Saturday, July 31, 2010

Mothers & midwives share their concerns about the "collaboration" regs with Nicola Roxon in Brisbane

Last Friday, mothers and midwives met with Federal Health Minister Nicola Roxon on the campaign trail at the Wynnum Hospital. They thanked her for Medicare for Midwives and then talked about how they felt the collaboration regulations the Government have introduced will derail the $120m maternity reforms.

This form of ‘collaboration’ sees women needing to have a doctor’s permission before she can claim Medicare rebates for her private midwifery care. Women also run the very real risk of losing their midwifery care at a moment’s notice with no right of recourse or appeal if the doctor decides to withdraw from the ‘collaboration agreement.

See pictures below...





Age newspaper article: Midwives attack new 'veto'

Click below for the article in today's Age:

Age newspaper article: Midwives attack new 'veto'
JULIA MEDEW, Sat July 31, 2010

In response, Liz Wilkes wrote the following letter to the editor:

As a midwife in private practice I provide care to women both at home and in hospital. I have great relationships with doctors where I live yet none will enter a signed agreement with me. Midwives in private practice will have to have a collaborative arrangement in place for ALL women, not just those birthing at home. Midwives always work collaboratively with doctors – we need to and our licence to practice requires us to. What this determination does is limit women’s ability to get a Medicare rebate for care from a private midwife to those who have a signed agreement with a doctor or have the doctor acknowledge all aspects of care. Doctors have no incentive to work this way, have a financial disincentive to participate and often have a philosophical difference in the way they provide care. I am distressed that after 6 years of study and 15 years of practice I am now reduced to having a doctor agree to the care I provide before my women are funded for their care.

Liz Wilkes

Private Practice Midwife

Toowoomba QLD


Letters to the editor can be emailed to: newsdesk@theage.com.au

Friday, July 30, 2010

ACM Educational Meeting Wed 25 Aug - safe sleeping, midwives & doulas, breech birth

See flyer below for seminar and rsvp details for ACM Qld's upcoming educational seminar on Wed 25 August, 1700hr-2000hr at RBWH.

* Professor (Adj) Jeanine Young - Safe Infant Sleeping: On-line training keeping us on-track in reducing infant mortality

* Associate Professor Fiona Bogossian - Midwives and Doulas Working Together

* Associate Professor Joan Webster - Evidence For Practice

* Professor Ian Jones with midwives, Ann Clarke & Marion Lengronne - Breech Birth: Facilitating Informed Choice

Upcoming Birth International workshops

Click here and below for upcoming workshops by Birth International, including:

Rising to the challenge: Caesareans
Brisbane - Wed 13 October


Rising to the challenge: OP labours/VBAC
Brisbane - Thurs 14 October


Sarah Buckley presenting:

The Hormonal physiology of normal birth
Brisbane - Fri 29 October


The hour after birth
Brisbane - Fri 29 October


Sherokee Ilse presenting:

Empty Arms - Making a difference when a baby dies
Brisbane - Tues 5 October

"Collaboration" media

Online article quoting Maternity Coalition on 6minutes.com.au: 'Secret' medical veto angers midwives
Wed 28 July 2010
Read comments here.

AMA's press release on Medical News Today website: Collaborative Arrangements Will Provide Better Care For Patients
Fri 30 July 2010

Thursday, July 29, 2010

Ch 9 news story: Concern over rise in cesarean numbers in Qld

Video - Ch 9 news story: Concern over rise in cesarean numbers
Thurs 29 July 2010

Two minute news story about the rising caesarean rate in Qld. Featuring FBC patron and radio announcer Robyn Bailey, Dr Gino Pecoraro and and midwife in private practice Andrea Codega.

News article: MIPP "bails up" Gillard in Melbourne

Another example of the ongoing campaign by mothers and midwives to bring attention to the "collaboration" issue during this election campaign...

Deakin battle brings PM Julia Gillard to Ringwood
Maroondah Leader, Thurs 29 July, 2010

The surprise visit went off without incident, apart from an independent midwife who bailed up Ms Gillard as she headed for the exit.

“At the moment the government are completely squashing us to be able to support women in homebirths, they’re trying to eradicate independent midwives,” Melinda Morieson, of Midwives Naturally, explained to media afterwards.

Ms Morieson said she was not happy with Ms Gillard’s response, who said that “giving the women the choice, it is really important” and asked her to contact Mr Symon.

Courier Mail article: Fears persist over midwife-led Gold Coast birth centre

Courier Mail article: Fears persist over midwife-led Gold Coast birth centre
Janelle Miles, Wed 28 July, 2010

Comments below the article include some from Bruce Teakle and Mary Sidebotham.

Message from Birthtalk


Been impacted by your birth and not been to Birthtalk yet? Want to help pave the way for better understanding about traumatic birth? A registered midwife is undertaking research in Brisbane, as part of her Masters of Midwifery study, to raise awareness of the potential for childbirth to cause emotional trauma or stress to women. She hopes her research will inform practice for health care professionals working with women in order to prevent or reduce the incidence & impact for women and their families. To participate, you need to live handy to Brisbane, have NOT been to Birthtalk, and be willing to undertake a 1 hr interview, and also to attend a Birthtalk meeting post-interview. To find out more, just email us at info@birthtalk.org
(Click here to go to our contact details & email link).

The Art of Mindful Birthing workshop, Sun 22nd Aug, Bris

See below for a message and flyer from Georgina Kelly:
Hello Lovely Women

I’m running a one day workshop of The Art of Mindful Birthing in August – flier attached. This will be slightly different from the usual 4 wk series that I run. The venue is new too, so I’m enjoying the sense of freshness.

I’d love your support in passing this flier on to any women who may be interested – pregnant women, women hoping to be pregnant, women who are processing past births, women who work with pregnant women etcetera!

Thank you!

Love Georgina

ps: sliding scale is possible for women with limited finances

Tuesday, July 27, 2010

Mothers protest midwifery regulations outside Gillard/Roxon launch in Brisbane today - photos, ABC news video, press release and MC letter to Roxon



Today PM Julia Gillard & Health Minister Nicola Roxon held a mental health funding announcement at the Convention Centre at Southbank, Brisbane. A number of mothers protested outside about our concern with the new midwifery regulations (as described in our previous post).

A HUGE THANK YOU TO everyone who was able to attend at such short notice and to everyone who said they wanted to come but couldn't make it.

