Announcement date
14 May 2024
Link to announcement
https://ministers.pmc.gov.au/gallagher/2024/budget-works-women
Problem being addressed
The Midwife Professional Indemnity Scheme (MPIS) currently indemnifies midwives for antenatal and postnatal care, but not homebirth and intrapartum care outside hospital. Owing to community demand, the Commonwealth sought to find a lasting market-based solution through a recent approach to market for insurers to offer cover for these services, but the tender was unsuccessful.
Due to the unavailability of suitable insurance products, Section 284 of the Health Practitioner Regulation National Law (National Law) currently allows a temporary exemption from Professional Indemnity Insurance (PII) for homebirths and intrapartum care outside hospitals. On 10 November 2023, Health Ministers agreed to extend the exemption to hold PII for Private Practising Midwives (PPMs) providing homebirth services until 1 July 2025.
Proposal
In response to the identified market failure, this proposal includes options for reform to address the lack of PII for midwives. The Impact Analysis considers four options to the provision of homebirths and intrapartum care outside of hospital:
- Option One: will maintain the current status-quo, where the exemption is retained and homebirths and intrapartum care outside hospital is permitted to proceed without insurance, alongside public programs.
- Option Two: will expand the current MPIS and Run-Off Cover Scheme to include low-risk home births and intrapartum care outside hospital, whereby the Government will cover 100% of the cost of claims for these new products, if the insurer provides such cover and manages claims.
- Option Three: will commence negotiations with state and territory governments, with the intention that provision of homebirths and intrapartum care outside hospital be facilitated by jurisdictions and covered under their indemnity arrangements.
- Option Four: will allow the National Law exemption to permanently conclude, making the provision of homebirths and intrapartum care outside hospital by PPMs unlawful, consistent with all other registered healthcare practitioners.
Assessment comments
The IA addresses the seven IA questions and follows an appropriate policy development process commensurate with the significance of the problem and magnitude of the proposed intervention. In particular, the IA clearly articulated the policy problem, and successfully synthesised a range of stakeholder views in considering the proposed interventions.
To be assessed as 'Exemplary' under the Australian Government Guide to Policy Impact Analysis, the IA would have benefitted from a more rigorous implementation plan, including a comprehensive assessment of implementation risks; milestones and governance arrangements; and the specification of interim and final decision points. The IA would have also benefitted from clearer structure to enhance clarity and readability.
Regulatory burden
The Department of Health and Aged Care estimates that the preferred option would result in an annual regulatory saving of $0.68 million.