Rising insurance costs and medical litigation reason for decline of private birthing services

Fear of being sued, new name and shame laws and reluctance to crisis manage births is part of the reason why Cairns Hospital will struggle to attract extra staff when private maternity services close later this year.

Fear of being sued, new name and shame laws and an unwillingness to crisis manage births when things go wrong is part of the reason why Cairns Hospital will struggle to attract extra obstetricians needed to cope with surging deliveries when private maternity services close later this year.

Increasing private insurance costs, the crippling cost of professional indemnity insurance and new Queensland laws that name and shame dodgy doctors before any proof of malpractice have contributed to expectant mothers abandoning the private system and obstetricians moving to less risky fields.

Cairns Private Hospital on Thursday announced the axing of private birthing services amid birthrates that have plummeted from 544 in 2015 to about 250 births this year.

After November 1 the Cairns Private Hospital will not offer birthing services. Picture: Brendan Radke

A $5m bailout package announced by Health Minister Shannon Fentiman on Thursday will be used to hire extra staff in a grapple to manage an influx of deliveries, that from November 1 will fall to the Cairns (public) Hospital.

An agreement has been reached to allow Cairns Public Hospital to utilise available beds at Ramsay Health’s Private Hospital, however this deal is expected to be for long stay patients, not mothers recovering post delivery.

National Association of Specialist Obstetricians and Gynaecologists president Gino Pecoraro

said the collapse of birthing services at Ramsay Health’s Cairns Private was being mirrored throughout the state due to the cost of private female reproductive cover that now cost double the premiums paid by men and a growing trend of medical litigation from which obstetricians are not protected by public hospital insurance if found to be negligent.

NASOG president and Queensland obstetrician Gino Pecoraro. Picture: Tara Croser.

“The private system is broken, it’s simply not affordable for the vast majority of Australian women,” he said.

“And obstetricians are the highest chance of being sued and highest chance of suicide of all the specialities.”

In the lead up to Ramsay Health pulling maternity services Cairns Private faced a perfect staffing storm that begun with the suicide of veteran obstetrician Dr Tom Wright in February last year.

Pediatrician Dr Tim Warnock and obstetrician Dr Tom Wright worked together for 30 years. Picture: Stewart McLean

Cairns Private obstetrician Dr Kiesey-Calding stopped delivering in June, the same month Dr Tim Warnock retired and obstetrician Dr Liz Jackson stepped way from private births last March.

Cairns and Hinterland Hospital and Health Service chief executive Leena Singh has said a recruitment process to find specialist staff was underway but denied any “significant issue with recruitment”.

But Dr Pecoraro claims the massive cost of indemnity insurance needed to safeguard against litigation is a major reason for doctors not wanting to work for Queensland Health.

Following the axing of private birthing services up to 40 women due to give birth at the Cairns Private after November 1 will be absorbed by the public system.

However, given that women are strongly encouraged to vacate public beds four hours after a normal vaginal birth compared to leaving a private facility after four days, more Far North women are now understood to be abandoning private health cover.

According to Dr Pecoraro a survey of Queensland obstetricians identified four blocks that have contributed to the statewide maternity crisis.

Cairns Hospital is expected to embark on a recruitment drive after Ramsay Health cut birthing services at Cairns Private Hospital. Picture: Brendan Radke

These include access to private practice, obstetricians not wanting to work in midwifery centric models, the immediate repealing of name and shame legislation and commercially competitive rates if a health service is going to rely on locums.

“Doctors want the legislation repealed, a change in legislation will make it easier to attract staff. The Premier can do that with the stroke of a pen,” he said.

Health minister Shannon Fentiman and MP Cynthia Lui addressed the media at Cairns Airport ahead of a independent inquiry into the troubled Torres and Cape Hospital and Health Service in July. Picture: Kristina Puljak

“We need the Health Minister, Premier and Prime Minister to fix the private medical system because we need both systems together to provide the service.”

Health Minister Shannon Fentiman said the transition of private patients to the public system would be done in a “safe and orderly manner” and disruption for mums-to-be will be “minimised”.

“From the first day I was sworn in as Health Minister, I have been clear that maternity services are a key priority for me,” she said.

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Originally published as Rising insurance costs and medical litigation reason for decline of private birthing services