See below for photos, a link to ABC News coverage, the press release MC Qld distributed to media afterwards and a link to the letter from Maternity Coalition to Minister Roxon outlining our concerns.









Link to video footage of ABC News story.


MC Qld's Press Release:
Brisbane Mums snubbed by Gillard & Roxon today


At 10.30am this morning a vocal group of Brisbane mothers gathered outside Prime Minister Gillard’s mental health launch at the Brisbane Convention Centre, to protest about doctors' control of midwifery practice and reduction of women's choices as a result of new Federal Government regulations.

“We welcome Julia Gillard’s announcement about increased funding for mental health. Suicide is the leading non-direct cause of death for new mothers. We know that good quality maternity care, including from a known midwife, is likely to be protective against post-natal depression”, said Melissa Fox, West End mother of two and Vice President of consumer group Maternity Coalition’s Queensland Branch.

“Last night a letter of concern was sent from maternity consumer advocacy group Maternity Coalition to Health Minister Roxon. This morning we mothers were very disappointed that neither politician met with us to hear our concerns”.

“The Government has committed $120m to Medicare for midwives. We call on the Government to remove the legislative barrier to enable the reforms to work. No action on the part of the Government would result in no improved access for women to midwifery models care ”.


Click here for the letter sent by Maternity Coalition's National President Lisa Metcalfe to Health Minister Nicola Roxon and cc'ed to Prime Minister Julia Gillard, setting out our concerns with the regulations.

Gold Coast Birth Centre article by journalist Dad

Click below for a very personal two page article in the Gold Coast Bulletin about the recent Gold Coast Birth Centre protest, by journalist and Dad Dwayne Grant.

Maternal instincts
by Dwayne Grant, Gold Coast Bulletin, Sat 24th July, 2010.

I may be at the Friends of the Birth Centre meeting as a journalist but my status as a birth centre dad carries more weight.

Monday, July 26, 2010

Doco series on UK maternity services starting tonight 8.30pm, SBS

One Born Every Minute
For official website click here.

8.30pm, Tues 27 July (for 8 weeks)
SBS
Every minute of every day, a baby is born in Britain. One Born Every Minute is an 8-part series that celebrates what it is really feels like to become a parent, by taking a bustling maternity hospital and filling it with forty cameras. Filming from the reception desk to the neo-natal ward; from the operating theatre to the birthing pool, this ground-breaking new series observes the dramatic, emotional and often funny moments that go hand in hand with bringing a new life into the world, from the perspective of the soon-to-be parents and family, as well as the hospital staff. 2010 BAFTA Winner for Best Factual Series. (From the UK, in English) (Documentary Series) *New Series* PG CC WS

The National Childbirth Trust in the UK released this statement about the series:

NCT COMMENT ON NEW CHANNEL 4 SERIES ‘ONE BORN EVERY MINUTE’

Released on 09/02/2010

Background

‘One Born Every Minute’ is a new documentary series on Channel 4 that follows the day to day life in a maternity ward. Filmed over a month the series highlights the intense experience of bringing a new life into this world from the perspective of the soon-to-be parent, the family, and the maternity ward staff.

Quote

Elizabeth Duff, Public Policy Officer, NCT says:

"‘One Born Every Minute’ shows the importance of the day a child is born in the parents’ life, with a narrative reflecting their thoughts, hopes and fears.

"This first day in the life of a new family deserves every chance to be wonderful – the NCT wants the experience of birth to enrich parents’ lives and give them confidence in their new roles. For this to happen, maternity services need midwives to provide continuous support to women in labour and their partners. The birth environment should be comfortable, relaxing and a place that is fit to start a family.

"‘One Born Every Minute’ shows the reality of maternity services today. The midwives do their job well under great pressure. Caring for a wide diversity of women, from every walk of life and with a variety of clinical conditions, they are overstretched and under-resourced – ‘firefighting’ instead of being able to give calm and continuous support to parents on the day their lives change forever.

"NCT has concerns about the challenges encountered by parents and staff in the maternity service environment. However, we are pleased to see the programme and its associated website http://lifebegins.channel4.com/ highlighting important issues about childbirth and maternity care. NCT offers support, information and contact opportunities to parents around the childbirth experience and the transition to parenthood."

Animation of birth

Click here to see an animated 4 min film "From Conception to Birth" on TheVisualMD. Watch the baby wriggle and turn through the pelvis from 3.00mins.

Seminar: "Midwifery practice and the Law", Sat 11 Sep, Sunshine Coast

See below for a flyer for a seminar being organised by Update Education:

Midwifery practice and the Law
*Protect yourself*Protect your colleagues*Protect your clients*
With speaker Hugh Carter, Barrister at Law and Specialist in Health Law

Topics include consent given by adults, adolescents and the legally incompetent
Medical negligence, confidentiality and the duty to inform
The status and rights of the unborn and end of life decision-making

Sat 11 Sept 11th, 8.30am - 3.30pm
Alexandra Beach Resort, Alexandra Parade, Sunshine Coast, Qld

Blog spotlight #2: The Unnecesarean - World Cesarean Rates: OECD Countries

A recent post on the blog The Unnecesarean showed a table of "the cesarean rates of OECD countries from 2004 to 2008".
World Cesarean Rates: OECD Countries

OECD Health Data 2010, released on 29 June 2010, is a comprehensive source of comparable statistics on health and health systems across OECD countries. According to its website, “it is an essential tool for health researchers and policy advisors in governments, the private sector and the academic community, to carry out comparative analyses and draw lessons from international comparisons of diverse health care systems.”

Click here to see the post and see where Australia sits.

Blog spotlight #1: Science & Sensibility - "Cascade of Normal" diagram

Check out a power point slide "Cascade of Normal" from Vicki Van Wagner's talk on midwifery in an Inuit region of Arctic northern Canada, at the Normal Labour & Birth International Research Conference, held 20-23 July in Vancouver. It's shown in Science & Sensibility's latest post Live blogging is hard.

Friday, July 23, 2010

IMPORTANT update from Maternity Coalition: The medical veto over Medicare for midwives is now law

The Government's $120 million national Maternity Reform Package is currently being implemented. From 1 November 2010 Medicare rebates will be payable for care from eligible private practice midwives, subject to certain conditions.

