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Speaker 1: Yesterday we spoke to two mums concerned about changes when

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Speaker 1: it comes to maternity services that are being delivered here

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Speaker 1: in the Northern Territory. Now we also saw the letter

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Speaker 1: advising that Midwiffery Group Practice on call services have been

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Speaker 1: stopped while the reviews carried out to ensure that the

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Speaker 1: model is sustainable. The letter states that anti natal and

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Speaker 1: post natal appointments are going to be conducted by the

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Speaker 1: Maternity Group Practice team during business hours, that labor and

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Speaker 1: birth care will be provided by midwives and doctors in

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Speaker 1: the delivery suite, which will also handle after hours calls

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Speaker 1: to midwives. Now, the letter goes on to say that

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Speaker 1: planned home births will be supported, but at times support

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Speaker 1: could be unavailable due to staffing limitations. Now joining us

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Speaker 1: on the line is the Nursing and Midwiffrey Federation's NTI Secretary,

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Speaker 1: Cath Hatcha Good morning to you, Cath.

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Speaker 2: Good morning Katie, and good morning to the listeners.

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Speaker 1: Good to have you on the show. Has What do

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Speaker 1: you know of this situation? Have you seen this letter?

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Speaker 2: I have seen the letter and the Midwifree Group Practice

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Speaker 2: midwives didn't realize that this letter was being sent to

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Speaker 2: consumers late last week and they were sent it by

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Speaker 2: consumers in the Darwin region and they were not consulted

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Speaker 2: about it, and they know that they're going to Four

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Speaker 2: out of the five teams are not going to do

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Speaker 2: on call, which is a real shame. But the reason

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Speaker 2: why they're not undertaking the on call is due to

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Speaker 2: staff shortages in the team.

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Speaker 1: So cath hang on. So those midwives that actually you

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Speaker 1: know that they are the ones that operate under the

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Speaker 1: midwifree group practice, they didn't know this was happening. No

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Speaker 1: you're joking. No, No, they must be feeling bloody ordinary,

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Speaker 1: you know then when they found out that letter had

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Speaker 1: gone out, like for a whole raft of reasons. But

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Speaker 1: you know, when I think of midwives and nurses, like

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Speaker 1: they genuinely care about their patients, and they genuinely care

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Speaker 1: about those mums, so I reckon they'd be pretty upset.

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Speaker 2: Yes, definitely lack of communications. So the team that is

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Speaker 2: still going to be on call is the home birth

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Speaker 2: team or they call it the Orange team, and those

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Speaker 2: three midwives that managed that team currently are fully staff,

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Speaker 2: so they'll still be able to as long as they're

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Speaker 2: not over their hours, you know, by extreme circumstances, they'll

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Speaker 2: still be able to care and hopefully women still be

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Speaker 2: able to have their babies at home, which is where

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Speaker 2: they wish to The other teams are shorter staff and

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Speaker 2: that they're hopefully this will be an interim measure while

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Speaker 2: they get some more midwives into the teams.

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Speaker 1: So, Kathy, is that the issue here? Is it just

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Speaker 1: a staffing issue?

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Speaker 2: It is at the moment, but the managers of the

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Speaker 2: midw three group practice do want to change and restructure

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Speaker 2: the whole groups. They do want to put another midwife

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Speaker 2: into the team, so instead of having three midwives per team,

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Speaker 2: they're having four. But they do want to change the

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Speaker 2: level of classification, so currently there should be three nurse four.

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Speaker 2: A nurse four is a very qualified, experienced midwife who

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Speaker 2: is able to work independently but also collaboratively with the

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Speaker 2: other team and the doctors if necessary, throughout that woman's

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Speaker 2: journey through her pregnancy, labor, birth and host natal. Currently

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Speaker 2: that's how it is at the moment. They want to

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Speaker 2: change it to four midwives with one being a nurse

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Speaker 2: for and that next one a nurse three, next one

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Speaker 2: a nurse two and a new graduate, but not a

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Speaker 2: new graduate in the home birth team. But that takes

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Speaker 2: a lot of resources to be able to for that

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Speaker 2: nurse for to be able to be there to educate,

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Speaker 2: support not just the nurse three two and two, but

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Speaker 2: the new graduate as well. They don't mind the new

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Speaker 2: graduates being comeing to the midw three group practice. That

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Speaker 2: happens in Alice Springs as well, but they're in Alice Springs.

