That fact that the NSW Health System is in crisis led to the appointment of Mr Peter Garling SC to conduct a review of the acute health care services in NSW in January 2008.
On 27th November, 2008, Mr Garling released his report. Terms of Reference and the report is available here:
The report makes sobering and fascinating reading as Mr Garling outlines the problems which are troubling our health care system, for example, problems such as increased numbers of people accessing health care facilities. Mr Garling praised the skill, competence and dedication of the health care staff, but outlines many changes which need to occur for the health care system to improve. A particularly important point that Garling makes is that "Furthermore, the rigid demarcation between what a doctor’s job is, and what a nurse’s job is, needs to be consigned to history. Once the concept of teamwork is accepted as the norm in treating a patient, it is easier to see why a qualified nurse practitioner should be able to do many jobs once reserved for doctors".
These comments by Garling demonstrate his deep recognition of the power dynamics which are keeping the health care system stuck in its medieval origins and which mitigate against true efficiency and effectiveness for patients well being. Even though Garling only mentions nurse-doctor working relations, his comments are very applicable to the power dynamics which trouble maternity services. His words echo the conclusions of my study into midwife-doctor interactions in the care of birthing women.
thesis available on line here: http://ogma.newcastle.edu.au:8080/vital/access/manager/Repository/uon:2509
The NSW Government is wanting feedback on the Garling Report. You can give feedback here:
Please take a moment to give feedback on this important report. In my feedback I've talked about how birth is normal and that we are seeing iatrogenic outcomes because birth has been treated as an illness. I've argued for an expansion of 1-2-1 midwifery services and talked about how mothers and babies are safer when women feel valued, listen to, respected and given information and then able to make choices which are actioned.
Imagine if we all gave this feedback?