For the last nine months consumer and midwifery groups have been lobbying hard around the one key sticking point of these reforms – how midwives and doctors will work together. The government stated from the outset that the midwife would be required under legislation to work in a “collaborative arrangement”. Consumers and midwives have argued for the definition of these arrangements to be one which supported women's choice and access, and which did not give doctors control over women's access to Medicare rebates.

After months of suspense, the Determination defining "collaborative arrangements" was quietly signed into law by the Governor General on 16 July, without notification to stakeholders. The Determination can be downloaded from this link.

The Determination provides 4 options for collaborative arrangements. Each option requires the midwife to have some form of permission from a doctor, before a woman can receive Medicare rebates.

The minimum form of permission is an "Arrangement - midwife's written records" (section 7 in the Determination). This option requires a named doctor of a specific type to acknowledge "that the practitioner will be collaborating in the patient’s care", and that the named doctor has received copies of a hospital booking letter and a maternity care plan.

These requirements will make it very difficult for women to access Medicare-funded care from midwives in private midwifery practice. We don't expect midwives in private midwifery practice (working for themselves, not a doctor) to be able to find private doctors who are willing to enter collaborative arrangements with them. In some cases this may be possible under very specific conditions. However it is unrealistic to expect that private doctors will collaborate in the care of women planning homebirths.

Even for women planning births in public hospitals, these requirements for collaborative arrangements will make it extremely unlikely for them to be able to access Medicare-funded midwifery care. There is no reason to expect public hospital doctors to enter the required collaborative arrangements with private midwives. They have no incentive, and there is no sign that state governments are planning to push them.

In March 2010 when the Senate was debating this legislation, the Government stated that "There is no intention to provide a right of veto over another health professional’s practice". However, under intense pressure from the medical lobby, this is exactly what has occurred. Most importantly, it is women's choices and access to care which are being vetoed, to protect medical control of the maternity marketplace.

If these reforms are to deliver the "choice and access" promised to Australian women by Government, the medical veto must be removed. Midwives must be accountable to the women they care for, and to their regulating body, not to another profession.

Go here for today's press release from the Greens on this issue:

Greens Will Act to Help Midwives

The Australian Greens said today that midwives are furious with the Federal Government over recently released regulations governing the way they practice.

Greens spokesperson for Health, Senator Rachel Siewert has committed to immediate action on the regulations upon the resumption of Parliament.

“As soon as the Senate next sits, the Greens will move a motion to disallow the collaborative arrangements regulation,” Senator Rachel Siewert said today.

"Women are outraged that they have been told that Medicare rebates will be available for private midwifery care and now the reality is that this will be limited to those employed in an obstetric model which many women have said over and over again that they don't want," concluded Senator Siewert.


******What mothers and midwives can do right now to try to change this******

- Tell your Federal election candidates that you want them to remove the doctor's veto over women's access to Medicare for midwives. Ask them if they will commit to doing this if elected.

- Tell your candidates that you want them to protect women's rights to choice in birth, and ask if they will commit to this.

- You can give these messages by writing, phoning, or stopping and talking to your candidate while they campaign in your electorate. You can call talkback, write emails to the editor, or wave a placard at an event.

To find your Federal electorate click here.

Please contact MC Qld if you want to know more or if you would like someone to come with you to see your MP/local candidates. Email: qldpresident@maternitycoalition.org.au

Mumatopia launch - Sat 14th Aug, Ipswich

Get along if you can to the launch of Cas McCullough's fabulous venture Mumatopia. The twilight market will include stalls, speakers, free entertainment, light refreshments, raffles and goody bags. See below for details:

Trailer: Guerilla Midwife documentary


Click here to watch a powerful, short preview of the documentary film "Guerilla Midwife" about midwife Robin Lim's work in Bali and Aceh. The film was made by her daughter, director Deja Bernhard. The film's website also has photos, poetry and more.
Guerilla Midwife
A 90 minute documentary film by Deja Bernhardt

Guerilla Midwife follows Ibu Robin Lim into the trenches of her work. From Bali, where hemorrhage after childbirth is a leading cause of death, into the Tsunami disaster zone in Aceh, where her battle is fought with only one weapon, love. In this culturally mesmerizing, heart wrenching documentary, you will discover why we must reinvent our protocols for pregnancy and childbirth in order to preserve our Planet's Humanity.

US obstetricians issue less restrictive VBAC guidelines, CIMS response

See below for an excerpt from the Wed 21st July release from the American College of Obstetricians and Gynecologists (ACOG):



Ob-Gyns Issue Less Restrictive VBAC Guidelines


For Release: July 21, 2010

Washington, DC -- Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans, according to guidelines released today by The American College of Obstetricians and Gynecologists.

"The current cesarean rate is undeniably high and absolutely concerns us as ob-gyns," said Richard N. Waldman, MD, president of The College. "These VBAC guidelines emphasize the need for thorough counseling of benefits and risks, shared patient-doctor decision making, and the importance of patient autonomy. Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals, and insurers to swing the pendulum back to fewer cesareans and a more reasonable VBAC rate."

In keeping with past recommendations, most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a TOLAC. In addition, "The College guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC," said Jeffrey L. Ecker, MD, from Massachusetts General Hospital in Boston and immediate past vice chair of the Committee on Practice Bulletins-Obstetrics who co-wrote the document with William A. Grobman, MD, from Northwestern University in Chicago.


The Coalition for Improving Maternity Services (CIMS) is a US coalition of individuals and national organizations with concern for the care and wellbeing of mothers, babies, and families. Their mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This is an excerpt from their response (click on link to read the entire release):


CIMS Responds to Promising but Conflicting Revised VBAC Guidelines

Raleigh, NC (July 23, 2010)-The Coalition for Improving Maternity Services (CIMS) supports the recommendations of the March 2010 National Institutes of Health (NIH) Consensus Statement on VBAC (vaginal birth after cesarean) and is pleased by the American College of Obstetricians and Gynecologists' (ACOG) newly revised practice guidelines (Practice Bulletin #115) that encourage expanded access to VBAC and confirm a woman's right to labor after a prior cesarean. However, ACOG made limited changes to what the NIH concluded was a key factor that blocked access to VBAC -- ACOG's previous recommendation that VBAC should take place only in hospitals where physicians capable of performing an emergency cesarean, anesthesiology, and supporting staff are "immediately available."

