AIMS Ireland - Twenty reasons to amend Sections 24 and 40

Published: Sunday, February 13, 2011

1. The Bill fails to reflect modern midwifery legislation in countries such as Canada and New Zealand.
2. If Section 24 is passed as drafted, then midwifery will be the only health care profession in Ireland without the ability to govern itself.
3. Midwives must be given the power to run their own affairs, if the profession is to survive.
4. The Midwives Committee must be self-governing, to protect the rights of the self-employed: the Bill empowers the Board to regulate the single most critical issue facing independent practice: professional indemnity.

5. Strengthening the profession of midwifery would help retain midwives. The current haemorrhaging of midwives threatens the health and welfare of mothers and babies.
6. Developing midwifery as a profession would improve the quality of maternity care and contribute to the sustainability of the health system as a whole.
7. Section 40 is (invisibly) tied to a state indemnity scheme that is embedded in a highly restrictive state contract governing all services provided by self-employed midwives.
8. Mandating insurance in circumstances where the sole indemnity accessible to self-employed midwives derives from a state scheme that borders on unworkable undermines midwives' economic rights.
9. By making professional indemnity a statutory requirement for midwives, Section 40 may be in breach of European law, by effectively stifling autonomous practice.
10. Criminalising midwives by setting lengthy terms of imprisonment for those who practice outside the terms of an indemnity scheme that amounts to state micro-management of professional practice is wrong.
11. In making it unlawful for a midwife to practice without indemnity, Section 40, as drafted, will ultimately destroy the livelihood of the self-employed sector, by effectively making public practice impossible and private practice unlawful.
12. In making private practice unlawful, in effect, Section 40 appears to contravene European law guaranteeing the right of establishment. EU Directive 2005/36/EC guarantees the right to pursue a profession, such as midwifery, in a self-employed capacity.
13. The Section, in effect, discriminates on gender grounds, by making indemnity compulsory for midwives but not for medical practitioners (or nurses) and by copperfastening a state indemnity scheme that is, in itself, highly gender discriminatory.
14. Section 40 also appears to breach competition law, by copperfastening the monopoly exercised by doctors over the services for birth.
15. In restricting the practice of self-employed midwives, Section 40, in effect, violates women's human rights. The terms under which midwives are legally required to work are also the conditions under which women are obliged to give birth.
16. In effectively denying large numbers of women the freedom to give birth at home, Section 40 denies them their right to respect for private life under Article 8 of the European Convention on Human Rights.
17. Section 40, in effect, conflicts with the right to self-determination in relation to medical treatment, including the right to decline certain interventions during labour.
18. The Section appears to fail two tests laid down by the European Court of Human Rights for domestic law in this area: foreseeability and an absence of arbitrariness.
19. Section 40 also appears to breach the right to respect for privacy by copperfastening the mandatory handover of midwifery notes to the state.
20. Finally, in making private midwifery practice unlawful, in effect, the Bill denies prospective parents the choice of private midwifery services in the community, including home birth.