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ARE WE FIT FOR THE FUTURE?
For the vast majority of midwives currently practising in Aotearoa, the College has always existed. Established 33 years ago, at a turbulent and formative time in our profession’s history and evolution, I have always considered our professional identity in this country to be intertwined with the College, to a greater or lesser extent. The re-establishment of midwifery autonomy and its important link to women’s autonomy over their childbirth choices is a fundamental part of our back story and professional identity.
The College has experienced the various iterations of the health system and the different entities which have been established and disestablished along the way: Regional Health Authorities; Crown Health Enterprises; the Health Funding Authority and Health and Hospital Service; District Health Boards and now Te Aka Whai Ora (Māori Health Authority); and Te Whatu Ora (Health New Zealand).
Throughout these changes, the College’s unique role and purpose (as expressed by our constitutional objectives) has remained clear. In its early days, in the absence of a dedicated regulatory authority, the College defined many of the professional frameworks which were necessary to develop in order to ‘re-establish’ the profession. As other entities such as the Midwifery Council have evolved over time, the College’s role has changed to become complementary to that of the regulator. As a membership organisation, we exist to represent the views and conscience of our profession. At times this may mean we engage in healthy and respectful debate with each other and with various other agencies in the wider health sector, although for the most part, we all have the same end goal; improving care and outcomes for māmā, pēpi and whānau.
Although the College’s objectives have been refreshed and updated over the years, our core function representing the collective As a membership organisation, we exist to represent the views and conscience of our profession. At times this may mean we engage in healthy and respectful debate with each other and with various other agencies in the wider health sector.
ALISON EDDY CHIEF EXECUTIVE
voice and vision of the profession has remained steadfast. Our reason for existing is not one of self-interest for the profession, but rather the clear understanding that the protection and promotion of universal access to quality midwifery care supports equity and improves outcomes for birthing women and newborns. Over the years since the College’s establishment, the evidence base which demonstrates this has grown considerably, giving strength to our purpose as an organisation.
COLLEGE’S OBJECTIVES
• To purposefully and continuously develop and maintain a strong autonomous midwifery profession in New Zealand. • To lead, promote and support partnershipbased midwifery practice that conforms to the Code of Ethics and the Standards for
Midwifery Practice. • To lead the development and maintenance of a quality assurance framework to improve maternity outcomes for women and families.
• To advocate for the development and provision of services, policies and programmes that support the improvement of maternity outcomes and health status of women and their whānau.
• To provide expert advice to government and other relevant agencies to strengthen and support the midwifery profession. • To advocate for, promote, and evaluate undergraduate and postgraduate education and provide continuing education for midwives.
• To conduct, promote and disseminate relevant research which provides an evidence base for midwifery practice in
New Zealand.
• To commit to upholding the articles of te
Tiriti O Waitangi by recognising Māori as
Tangata Whenua of Aotearoa. • To build and maintain relationships with relevant national and international agencies to the benefit of midwifery in
New Zealand, and to contribute to the global midwifery community. • To operate in an efficient and effective manner to the benefit of its members through the delivery of a comprehensive professional service to its members.
College Annual General Meeting (AGM)
Date: 23 November 2022
Venue: Novotel Hotel, Cathedral Square, Christchurch
Time: 6.00pm
Remits for consideration: Social Media
consensus statement. Members will be notified of any further AGM remits prior to the meeting, via email.
At a societal level midwifery has acted as a change agent to advocate for women’s reproductive rights, particularly in relation to choices over childbirth and challenging unnecessary medicalisation. Globally, midwifery also plays an important role in advocating against the discrimination women experience as a result of their unique biological reproductive capabilities. Although we may feel we have made significant progress, the recent US Supreme Court decision overturning Roe vs Wade demonstrates that our work is not yet over.
As a profession, we have a strong social mandate. We are accepted by the public as possessing particular knowledge and skills, which we are trusted to utilise in the interest of others. Essentially, the public trusts us to carry out our role as we have been educated to, adhering to the accepted professional standards. When we consider our social mandate, alongside our role to act as change agents for women’s reproductive rights, we must also consider our responsibility to address the well documented health inequities particular individuals and groups experience.
Although these are the result of issues such as intergenerational poverty, colonisation, institutional racism and the Crown’s failure to honour its te Tiriti commitments - all of which go well beyond the scope of what health professionals, let alone the entire health system, can solve - we cannot ignore these issues. Although the College is not a Crown entity, we must consider our responsibilities as an organisation, to address what we can within the context of maternity care.
The College’s board has deliberated over our priorities as we have been updating our strategic plan. Through these discussions, four key areas have been identified to focus on over the next four years.
2022–2026: Strategic plan focus areas Ōritetanga: equity, inclusion and belonging Rangatiratanga: leadership & advocacy Te mahi: support a cohesive, sustainable and innovative workforce for the future
Kāwanatanga: strengthening our organisational structure and capacity
The College’s responsibility to uphold the articles of te Tiriti O Waitangi have been a central feature of the board’s deliberations as the plan was developed. Instead of this responsibility being a stand alone focus area, it is intentionally woven throughout the entire plan, to provide more meaningful direction. Undergoing this process has stimulated further conversations about how we achieve our goals and what this means in terms of our organisational governance, leadership and wider capacity. The College has already taken positive steps toward honouring this commitment, with the cultural review we are about to embark on.
Built on a culture of commitment to the profession by its members, the College started as a grassroots feminist organisation. Our membership has grown over the last 33 years, as has our understanding of the health gains our profession has the potential to contribute to. Our way of working and organisational model has served us well. But if we are to remain successful, we must ask ourselves what we need to change, to ensure we are ready to take on the challenges we face in Aotearoa in 2022. square
class action update
Over 1,300 members have signed up to participate in the class action developed by the College to enforce the terms of the settlement agreement against the Government.
This level of response demonstrates the depth of concern and feeling amongst the profession about the manner in which the profession’s views have been disregarded, and the desire to hold the Government to account for repeated failures to honour commitments made to the College - and the profession more generally - in legally binding agreements.
Under the terms of the current settlement agreement, the Government agreed to:
• develop a new primary midwifery services contract; • fund primary midwifery services to a ‘fair and reasonable’ amount; and • explore what support services (in the form of a midwifery provider organisation) would be required to sustain them.
The College has been working tirelessly on behalf of the profession to hold the Government to its commitments for several years now. Most recently, the College met with the Minister and Associate Minister of Health to ensure the Government fully understood the nature of the issues, why we were proposing to take legal action, and what our desired outcomes are.
The Minister and Associate Minister expressed genuine concern about the Government’s failure to comply with its commitments to the profession. They have indicated an intention to take meaningful action to address our concerns, including setting in place a process to develop a new contract and consider the wider support services needed for primary midwifery services. Minister Little has committed to overseeing the work directly. This is a welcome and constructive response from the Minister and Associate Minister of Health.
However, given the Government’s history of broken promises despite formally entering into settlement agreements on two occasions, the College considers that it is incumbent upon it to take steps to protect the legal position of its members. The College has therefore filed a legal claim on 31 August 2022. The purpose of the claim is to protect the legal position of the College’s members and the profession more generally, under the terms of the existing settlement agreement entered into with the Government.
The College remains committed to exploring all avenues for a durable solution that protects the interests of its members and resolves the systemic issues faced by the profession. This includes enforcing the commitments made by the Government to the profession and/or working constructively with Te Whatu Ora to secure a durable solution to the systemic issues faced by the profession. square
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Image: Angela Scott Photography