The NIH reported that the "immediately available" recommendation, made by ACOG and the American Society of Anesthesiologists (ASA) in 2008, was based on opinion rather than strong support from high-quality evidence. More importantly, the NIH concluded that in too many areas of the country certain resources are "too few" for all hospitals to comply with the "immediately available" recommendation. CIMS questions the logic of drafting clinical guidelines that in fact cannot be realistically implemented.

NIH found that malpractice liability concerns in light of the continued "immediately available" recommendation may continue to restrain providers who would otherwise support women's wishes for VBAC.

CIMS gives ACOG much credit in its efforts to incorporate women's autonomy, values and preferences in their revised VBAC guidelines, but urges ACOG to reconsider and remove the current selective barrier to women's access to VBAC stemming from the "immediately available" recommendation.

Gold Coast Birth Centre update from ACM Qld


Australian College of Midwives - E-Bulletin
Wed 21 July 2010

Gold Coast Birth Centre re-open for business

The unexpected and unwarranted closure of the Gold Coast Birth Centre at 5pm on Thursday 15 July without warning or consultation sent shock waves through the birthing community in South East Queensland and beyond. The Australian College of Midwives Queensland was first notified of the closure through their close links with Maternity Coalition. Action commenced immediately with Friends of the Birth Centre organising a rally in Little High St in front of the CEO’s office on Friday 16 July. ACMQ, Maternity Coalition, Friends of the Birth Centre notified people in the maternity reform network to attend the rally.

500 women and their families gathered at the Gold Coast on Friday at 11am with widespread media action. Deirdrie Cullen led the MC and FBC women in this rally with Dr Kerry Peart from Griffith University and a large number of student midwives joining the rally. Associate Professor Jenny Gamble, media spokesperson for ACMQ, and Deirdre Cullen (FBC) gave many media interviews throughout Thursday night, Friday and Saturday and spoke passionately at the rally about this being an example of poor obstetric behaviour rather than a safety concern.

A link to Channel 9 coverage of the rally posted to YouTube:
http://www.youtube.com/user/janiceingerman

A link to Channel 7 coverage of the rally:
http://au.news.yahoo.com/video/queensland/watch/20905521/

Concurrent to the rally being held at the Gold Coast a number of other important meetings and contacts were made. Dr Mary Sidebotham, Vice President of ACMQ and Liz Wilkes met with the Chief Nursing Officer and Dr Belinda Maier, Midwifery Advisor and subsequently with the Director General for Queensland Health, Mick Reid. The DG assured prompt action to re-open the Birth Centre and committed to an independent enquiry of the Gold Coast maternity service with consumer and midwifery involvement.

Hazel Brittain ACMQ President, contacted midwifery managers at the Gold Coast Hospital, while Jocelyn Toohill and Rosemary Blyth supported local midwives and assisted them to deal with the situation. The QNU and local MP’s were briefed.

Following the rally, a noisy group met with the CEO in an impromptu meeting to air concerns. The CEO cited withdrawal of “support” by obstetric consultant staff as the reason for the closure. A core group of women and midwives met with the CEO from 5:30pm and just before 8pm completed negotiations with decision to re-open the Birth Centre immediately. The first birth in the re-opened Birth Centre occurred just after dawn on Saturday morning to a woman who had been rallying and speaking to the media at the rally – women are amazing.

This incident highlights the tenuousness of midwifery group practice and the ability of midwives to provide continuity of care. ACMQ have recently discussed safety and clinical care at the GCH Birth Centre reference group and there have been no reports of concerns. It is extremely important that midwives recognise that these actions are indications of poor collaboration on the part of some specialist obstetric staff and call for appropriate management of all professionals working in the pubic sector.

ACMQ would like to thank the women, babies, husbands, midwives, student midwives and other consumers who gathered at such short notice to support this important and safe service. ACMQ will continue to seek a public statement from the CEO of the Gold Coast District that the service provides high quality midwifery care, excellent clinical outcomes, and that there are no concerns about public safety. We will push for independence in the GCH maternity service review and ensure midwifery and consumer representation.

Go Queeensland maternity reformers - what a team effort!

Wednesday, July 21, 2010

Wesley Maternity Conference "Legal and Ethical Issues in Maternity Care" Wesley seminar - special rate for MC & HMA members extended til Fri 30 July

Organisers of the Wesley Maternity Conference "Legal and Ethical Issues in Maternity Care" have kindly extended the special $125 rate for all MC & HMA members up to & including 30 July.

Legal and Ethical Issues in Maternity Care
Saturday 7 August 2010
Wesley Hospital, Auchenflower

The Wesley Maternity Conference is an opportunity to learn more about legal and ethical issues, advocacy, evidence-based practice, the consumer perspective and much more.


For more information including details of MC's speakers click here.

Consumer Representative sought - Informed Consent Reference Group

See below from Health Consumers Queensland. Please contact HCQ for an Expression of Interest form if you would like to apply...


Consumer Representative sought - Informed Consent Reference Group

The Patient Safety & Quality Improvement Service is requesting HCQ's assistance with the recruitment of one (1) consumer representative for their Reference Group.

Mariee Piper, Informed Consent Program Manager, Queensland Health, has provided the following information about the consumer representative role and reimbursement rates.

The consumer representative would need to:
- Attend quarterly Reference Group meetings which will be 2hrs in duration (next meeting Wednesday 4 August, 2 - 4pm) and located at the Royal Brisbane & Women's Hospital, Level 14, Block 7, Herston Road, Herston. Members serve a 2 year term.
- Actively contribute to the reference group by reflecting the consumer's experience and having a voice in how informed consent in relation to medical procedures is strategically conducted in Queensland Health.
- Have an open interest in, and knowledge base of, informed consent to be able to receive and disseminate information, identify and problem solve issues relevant to the Informed Consent Program.
- Be prepared to read and review documents in preparation for meetings and on occasion comment via email on documents between meetings.
- Have a mechanism to feedback information to other consumers and to represent other consumers' views.
- We encourage consumers who have experience in and representing Adults and Young Adults (18-24years) to apply as this group is currently under represented on this reference group.

The reimbursement rates for the consumer representative are:
- $96 for meetings <4hrs (includes preparation time)
- $159 for meetings >4hrs (includes preparation time)
- Motor vehicle allowance (varies depending on the cc of the vehicle- $0.58 to $0.70/km)
- Consideration will be given to reimbursement of reasonable travel and accommodation to attend meetings and forums.

