FEATURE
PRIMARY MATERNITY SERVICES NOTICE UPDATED: WHAT DOES IT MEAN IN REAL TERMS? Pursuant to Section 88 of the New Zealand Public Health and Disability Act 2000, the Primary Maternity Services Notice 2007 has been updated by the Government to implement the $85 million that was allocated to primary maternity services in the 2020 Budget. Following a public consultation period from September to November 2020 and considerable input from the College, the notice has now been gazetted and is a substantial improvement on the previous consulted version, indicating the Ministry has taken the College’s feedback on board and responded accordingly. The updated Primary Maternity Services Notice 2021 replaces the 2007 notice in its entirety, and will be implemented on 29 November 2021, once IT systems have
been adapted to enable claiming under the new notice. The most significant changes to the notice are as follows: • A single-service payment for consultation during pregnancy - where the midwife is not the woman’s LMC - has been introduced (e.g. early pregnancy advice and care, but woman does not register). • A payment for registration with an LMC is now claimable. • Fees for each trimester of antenatal care will now be claimable and paid at the conclusion
Whilst the revisions to the notice don’t provide the ultimate solution to the overarching issues currently facing the midwifery profession, the improvements do acknowledge aspects of primary maternity care that have long been undervalued and overlooked.
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of each trimester, rather than paid as lump sums at the end of the second trimester and/ or with the labour and birth fee. • The second midwife fee will become a permanent fixture under the updated notice. • Payments for care provided to women who have experienced a miscarriage will now be easier to access. • A missed birth fee for rural midwives will be claimable.
TRAVEL PAYMENTS Although this section of the notice has not yet been gazetted, the revisions at time of writing are explained here. Final details will be published on the Ministry’s website in due course. Payments in recognition of travel costs will be structured differently under the new notice and will be claimable for each period of care: antenatal, labour/birth and postnatal. Payments will be graduated according to degree of rurality and level of urban accessibility (UA) in line with the Government’s recent review of its previous classification system (which dated back to 1992). The six new classifications apply across all modules of the notice and payment will be determined by the woman’s address: • Major, large or medium urban area • High urban accessibility • Medium urban accessibility • Low urban accessibility • Remote
• A transfer fee for all midwives (urban or rural)
• Very remote
for ambulance transfers will be claimable.
(Stats NZ, 2020)
