23 July 2019
Dear members,
The purpose of this email is to update on progress and developments occurring under the College’s mediation agreement with the Ministry of Health.
There are three key components to the agreement that we are currently undertaking to address. These are as follows;
- To determine fair and reasonable pay for LMC midwives
- To develop a new contract framework for primary midwifery services
- The development of a new funding structure or method
The Ministry inform us that certain aspects of the work above, principally the development and agreement to a new funding structure is a policy decision which requires cabinet approval, and the Ministry are preparing policy advice to assist this decision making.
The College is aware that the Ministry has been hosting a series of workshops around New Zealand, seeking feedback on what midwives (and other groups) envisage the future of midwifery and maternity services to be to assist in the development of this policy advice. We have also had a number of midwives contacting us, expressing concern as to why they have been approached to attend one of these meetings and then unclear what the purpose of the meeting is once they have attended.
The College is concerned that the Ministry is diluting the collective voice of midwifery in this approach and also potentially breaching the mediation agreement that we have with them about how the advice is prepared.
We have relayed our concerns to the Ministry of Health and they have agreed to cease the meetings. The College has also sought a formal meeting with the Ministry under the terms of our mediation agreement to clarify our expectations of working in good faith with them and we will keep you informed as to the outcomes from this discussion.
Below please find a brief summary of the work completed to date on each of the three components mentioned above.
Current Status of Agreement Components
1) Fair and reasonable pay for LMC midwives
To establish fair and reasonable pay for community midwives, the Ministry of Health has contracted Price Waterhouse Coopers to undertake an independent formal job analysis of the role of LMC midwives. This involves a process which is very similar to work that was undertaken during the co-design, whereby the responsibilities and role of the community LMC midwife are fully described, then comparator groups are agreed, and price for a full time equivalent LMC midwife determined on the basis of equivalence with the comparator groups. The Ministry of Health have contracted Price Waterhouse Coopers to undertake this work, which will be completed in time to inform the budget bid work which will commence in October this year for budget 2020. The College has been closely involved in the process to date and will be until the process is concluded. We will continue to update members as the work progresses.
2) Developing a new contract framework for primary midwifery services
A midwifery working group is developing a draft contract framework / service specification for a new primary midwifery services contract. An early draft will be discussed with the College’s board at the meeting this coming week. The College has made its expectations to the Ministry clear that our members will expect to be fully consulted on a final draft once it is available.
3) Development of a new funding structure or method
One of the recommendations from the co-design was the development of a national organisation to administer funds to community midwives, as opposed to funds being administered directly by the Ministry of Health (as they currently are) or devolved to DHBs. Such an organisation would also be responsible for providing structural, workforce and business support for community midwives to assist in the sustainability of providing a community based service and managing and negotiating the contract on an annual basis (including price for example)
The College believes that an important and critical consideration when developing this organisation is that it is midwifery led and is set up in a way that helps to future proof the role and value of the community midwife and as a consequence the care provided to women in Aotearoa.
The Next Steps
We are working to a deadline of July 2020 for a new contract framework to be in place. I want to acknowledge again, the frustration and disappointment that many midwives are experiencing as a result of the protracted and convoluted nature of these negotiations with the Ministry.
The College’s objective is not only to ensure fair and reasonable pay for community midwives, but also to ensure that there are sufficient structures to support and enable community midwives to work sustainably within a midwifery continuity of care model, which also supports professional autonomy and women centred care.
The national board will be fully updated on the mediation work at the meeting this week and regional chairs will be feeding back more detailed information to members at the next regional College meetings.
Ngā mihi
Alison Eddy
Chief Executive
PO Box 21-106 | Edgeware| Christchurch 8143
T (03) 372 2732| F (03) 377 5662| www.midwife.org.nz |https://www.facebook.com/nzcom/