Health consumers who would like to express interest in this consumer representative position need to register as a member of HCQ's consumer network. If you are not already a member you can register at www.health.qld.gov.au/hcq/network_reps/rego_form.asp

If you are interested in nominating for this consumer representative role could you please complete the attached expression of interest form and return this to Olivia Spadina (details below) by 30 July 2010.

Contact details:

Olivia Spadina, Senior Policy Officer
Health Consumers Queensland
PO Box 48, Brisbane QLD 4001
Ph: 07 3234 0611 / email: dshcq@health.qld.gov.au

If you require any further information about this position and the nomination process please contact Olivia Spadina on 07 3234 0611.

Thank you for your assistance.

Kind regards

Secretariat
Health Consumers Queensland
Ph: 1800 613 251* (toll free) / 07 3234 0611
*Mobile calls to this number may incur extra charges depending on your mobile phone service provider.

ACM - E-Bulletin: Beaudesert petition

In regards to Beaudesert Maternity services (see previous post for background), please see below...

Australian College of Midwives - E-Bulletin


Dear friends and colleagues,

Many of you will be aware of the current consultation surrounding provision of maternity services in the Beaudesert area.

It is important that we collect the views of the local and wider community to demonstrate support for provision of local maternity services for women.
An e petition has been generated to demonstrate to government that there is support for the provision of midwifery led services in the Beaudesert areas.

I would ask you to take the time to go the web linked page and sign the petition (click here).

Whilst you may not personally be involved with or affected by provision of services in Beaudesert this is an important statement to make in support of all women being able to access services locally throughout the State.

Please pass this message on through your networks and encourage your friends and colleagues to show their support too

best wishes

Dr Mary Sidebotham
Vice President
Australian College of Midwives
(Queensland Branch)
Ph 338 21378
M 0434932303

m.sidebotham@griffith.edu.au

GC Bulletin article: Mum defends birth centre after stillbirth

Gold Coast Bulletin article:Mum defends birth centre after stillbirth
, Tuesday July 20th, 2010.

calmbirth® course with Sharon Gavioli in Brisbane - Sat 31 Jul-Sun 1 August



See below for a message from Sharon Gavioli:


To my fellow birth workers and supporters,

There is another calmbirth® course coming up in less in 2 weeks on Saturday the 31st and Sunday the 1st of August from 9-5 each day. The course is held at Kybra at Runcorn which is just off the gateway.

Currently there is only space for 2 more women and their partners available.

The program aim is to address the beliefs and fears women and men have around birth and then from this platform offers tools to enable the women to reconnect to her own innate inner resources. It also provides men and other support people a clear understanding how to support themselves and the birthing woman. For more information about calmbirth see www.calmbirthbrisbane.com.au

I personally feel the program offers a new way for women and their partners to embrace their baby's birth. It provides simple and effective understandings and tools for all birth and all birth settings.

From the words from a woman who attended the calmbirth® program: "The birth was an unexplainable incredible experience, I felt total calmness and confidence throughout the entire birth, She was born as I'd hoped." Lisa

I would appreciate you sending this email and flyer to your networks and any friends who you feel may be interested.

With thanks,

Sharon

Sharon Gavioli RN,
Grad, Dip, Childbirth Education
Ad. Dip. Counselling
Reg. calmbirth® Practitioner
p. 0417 083 803
e. sharon@calmbirthbrisbane.com.au
www.calmbirthbrisbane.com.au

Courier Mail article: Almost half of Qld women birthing in private hospitals having caesareans

Caesarean deliveries on the rise in Queensland private hospitals
Courier Mail, Monday 19 July, 2010

ALMOST half of Queensland women giving birth in private hospitals are having caesareans and the numbers are rising.

Queensland Health figures show 48.6 per cent of the almost 19,000 mothers who delivered babies in private hospitals last year had caesarean sections.

That compares to 27.6 per cent of the 43,000 who gave birth in the public sector.

Overall, 33.9 per cent of Queensland mothers in 2009 delivered their babies via caesarean, compared to 30.9 per cent nationwide.

For the whole article go here.

Monday, July 19, 2010

Today's GC BC media plus link to birth centre activism photo album

Two great articles from today's Gold Coast Bulletin:

Coast birth centre pushes on
Stephanie Bedo | July 19th, 2010
A single phone call was all it took to spark a rally at which hundreds of locals protested against the centre's sudden closure last week.

A telephone contact tree sprung into action on Thursday night and within hours women far and wide knew about the rally at Southport that would help save the Gold Coast Hospital's Birth Centre.

Deirdrie Cullen was a woman on a mission.

As founding member of Friends of the Birth Centre Gold Coast branch, she knew whom to call.

Through text messaging, email and shout-outs on social media, word spread fast 'be there at 11am Friday to show your support'.

The main players were Friends of the Birth Centre, the Maternity Coalition and Gold Coast Home Birth Group but they sparked many other organisations to join in.


Birth centre to remain open during review
Stephanie Bedo | July 19th, 2010

GOLD Coast Health District chief executive Dr Adrian Nowitzke has this afternoon announced the Gold Coast Birth Centre will remain open while an external review of maternity services is undertaken.

Dr Nowitzke said the review would look at the entire service and cover birthing, gynaecology and clinical and corporate governance of obstetricians and midwives.

He said the review committee would comprise interstate and independent members and would be represented through doctors, midwives and consumers.

``At the end of the day we've caused distress to people on the Coast,'' he said.

``We take that very seriously and we're very sorry for that.''
Dr Nowitzke said he wanted to make it clear he fully supported the midwifery model of care, as did the obstetricians.

He said midwifery was constantly changing and the hospital had to change with it, which was one of the reasons for the review.


Facebook photo album - Mothers & midwives working together - Birth Centres in Qld

Whether you are on Facebook or not, you can click on this link to see a photo album showing some of the history of many, many mothers and midwives in Qld supporting birth centres. The slides are from a power point presentation of over 250 slides by Maternity Coalition's Qld Branch called "Passion, Politics and Parents - Birth Reform in Queensland since 2001".

Listen or download: Sue Kildea on ABC Radio National - Birthing on country for Aboriginal women

As flagged in our previous post, go here within the next week to listen or download Sue's interview (13 mins). It includes her description of an exciting new joint statement at the Breathing New Life Conference between ACM, RANZCOG & ACRRM which is supportive of trialling a model similar to the Inuit model.

