ACM Board Statement Professional Indemnity Insurance: Low Risk Homebirth

13 June 2024

The ACM Board met on 12th June to discuss the multiple concerns raised in correspondence from members and consumers with regards to the recent budget measure for the development of a low-risk homebirth Professional indemnity insurance (PII) product.

The Board acknowledges the long-term advocacy by various stakeholders, consumers, and stakeholder groups for the ceasing of the homebirth insurance exemption and the development of a fit for purpose PII product for individual privately practising midwives. ACM have engaged for many years with Government and with the Department of Health and Aged Care to seek to contribute to planning for an insurance solution, unfortunately this has not been possible due to the confidential nature of a tender process. The Board shares the concerns of members with regards to the possible negative outcomes for both midwifery and women if such a product is not fit for purpose.

ACM has formally raised these concerns with the Commonwealth at the highest level. We have written to both Minister Butler and Assistant Minister Kearney and we have met with Minister Butler’s Policy Adviser and the Commonwealth Chief Nursing and Midwifery Officer to express our concerns. ACM has urged Government to review the current approach to PII for homebirth, to ensure that the insured parameters for homebirth do not ‘risk out’ the many women who seek homebirth as their choice of care.

We have confirmed that the definition of ‘low risk’ is yet to be determined and that a consultation process is being finalised. The date the Government is working towards to ensure all consultation, regulatory and legislation requirements have undertaken due diligence is 1 July 2025, with the existing exemption expected to cease on 30th June 2025.

We understand the perceived and actual implications these legislative and regulatory changes may have on midwives and, women and families accessing maternity care. ACM is committed to working with Government and key stakeholders to represent the profession and ensure there is a balanced view to discussions that will include aspects such as risk, clinical practice, legislation, regulation, access to care, human rights, sustainable career choices for midwives, financial and economic decision making.

While the intent of Government is to increase access to care for women, ACM seeks ongoing consultation and member engagement to ensure there is clear awareness of likely unintended consequences, such as reduced access to options for care and choice for women, freebirth, potential loss of autonomy and business for Privately Practising Midwives, and sustainability of the PII product into the future. ACM’s advocacy and multiple recent submissions, for example to the Scope of Practice review, National Reform Health Agreement and NSW Birth Trauma inquiry, prioritise continuity of midwifery carer, midwives working in primary care through enhancing endorsed midwife pathways, and removing barriers to midwives working to full scope of practice.

The Board wishes to ensure that members are aware that the National Midwifery Guidelines for consultation and referral process for midwifery have not changed. In view of expected PII changes and the recent reversal of collaborative arrangements however, ACM will update the Guidelines as a priority. As per ACM’s pre budget submission, ACM is advocating for funding to ensure guidelines are updated and available to all midwives and health practitioners in a timely manner.

We acknowledge that this is a worrying and uncertain time for privately practising midwives, and for midwifery, and we hear the concerns you have raised in your correspondence. Please be assured that we have been and will continue to work proactively with the Commonwealth and other stakeholders to ensure that the voices of midwives are heard in this consultation process which will take some time. We will ensure to keep midwives updated as this progresses, and include our members in the consultation process.