NT government cancels controversial $1.1 million private midwife contract with Claire Marks
Claire Marks was put on a number of conditions by the nursing and midwifery board last November. (ABC News: Marcus Kennedy)
In short:
Nearly 10 months after handing a Darwin midwife $1.1 million to establish a private midwifery service, the NT government has confirmed it's axed the contract.
In a social media post Claire Marks posted that following "a year of unforeseen and significant challenges" Midwives in Darwin will be pausing its private midwifery services.
What's next?
The Australian Nursing and Midwifery Federation says the government now needs to focus its support on existing services.
The Northern Territory government has confirmed it has terminated a $1.1 million dollar contract it handed to a Darwin midwife, nearly 10 months after doctors began raising concerns about the deal.
Claire Marks was awarded the money last September to establish a private midwifery service — as part of her business Midwives in Darwin — as the NT government scrambled to address the loss of the Territory's only private maternity ward.
However, at the time the 12-month contract was signed, Ms Marks was being investigated by the Nursing and Midwifery Board of Australia.
Just two months later, the regulator imposed conditions on her registration including that she must not practice without supervision and that she engage an approved mentor to address her management of care and maternal observations.
The Australian Health Practitioner Regulation Agency (AHPRA), which oversees the Nursing and Midwifery Board, has not disclosed the specific grounds for the restrictions it placed on Ms Marks, but has previously said conditions are only imposed when a national board deems it "necessary to protect the public".
On Thursday, NT Health deputy chief executive Kim Charles confirmed the contract had been axed and told the ABC the department was unaware of the restrictions at the time the contract was signed.
"NT Health has discontinued its contracted arrangement with provider C E Marks Pty Ltd for the delivery of privately funded maternity services,"Ms Charles said.
"Following a review of the contract, NT Health has determined that the service, as originally intended, cannot be delivered in line with the required governance and safety expectations."
Midwives in Darwin was to establish a private midwifery service as part of its practice. (ABC News: Marcus Kennedy)
Ms Charles said NT Health followed procurement processes, but "information that led to the discontinuation of the contract" was not known at the time of signing.
The ABC asked what due diligence was undertaken by the NT government before awarding the contract, but did not receive a direct response.
Questions regarding how much taxpayer funding was expended on the contract and whether any funds would be recovered were also not answered.
Ms Charles said no clinical services or patient care had commenced under the service "as the contract was in its establishment phase".
"NT Health remains committed to providing safe and supportive maternity care for all women and their families," she said.
The Territory's only private maternity ward was closed last year. (ABC News: Mark Leonardi)
'No reason' given for decision
In a statement to the ABC, Ms Marks said NT Health had not provided "a transparent account of what allegedly changed after the contract was signed".
"Women and families deserve better than bureaucratic backtracking and opaque decision-making dressed up as safety concerns,"she said.
"Continuity of midwifery care is well recognised as improving engagement, trust and outcomes.
"NT Health’s decision undermines that model and leaves women and families with fewer options at one of the most important times in their lives."
In March, Midwives in Darwin (MiD) — which Ms Marks is the director of — announced on social media it had expanded its team by three staff members.
But on Thursday, Ms Marks posted on MiD's social media that the private midwifery service would be paused.
"Following a year of unforeseen [and] significant challenges, this has been an incredibly difficult decision, and not one I ever imagined having to make," the post states.
The post said women currently receiving care with MiD had been contacted and that they would no longer be accepting new clients.
"This outcome is a loss for Darwin women and families seeking privately funded, midwifery-led continuity of care," Ms Marks told the ABC.
"Midwives in Darwin remain committed to safe, evidence-based, woman-centred maternity care and will continue advocating for genuine choice in the Northern Territory."
Doctors wanted to see situation 'resolved'
John Zorbas, the president of the Australian Medical Association's NT branch and a specialist emergency physician at Royal Darwin Hospital, welcomed the government's decision to terminate the contract, saying "ultimately this is the right outcome".
"We've been in constant contact with NT Health since we first identified this issue and made it very clear that we wanted to see it resolved," he said.
John Zorbas says doctors wanted to see the provision of a safe service. (ABC News: Marcus Kennedy)
"Ultimately, the national regulator had said that [Ms Marks] required strict conditions of supervision. [And whether it be] doctors, nurses or midwives, it would be difficult to see how anyone could provide a service to supervise others when they themselves needed supervision.
"[Doctors] also held particular concerns about some of her posts on social media, painting hospitals and birthing suites as harmful and dangerous places.
The AMA says a now deleted post on a Midwives in Darwin social media page raised concerns. (Supplied)
"That kind of misinformation leads to poorer birthing experiences for women and has no place inside our health services."
In her statement, Ms Marks said the AMA is not a "neutral voice in this debate".
"It is a doctors' lobby group defending its broader interest and attacking a service that would have expanded women's choices," she said.
"This looks less like a genuine safety concern and more like professional protectionism at the expense of women's choice."
Australian Nursing and Midwifery Federation (ANMF) NT secretary Heidi Crisp said midwives were under more pressure since the NT's only private maternity ward shut down last year.
She said they now needed the NT government to focus on supporting core services already in existence.
"I do have full faith that the midwives can cope, they do work under pressure and provide high quality care at all times," Ms Crisp said.
Heidi Crisp says the NT government should focus on resourcing already operating midwifery services. (ABC News: Dane Hirst)
"But considering the nursing and midwifery shortage, we are calling on the Northern Territory government to ease that pressure by providing a highly competitive [pay] rate.
"I think the government should be investing more heavily in our current public sector … we have an amazing midwifery group practice, we have core maternity services that are of high quality and providing excellent care to the women of Darwin already."