Birthing on country for Aboriginal women

By Maria Tickle

Thursday, 15/07/2010

The stories of Aboriginal women from remote communities who were transported to Darwin to give birth because their community didn't have medical support are compelling.

In Francesca's words "It takes a long time, always them watching and they put you onto a lonely machine, no company, no-one to rub you, just a green bowl and cold water to wash your face in."

Michealis says "When I had the baby there were big mobs of people and male doctors watching. I was on the bed and told open my legs up. I didn't like being there, I didn't like the men being there and I didn't like being watched. It was such a shame job."

This way of giving birth may change if a model of community birthing which has been successful in Canada for the past 20 years is adopted here.

Last week the president of the Royal Australian and New Zealand College of Obstetricians and Midwives, Ted Weaver, gave support for a trial of such a program whereby indigenous women from the community are trained as midwives.

In this report: Sue Kildea, Professor of Midwifery, Australian Catholic University and Mater Mothers Hospital in Brisbane


Listen to or download story.


Click on:
Thursday 15 July 2010
1145 Birthing on country for Aboriginal women

Saturday, July 17, 2010

Gold Coast Birth Centre REOPENED - media roundup & FBC meeting tomorrow 10am (Mon)

See below for a media roundup of the protest against the closure of the Gold Coast Birth Centre.

Photos, comments, stories and updates are on the Save Gold Coast Birth Centre Facebook group. The group has grown to almost 1500 members in just over 48 hours!

Friends of the Birth Centre's Gold Coast branch are meeting on Monday at the Southport Library from 10am, so get along if you can!


MEDIA:


Article in Gold Coast Bulletin plus VIDEO: "Birth centre open and baby comes too", Saturday 17 July, 2010.

THE Gold Coast Hospital's Birth Centre was reopened in the nick of time for Karen and Ben Trevers-Grace following a tumultuous 24 hours in which the centre was closed, picketed and then forced to re-open and then was became the scene of the birth of their second son.

Mrs Trevers-Grace of Coombabah said after yesterday's rollercoaster ride, she was relieved to hear the good news.

''We got a call from the CEO himself at 7pm to tell us it was reopening and we were so relieved,'' she said.

''I think it showed because my body realised it was safe to give birth and two hours later I was in labor.''


Editorial in Gold Coast Bulletin:"Mums-to-be need better treatment", Saturday 17 July, 2010.

Article in Gold Coast Bulletin plus VIDEO: "Mum power reopens Coast birth centre", Saturday 17 July, 2010.

Article in Courier Mail: "Protests get Gold Coast Hospital's birth centre reopened", Friday 16 July, 2010.

After a full day of negotiations, Dr Nowitzke agreed to reopen the centre.

Maternity Coalition Queensland branch president Rebecca Jenkinson called the closure ''an attack on women's choices''.

Online article on ABC: "Families in shock at birth centre closure", Friday 16 July, 2010.

7 News video story, Friday 16 July, 2010.

Online article on Prime: "Mums and midwives rally after birth centre closure", Friday 16 July, 2010.

Article in Gold Coast Bulletin plus VIDEO: "Hundreds march to save Coast birth centre", Friday 16 July, 2010.

Article in The Australian: "Protests after Gold Coast Hopsital's birth centre closed over safety concerns", Friday 16 July, 2010.

Call for EOIs for assistance to attend HCQ's Patient Travel Assistance Forum - Mount Isa - Tuesday 3 August 2010

See below...

Health consumers living in the North, Far North and North West Queensland and the Gulf are invited to express interest in attending a forum Health Consumers Queensland is holding in relation to Patient Travel Assistance.

Health Consumers Queensland (HCQ) aims to strengthen the consumer (patient) perspective in health services policy, systems and service reform and improvement by providing the Minister for Health with information and advice and by supporting and promoting consumer engagement and advocacy.

HCQ is hosting a targeted forum for consumers in the North, Far North and North West Queensland and the Gulf in relation to the Patient Travel Assistance on Tuesday, 3 August 2010 at The All Seasons Hotel, Rodeo Drive, Mount Isa from 6:30 pm to 9.00 pm. Attached is further information about the forum.

The purpose of the forum is to gather a cross section of consumers' perspectives in the North, Far North and North West Queensland and the Gulf about current issues relating to the Patient Travel Assistance and to explore solutions and strategies to improve outcomes for health consumers.

Limited sponsorship (accommodation and travel) is available to those consumers who would otherwise be unable to attend this event.

Applicants wanting to attend must complete an expression of interest form. Those wanting sponsorship and/or support need to indicate this on page 3 of the expression of interest form.

The expression of interest form can be returned by email, post or fax to HCQ as per the details on the application form. If you require assistance to complete the form, please phone (07) 3234 0611 and a member of the Secretariat will be able to assist you.

Please note this document contains attachments which are over 1MB to download from your computer. If you have difficulty in accessing, reading or printing this, please contact Health Consumers Queensland on 3234 0611 and we can assist you.

We look forward to seeing you at the forum.


Kind regards

Secretariat
Health Consumers Queensland
Ph: 1800 613 251* (toll free) / 07 3234 0611
*Mobile calls to this number may incur extra charges depending on your mobile phone service provider.
********************************************************************************


Thursday, July 15, 2010

Gold Coast Birth Centre CLOSED yesterday - RALLY TODAY 11am

See below for Maternity Coalition Queensland's press release sent out last night.

Join the Save Gold Coast Birth Centre Facebook group to stay updated.

PRESS RELEASE: Thurs 15 July

Gold Coast Birth Centre shut without notice – women rally


The closure of the Gold Coast Birth Centre this afternoon at 5pm without consultation or explanation has left Queensland women outraged and preparing to rally. Hundreds of women will be left without their expected birth care as a result of a completely unexplained closure.

Rebecca Jenkinson, mother of two and President of Maternity Coalition Queensland branch said that women will be travelling from all over the South East to protest. “There have been rumblings for months about hostile attitudes from the Gold Coast Hospital management. Now this closure has occurred today without consultation or proper process.”

The best quality evidence shows birth centre midwifery care to be at least as safe as standard birth care. “Transfers to medical care are a normal and safe part of birth centre care and adverse outcomes occur in all models from time to time. But these women are in a birth centre metres away from a regular birth unit – on the same floor even. This closure is an attack on women’s choices.”