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Speaker 2: They have about six to eight midwives with one nurse

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Speaker 2: graduate to support through that twelve months.

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Speaker 1: Kas, is this as I mean, are these staffing issues.

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Speaker 1: Is it a result of, you know, additional pressure following

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Speaker 1: the closure of the Darwin Private Hospital.

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Speaker 2: No, this has been on the table, this restructure for

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Speaker 2: a number of months, well before the closure of the

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Speaker 2: maternity service at the Darwin Private So the Darwin Private

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Speaker 2: women who now coming through Royal Darwin should be able

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Speaker 2: to still continue to see their obstetrician through their pregnancy

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Speaker 2: and be able to come into delivery suite to labor

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Speaker 2: and have their birth with their obstetrician.

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Speaker 1: Kas. We are being told though, or we are certainly

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Speaker 1: hearing that some private obs are sort of questioning their

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Speaker 1: futures in the territory, you know, as a result of

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Speaker 1: the situation that we're currently in, Like, are you hearing

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Speaker 1: much of that?

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Speaker 2: I have heard rumors. I don't know whether that's actual

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Speaker 2: facts or not, but it would be a great shame

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Speaker 2: if the two obstetricians don't continue the services and therefore

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Speaker 2: there's no option with private care in the Darwin region.

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Speaker 1: Yeah, I will also point out, you know, I've certainly

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Speaker 1: not had that confirm. That is just something that we'd

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Speaker 1: sort of, you know, been told kas. You know, what

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Speaker 1: do you think needs to happen here? Is it fair

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Speaker 1: enough that a restructure gets underway? What do you think

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Speaker 1: needs to happen?

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Speaker 2: The midwives and us as the union think the restructure

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Speaker 2: is a load of shite that it shouldn't happen. Yes,

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Speaker 2: maybe include another midwife in each team to begin, so

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Speaker 2: there would be four midwives per team and then they

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Speaker 2: can take on more caseload per team, so therefore more

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Speaker 2: women be able to access the continuity of care model.

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Speaker 2: And yes, if the midwife is a junior midwife and

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Speaker 2: is not up to the skill to be as a

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Speaker 2: nurse for then in the interim she should be paid

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Speaker 2: at that level, whether it be nurse two or three.

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Speaker 2: And once she gets to that skilled level of being

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Speaker 2: a very caseload model experience midwives. She should then be

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Speaker 2: a nurse for position. The restructure is not going to

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Speaker 2: benefit the midwives or the women that it's going to

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Speaker 2: make it worse. And I think Minister Edgington has a

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Speaker 2: case here because the statistics of mortality and morbidity in

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Speaker 2: the territory is much worse compared to other states in

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Speaker 2: the Australia. So we have a.

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Speaker 1: We've got to look after them. It's like a duty

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Speaker 1: of care to make sure.

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Speaker 2: What I was thinking, we have a duty of care.

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Speaker 2: The government, the managers at will dah In Hospital have

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Speaker 2: a duty of care to be able to provide the

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Speaker 2: best care possible to reduce these rates.

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Speaker 1: Kath. We also yesterday we spoke to one of the

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Speaker 1: mums who made us aware of this situation. But then

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Speaker 1: we had another mum call in who actually lives in

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Speaker 1: a remote community. She's out near the Daily River and

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Speaker 1: she's really worried about these changes and what it's going

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Speaker 1: to mean, you know for somebody like her, who's who's

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Speaker 1: going to be well, who probably will have to come

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Speaker 1: and give birth in Darwin, and he's coming to Darwin

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Speaker 1: for appointments, et cetera. But you know, not being able

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Speaker 1: to get that, you know, not being able to get

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Speaker 1: that after ours care, et cetera as well, like it's

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Speaker 1: you know that is concerning, right it is.

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Speaker 2: And so the midwives would be beyond call during say

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Speaker 2: eight am to eight pm so as a example, and

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Speaker 2: then after that they will have their phones diverted to

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Speaker 2: the delay suite. So if they ring their midwives phone

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Speaker 2: after hours, at the moment, it will go to delivery

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Speaker 2: suite and a midwife will be able to guide that

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Speaker 2: mother to what the next steps would be. But hopefully

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Speaker 2: this is an interim. The managers at the hospital need

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Speaker 2: to get more staff. They need to make them permanent.

