Last week the Ministry of Health released a press statement saying it was working “with urgency” with the New Zealand College of Midwives on a maternity programme to address current pressures – including addressing workforce shortages and delivering a sustainable model of care.
But many midwives – who are marching on Parliament a fortnight before the May 17 Budget – remain wary that the protracted process, that began with a historic pay equity claim back in 2015, will actually deliver a fully funded, sustainable funding model.
“I think that if the Budget doesn’t come through in a big way for midwives we will see a huge number of midwives leaving,”
says Charlie Ferris, one of the midwives behind the successful social media campaign, ‘Dear David, Aotearoa needs midwives’. One of the most recent posts on the Facebook page is by a 33 week pregnant woman saying she said goodbye this week to her rural midwife who was leaving the profession due to burnout, leaving the rural town of 8000 with one just midwife and two locums.
Ferris, herself a rural lead maternity carer (LMC) said the Ministry’s release talking about having found a “positive way forward” sounded like midwives would get “something” in the Budget. “But whether that is 2 per cent or 20 per cent we are completely in the dark and a lot of midwives are on tenterhooks wondering whether ‘should I leave or should I stay’ in practice,” said Ferris. “Because a lot of us are just hanging on waiting for that outcome.”
The College’s 2015 historic pay equity claim under the Bill of Rights Act lead to mediation with the Ministry of Health in 2016 and an agreement in May 2017 to withdraw the court action in return for a 2 per cent funding increase and an agreement to co-design a new funding model that resolved the College’s longstanding concerns about pay equity for self-employed LMC midwives.
But nearly a year on the Acting Director-General Stephen McKernan said that the Ministry had “taken on board advice from the College to include elements of the co-design process” and as a result had agreed to develop a Memorandum of Understanding with the College to “improve ongoing collaboration on the maternity work programme”.
Karen Guilliland, the College of Midwives chief executive, said the College and Ministry “agree a midwifery continuity of care model must be resourced effectively to provide support during pregnancy, labour and birth and through the postnatal period until the baby is six week old”. She added she was also pleased that current workforce shortage issues – like continuing to provide rural primary maternity services – would be prioritised for resolution. The College would make no further comment on what point the negotiations had reached and what elements of the still under wraps co-design model were to be included.
Ferris said midwives were putting their trust in the College but hearing the Ministry would include only ‘elements’ of the co-design rather than fully fund it was “disheartening” and her major concern was that if a truly sustainable model was not funded then the profession could be back where it started in just a few years.
“I know colleagues who have been in midwifery for several decades who say it’s always the same ‘we fight really hard for equal pay, we get given a little bit and things are okay for a few years and then it goes downhill again’ and the cycle starts again.”
LMC midwives fought a case for equal pay for work of equal value in 1993 through the Maternity Benefits Tribunal and won, but the last major pay boost had been in 2007 with only several small inflation increases in the decade since.
Ferris said to be paid well for a job they loved would be the ultimate win for midwives but currently the career was “ridiculously unaffordable”.
She said for rural midwives like herself a 60-70 hour week was the norm with weeks of 80-100 hours not uncommon because of the high travel times between the three towns she served and the base hospital. She said it had been calculated that if rural midwives divided their take-home pay across the ‘often obscene’ hours they worked it would average out at around $7.23 per hour. And for urban LMC midwives at about $12.40 an hour.
Ferris said the result was that communities like Wanaka had nearly a dozen midwives but only a couple were working full-time because the others found it unsustainable. She added that their core midwife colleagues in hospitals were also underpaid and over-worked and if maternity units were short-staffed and short on beds that impacted on the support they could give LMC clients’ requiring secondary support and could see mothers encouraged out the door and discharged early back home which created a ‘huge workload’ for LMCs.
“The main message we want to push to Health Minister David Clark is that New Zealand has an absolutely phenomenal, world-class maternity system with fabulous outcomes…the only point that lets us down is a lack of funding.”
Thursday May 3 ‘Dear David’ midwife marches, walks and rallies
Wellington 11am Civic Square to march to Parliament for “Delivery to David”
Dunedin 11am Museum Reserve – Rally
Auckland 11.30 Central City (to be confirmed)
Taupo 9.30 Lakefront (opposite fire station) for Support our Midwives walk
Hamilton 11am Memorial Drive (then March)
Tauranga 12pm Red Square (Walk with Midwives)
More information at: https://www.facebook.com/deardavidclark/
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