“At a time when both the Federal and State Governments are looking to expand midwifery choices for pregnant and birthing women it seems that Gold Coast Hospital are out of step with what’s happening across Queensland and Australia. In fact, the state government is planning to open another Birth Centre in Toowoomba by the end of this year because this model of care is so popular with families.”

Maternity Coalition were involved in the lobbying which led to the election commitment to establish a Birth Centre at the Gold Coast Hospital. “Five years on, the Government should be moving to expand this model of care, and give all women access to continuity of carer from a known midwife” Ms Jenkinson said. “We call upon the Minister for Health to act urgently to protect women’s access to this kind of care – a model of care that has repeatedly been shown to be safe and is in great demand from women” Ms Jenkinson added

Women are gathering from 11am at Little High Street, Southport with their babies to demand that the Birth Centre be immediately reopened.

For more information contact Maternity Coalition Qld Media Spokesperson: Joanne Smethurst, 07 3256 8127.

Tuesday, July 13, 2010

Sue Kildea on Radio National tomorrow approx 11.30am (Thurs 15 July)

Sue Kildea will be on ABC Radio National's Bush Telegraph program tomorrow approx. 11.30am. She will be discussing birth on country and her upcoming trip to Inuit communities in Canada. Listen in or listen to the podcast afterwards.

Professor Sue Kildea is the Professor of Midwifery and Clinical Chair of Midwifery for the ACU and Mater Health Service.

She is a registered nurse and midwife with clinical, management, policy, education and research experience across both acute care and primary health care settings. Together with Molly Wardaguga, a Senior Aboriginal Health Worker from Maningrida, Professor Kildea was the joint recipient of the UTS Human Rights Award in 2004 for contribution to advancing reconciliation between Indigenous and non-Indigenous Australians. She has performed World Health Organisation and other consultancies in Vietnam, Mongolia and Indonesia and worked as a midwife in South Africa. She is currently a chief investigator on 3 NHMRC grants, 4 government funded grants and tenders, 3 internal grants (evaluations). Professor Kildea will be presenting at the Normal Birth conference in Vancouver in August 2010.

And yet MORE homebirth media!

ABC online article: "Support for plan to assist home births in remote areas", Tuesday 13 July, 2010:
Three peak bodies for childbirth are pledging their support for a program to allow mothers in remote areas to have babies in their communities, rather than travel to cities.

The Australian College of Midwives, Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the College of Rural and Remote Medicine have backed the proposal, which is modelled on a similar program in the Inuit community in remote Canada.

The Australian Opinion piece by Debbie Slater, Childbirth Australia: "Homebirth statistics", Tuesday 13 July, 2010.

Blog post on midwivesVictoria: "MANA critique of Wax et al, Am J Obstet Gynecol 2010", Monday 12 July, 2010.

Sydney Morning Herald article: "Home births a lonelier option due to midwife insurance risk". Features quotes from the Australian College of Midwives, Homebirth Australia and homebirth mother Tilly Mitchell. Sunday 11 July, 2010.

Blog post on Science & Sensibility: A Research Blog About Healthy Pregnancy, Birth & Beyond from Lamaze International: "Meta-analysis: the wrong tool (wielded improperly)", Saturday 10th July, 2010 by Amy Romano.

Border Mail article: "Dannii ‘showed home birth safe’", Saturday 10th July, 2010.

Daily Telegraph article: "Dannii Minogue shows new baby Ethan to the world via Twitter", Saturday 10th July, 2010.

The Australian Opinion piece by midwife Barb Cook: "Impossible midwives: private midwifery care", Saturday 10th July, 2010.

Blog post by Jennifer Block (US author of "Pushed"): New AJOG Home Birth Study Political?, Thursday 8th July, 2010.

Thursday, July 8, 2010

More homebirth media

* “Dannii Minogue has baby boy, home-birth plan scrapped” – SMH, July 7

* Opinion piece: “Home birth not worth risk, Dannii” - Herald Sun, July 9

* Story: “Dannii's bouncing bundle of controversy” - 7pm Project, July 8

* Video: “Risks involved with home birth” featuring an interview with obstetrician Dr Gino Pecoraro. Search for “home birth” here - 7pm Project, July 8.

* “U.S. home birth risk review 'political': MD” – CBC News, July 2
But Dr. Michael Klein, an emeritus professor of family practice and pediatrics at the University of British Columbia, said the U.S. conclusions are "crap" that don't consider the facts.

"It's a politically motivated study that was motivated by the American College of Obstetrics and Gynecology who is unalterably opposed to home birth, and they probably were quite happy to publish this article because it fits with their political position," Klein said.

* Blog post: “A new meta-analysis on the safety of home birth?” Science & Sensibility: A Research Blog About Healthy Pregnancy, Birth & Beyond from Lamaze International, July 5
The meta-analysis is compromised by the inclusion of a deeply flawed study that relies on birth certificates and includes preterm births, unplanned home births, and home births attended by unqualified providers. In the only analysis in which the researchers excluded this study, the significant excess of neonatal mortality disappeared.

TODAY -Third stage of labour education session at Mater Mothers Hospital with Kathleen Fahy

Optimal third stage of labour care for women at low-risk of postpartum haemorrhage: theory, evidence and practice

Dr Kathleen Fahy RM, PhD
Professor of Midwifery, Newcastle University

Friday 9th July

15.00-16.00

Conference Room 5.1, Mater Mothers' Hospital, South Brisbane

All Welcome

For more information contact Jyai Allen: Jyai.Allen@mater.org.au

Professor Kathleen Fahy is the Editor of Women and Birth: Journal of the Australian College of Midwives. She is Professor of Midwifery at the University of Newcastle.

MC speakers at "Legal and Ethical Issues in Maternity Care" one day seminar, Wesley Hospital - Sat 7 Aug

Bruce Teakle and Kylie Downie are speaking at the following seminar being organised by Marie Barton, Clinical Midwife Educator at the Wesley Hospital.

Legal and Ethical Issues in Maternity Care
Saturday 7 August 2010
Wesley Hospital, Auchenflower

The Wesley Maternity Conference is an opportunity to learn more about legal and ethical issues, advocacy, evidence-based practice, the consumer perspective and much more.