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Speaker 2: They need to stop these contracts. They need to stop

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Speaker 2: the high sorry the HDA which is increasing there from

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Speaker 2: a nurse too to a nurse FO. They need to

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Speaker 2: make them permanent. There's only five out of the fifteen

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Speaker 2: that are permanent in those positions, and it's they're not

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Speaker 2: being advertising correctly for midwives. So midwives are not wanting

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Speaker 2: to stay because they can't buy a house if they

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Speaker 2: haven't got a permanent contract. All that sort of rolls

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Speaker 2: on into their own personal life. And it's completely wrong.

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Speaker 2: Whereas the Alice Springs model, and I believe the ghost

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Speaker 2: model that is currently being looked to set up is

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Speaker 2: going to be all nursed for. And why is this

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Speaker 2: change is going to happen here in Royal Darwin. I

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Speaker 2: believe they tell me it's not, but I believe it's

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Speaker 2: a cough cuffing exercise, which is completely wrong.

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Speaker 1: I really hope not. I really hope not, cath because

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Speaker 1: you know, women, families deserve the right to be able

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Speaker 1: to you know, to go to the hospital, to have

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Speaker 1: that service, you know, to have those midwives there. And

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Speaker 1: I know that the midwives absolutely want to be able

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Speaker 1: to deliver that service to the best of their ability

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Speaker 1: as well. But as you touched on earlier, you know,

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Speaker 1: the scary or not scary, but the really sad part

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Speaker 1: is that we do have, you know, high mortality rates

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Speaker 1: here in the Northern Territory. Like I myself have friends

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Speaker 1: who've lost babies, you know, for different reasons, you know,

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Speaker 1: and we've just got to make sure that we are

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Speaker 1: not cutting costs at the risk to Northern Territory families.

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Speaker 2: Absolutely, yep. And the women out there in the Darwin

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Speaker 2: and the Greater area. They need to right to Minister

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Speaker 2: Edginton and say this should not be happening. There should

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Speaker 2: also be increased numbers berthing in the birth center. So

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Speaker 2: since some changes were made about seven or eight years ago,

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Speaker 2: the rates of birthing in the birth center have completely plummeted.

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Speaker 2: And you know, the women of Darwin region really pushed

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Speaker 2: for that to the last twenty five years for a

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Speaker 2: birth center to be builtan built. The numbers of rates

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Speaker 2: of birthing per year were increasing and the midw free

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Speaker 2: group practice at the time were a really well run service.

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Speaker 2: And then they did some changes which were for the

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Speaker 2: wrong which we tried to stop, and the services to

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Speaker 2: have babies in the birth center decreased plummeted greatly. So

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Speaker 2: if that increased, the numbers in birthing in the birth

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Speaker 2: center would decrease the pressure on delivery suite on the

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Speaker 2: sixth floor and women wouldn't be perhaps having their labors

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Speaker 2: in the corridors or in the maternity ward, they would

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Speaker 2: be having the care in a delivery room, in a

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Speaker 2: birthing room.

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Speaker 1: Katz. We have just had a couple of moms getting contact.

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Speaker 1: Tessa's been in contact and said that one of the midwile. Sorry,

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Speaker 1: one of the obstetricians I think her name is Aliah

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Speaker 1: the Muri is finishing at the end of the year

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Speaker 1: and isn't taking on new patients. Another person has said

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Speaker 1: that Jenny Mitchell's retirement's been well known and acknowledged by

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Speaker 1: NT Health as somebody else's message through and said, Katie,

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Speaker 1: you can no longer make appointments with private obs at

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Speaker 1: this point in time, like this is this is actually

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Speaker 1: real worry.

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Speaker 2: It is worry, and I feel sorry for the women

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Speaker 2: of Darwin who won a private obstetrician for their experience

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Speaker 2: as being a mother. Yep.

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Speaker 1: Oh well, look, we'll continue this discussion CAV hopefully going

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Speaker 1: to have the Department of Health on the show tomorrow,

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Speaker 1: so please let us know if there's anything else we

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Speaker 1: should be aware of. I always appreciate your time. Thank

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Speaker 1: you very much for joining me on the show.

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Speaker 2: Yep, thank you, Katie, thank you