The Independent Midwives Association (IMA) state that 'Independent midwives practise outside the NHS, usually not because of a desire to have private clients but because it has become increasingly difficult within the NHS to provide the standard of woman-centred, autonomous midwifery practice they wish to give.' Midwives have become disillusioned with the care they are able to provide on the NHS and want to be able to practice the sort of care that made them want to become midwives in the first place - one to one care to support women to have normal births with minimal intervention. Government proposals to make professional indemnity insurance (PII) compulsory for all independent healthcare providors is not a problem in itself, the problem is that the lack of providers of such insurance and the prohibitive expense of policies will effectively put IMs out of business. The government response to this is to suggest various models that would enable midwives to work under NHS trusts. They suggest that 'The Government are committed to supporting independent midwives to find a method to access indemnity cover, as this is clearly in the public’s best interests.'
The future of the profession remains unclear. The upshot at the moment means that IMs are still legally allowed to practice without PII but possibly not for much longer. For the client this means that although insurance can be obtained for pre-natal and post-natal care it is not currently possible for IMs to obtain insurance for the actual birth. This does not mean that we could not make a claim in the event of negligence causing injury during the birth but it means we would be suing the midwife as an individual and not a professional and so any claim would be settled against their personal assets - house etc. Not good...
The IMA latest new section indicates that as of March 08 'Work on The White Paper ‘ Trust, Assurance and Safety – The Regulation of Health Care Professionals in the 21st Century’ is not expected to be completed before end of 2009 / early 2010. A consultation period will then follow. It is under this White Paper that any changes required to make Professional Indemnity Insurance (PII) mandatory will happen. We will be informed if there is any alteration to this timetable.'
Checkout the Born Stroppy blog for more info and opinion on the subject.