Topics & speakers include the following:

* Legal Issues and Risk Management in Obstetrics - Ms Marianna Kelly (Risk Adviser and Medico-Legal Adviser, Avant Law) & Mr Christopher West (Solicitor, Avant Law)

* Obstetric Malpractice - Dr Ted Weaver (RANZCOG President, Obstetrician and Gynaecologist

* Applying Evidence to Improve Maternity Care: Moving Forward with Learnings of the Past - Associate Professor Vicki Flenady (Acting Director, Mater Mothers’ Research Centre

* Informed Consent / Informed Choice in Maternity Care - Dr Belinda Maier (Midwifery Adviser to the Chief Nursing Officer, Queensland Health

* Informed Choice: The Consumer Perspective - Bruce Teakle and Kylie Downie (Maternity Coalition)

* Ethics and Advocacy Issues in Practice - Mary Sidebotham (Midwifery Lecturer, Griffith University)

NOTE: MC members are welcome to register by Friday 16th July at the Early Bird rate of $125.00. No registrations will be taken after Friday 30 July, for catering purposes.

For further information, see the flier below or contact Marie Barton, Clinical Midwife Educator, Maternity Unit, Wesley Hospital:
Phone: 07 3232 7158
Mobile: 0408 454 314
Email: marie.barton@uchealth.com.au



Sunday, July 4, 2010

EOIs for funded consumer places for ACM State Conference due - Thur 15 July


We mentioned in a previous post that the Australian College of Midwives (ACM)'s Qld State Conference is being held at the Sea World Resort, Gold Coast from 15-17th September 2010.

Maternity Coalition Queensland has recently secured funding to support consumers wishing to attend the conference. We are able to fund conference registration, accommodation and travel costs of successful nominees. Consumers from all parts of Queensland are encouraged to apply, including those who may not previously have been members of MC.

Please email Bec Jenkinson, Maternity Coalition Queensland Branch President (qldpresident@maternitycoalition.org.au) if you would like to receive the EOI form below as a Word document, to fill in and submit via email by Thursday 15 July.

Thursday, July 1, 2010

NSW seeks to reduce caesareans and support normal birth

The Towards Normal birth policy in NSW was launched on Wednesday.

MATERNITY – TOWARDS NORMAL BIRTH IN NSW - A woman friendly birth initiative: protecting, promoting and supporting normal birth

This policy provides direction to NSW maternity services regarding actions to increase the vaginal birth rate in NSW and decrease the caesarean section operation rate; to develop, implement and evaluate strategies to support women and to ensure that midwives and doctors have the knowledge and skills necessary to implement this policy.

July 1, 2010
Sydney Morning Herald, Thurs 1 July, 2010
"Caesareans a target of $42m boost for hospitals"
NSW's runaway caesarean birth rate is set to be reined in by one-third under an ambitious five-year plan to normalise the process of giving birth and reduce unnecessary intervention in public hospitals.

The proportion of surgical births should be reduced to 20 per cent by 2015, from 30 per cent now, and first-time mothers would be attended by the same midwife throughout labour.

The option of labouring in water, although not necessarily water birth, would be offered universally under the mandatory policy.

International study claims triple neo-natal death risk for homebirths

The Age, Thurs 1 July, 2010
"Home birth triples neo-natal death risk: study"

The study in the American Journal of Obstetrics and Gynaecology will inflame passions. But, say the researchers from Maine Medical Centre in Portland, the findings must be addressed. "Women, particularly low-risk parous [having given birth before] individuals, choosing home birth are in large part successful in achieving their goal of delivering with less morbidity [damage] and medical intervention than experienced during hospital-based childbirth," they write.

"Of significant concern, these apparent benefits are associated with a near tripling of the neonatal mortality rate among nonanomalous [without birth defects] infants."

The researchers pulled together data from studies in the US and in Europe. They considered a total of 342,056 planned home births and 207,551 planned hospital births.

The increased death rate was in neonates - babies in the four weeks after delivery. The team found double the number of deaths overall among those born at home and triple the number when they removed those with congenital defects from the calculation. The main causes were breathing problems during birth and failed resuscitation after delivery.



The Globe and Mail, Wed 30 Jun, 2010
"U.S. analysis on home birth risks seen as deeply flawed"

Patricia Janssen, an associate professor at the University of British Columbia’s school of population and public health, says that conclusion is “sensationalist” and based on data that are in some cases decades old, on very small samples and in some cases incomplete.

In many cases, she says, women included in the studies may not have planned to give birth at home. They may not have been attended by a properly trained midwife. And much of the data used were retrospectively, gathered using birth records, which may not include enough information.

Dr. Janssen’s most recent research, published last September, found no difference in outcomes between planned hospital births and planned home births. Similar results were found in an Ontario study.



MIDIRS: Midwives Information Resource Services, Thurs 1 July, 2010
"Home births in UK safe say midwives"

Commenting on the research on ‘maternal and newborn outcomes in planned home birth versus planned hospital births’ in the American Journal of Obstetrics & Gynecology, Mervi Jokinen, Practice and Standards Development Advisor at the Royal College of Midwives, said: “It is certainly a study that will generate discussion around home births, and is important in adding to the body of evidence around this.

“Whilst it is interesting, I do question the validity of its findings for the UK. Comparison of the results is difficult because the study’s authors are working with data collected differently in many countries.


New York homebirth

WITV/WGBH Newschannel 34
"Midwife Reform Bill Passes Legislature"

Licensed professional midwives would be able to practice independently under a bill that passed the Senate on Wednesday by a vote of 61-0. "This is an important step forward for women's health," said Assembly Health Committee chair Richard N. Gottfried, author of the bill, A. 8117-B, which overwhelming passed the Assembly on Monday, June 28, by a vote of 95-17. The bill now heads to Governor David Paterson to be signed into law.

Professional midwives have been licensed in New York State for decades. They provide prenatal care, deliveries, and primary gynecological care. However, they are required to have a "written practice agreement" with an obstetrician or a hospital that provides obstetric services. The bill would repeal the requirement for a written practice agreement.

Article: "Does a lover really have first claim on breasts?"

Sydney Morning Herald, Wed June 30, 2010
"Does a lover really have first claim on breasts?"
Women's bodies have become so associated with sex that now a mothers' magazine has called breast-feeding 'creepy'. Rowan Pelling is appalled.