webpage gives you lots of information about what’s going on and what it means for consumers.
QLD Government’s Continuity of Carer target by 2013
Letter from Deputy Premier and Minister for Health to Maternity Coalition (PDF)
In 2010, Deputy Premier and Minister for Health wrote to Maternity Coalition to commit to targets for Continuity of Carer. “…by the end of 2013, 10 percent of all births in Queensland Health public hospitals will occur in a continuity of carer model.’ Continuity of carer is discussed in the letter as being ‘where a woman will see the same midwife or small group of midwives during her pregnancy, at birth, and post-natally…’ This letter clearly articulates what the QLD Government has signed up to and therefore is incredibly useful for consumer representatives to know about.
QLD Government’s Maternity continuity of carer target – Implementation Plan
Implementation Plan (PDF)
Another essential reference for consumer representatives; outlines the strategy to achieve the continuity of carer target including the district breakdown of births in each facility that need to be in a continuity of carer model by 2013. Every single public maternity unit will need to do work to achieve their 2013 target.
Key documents for maternity consumer representatives:
QLD’s independent review of maternity services – 2005
Recommended a set of guiding principles to underpin maternity reform:
- Care is safe and feels safe
- Care is open and honest
- Care is local or feels local
- Care is integrated
- Care belongs to consumers
- Carers work together and communicate
Identified gaps in available maternity services in Queensland, in particular in postnatal care, services in rural and remote areas and services to indigenous women.
Recommended establishment of ‘bub-hubs’, community-based, multi-disciplinary primary care maternity teams that would provide women with antenatal and postnatal care in the community, with the same team continuing to provide the woman’s birth care in the local hospital.
QLD Government’s response to the review
QLD Government’s response to Re-Birthing was cautiously supportive and they:
- Established a Maternity Unit in Queensland Health
- Established Midwifery Advisory position in Office of Chief Nursing Officer (OCNO)
- Established Queensland Centre for Mothers and Babies, which has a different ambit to the proposed independent body
National Maternity Services Plan
http://www.health.gov.au/internet/main/publishing.nsf/Content/maternityservicesplan – you will need to scroll down to the very bottom of this page to find this document.
This weblink opens a PDF.
This plan was developed by the Australian Health Ministers Conference (made up of all of the state, territory and federal health ministers) in 2011. It’s an important part of the Federal Government’s maternity reform package that gave Medicare to Midwives for the first time.
Sets out a five year vision for maternity care in Australia (including breaking vision into early, middle and later components).
Establishes a range of priorities (although not measurable targets with timelines):
- Access: to information; range of models of care; for women in rural and remote areas.
- Service delivery: high quality, evidence-based maternity care; culturally competent care for Aboriginal and Torres Strait Islander women; services for women who have medical, socio-economic or other risk factors.
- Workforce: woman-centred care within a wellness paradigm; Aboriginal and Torres Strait Islander workforce; rural and remote workforce; culture of interdisciplinary collaboration.
- Infrastructure: Safety and quality system; service planning, design and implementation is woman-centred.
Developed by the National Health and Medical Research Council in 2010 as part of the national maternity reform process. It is useful for consumer representatives because it establishes definitions of key terms: collaboration, informed choice, informed consent, informed refusal and woman-centred care.
It also establishes 9 principles of collaborative maternity care.
Primary Maternity Services Framework
Important document (from 2008) as it recognises maternity care as a primary health care service (first time this was recognised at this level of policy) and was developed by a committee of Australia’s health ministers (all the state, Territory and Federal Health Ministers).
Australian College of Midwives Guidelines
Provides a single, nationally consistent and evidence-informed framework to assist midwives to make decisions, in consultation with the woman receiving care, about when to discuss care with other midwives, and/or to consult with or transfer a women’s care to a suitably qualified doctor.
Recently endorsed by Queensland Health for use in all Queensland Health midwifery models of care.
More key maternity care documents
A useful list of more key maternity documents and direct links to them including:
- Statewide breastfeeding policy
- National breastfeeding strategy
- National perinatal depression initiative
Informed choice, consent and the law
Informed choice, consent and the law: The legalities of ‘yes I can” and “no I won’t”. Informed decision making as a human right.
Open this document as a PDF.
An article on informed decision making as a human right by solicitor, Ann Catchlove, published in Birth Matters, Journal of Maternity Coalition.
Queensland Health useful websites:
Maternity Unit initiatives include:
- Monitoring and reporting bi-annually to Government on progress against the Maternity and Newborn Services in Queensland Work Plan 2008-2012
- Working with maternity staff within health districts and throughout Queensland to improve collaboration and integrate hospital and community maternity care
- Implementing the Universal Postnatal Contact Services initiative
Nursing and Midwifery Office Queensland (NMOQ)
NMOQ was formerly known as Office of the Chief Nursing Officer (2011) and is the QLD Health agency responsible for nursing and midwifery professional issues and has a midwifery advisor.
The Rural Maternity Initiative that funds and supports rural maternity units to improve their model of maternity care is coordinated by this unit. You can also download a copy of the Midwifery Models of Care: Implementation Guide and soon (hopefully by November 2011) the second edition of this important guide.
Statewide Maternity and Neonatal Clinical Network
This clinical network is made up of clinicians and consumer representatives from across the state. The clinical network advises, guides and directs Queensland Health and the Queensland Government on a range of maternity and neonatal service issues and activities across Queensland.
QLD Maternal and Perinatal Quality Council
Its purposes are to:
- Collect and analyse clinical information regarding maternal and perinatal mortality (deaths) and morbidity (sickness, illness, injury) in Queensland to identify state-wide and facility-specific trends.
- Make recommendations to the Minister for Health on standards and quality indicators of maternal and perinatal clinical care to enable health providers in Queensland to improve safety and quality.
- Assist with the adoption of such standards in both public and private sectors.
QLD Maternity and Neonatal Clinical Guidelines Program
Its purpose is to:
- Develop guidelines for maternity and neonatal care in Queensland. You can view all the guidelines from this website.
Health Consumers Queensland
Health Consumers Queensland provides the Minister for Health with information and advice from a consumer (patient) perspective and supports and promotes consumer engagement and advocacy. Their website is a treasure trove of useful resources and information for consumer representatives.
Making a complaint
Useful information about QLD Health’s consumer complaints process.
The following books might be useful to you in your consumer representation work. They are also just plain interesting! Local libraries are often very keen to hear from patrons with recommendations about book purchases. Maybe your library would consider purchasing some of these for local mums? Australian Breastfeeding Association (ABA) branches often maintain libraries that may include some of these books, or the branch may be interested in donating to a local public library. Also, some midwifery models of care operate a library so mums-to-be can access supportive books during their pregnancy. You could ask your local hospital to establish such a service.
List of recommended resources to read (PDF)
Health Service District Directory
Download PDF document