Campaigners of the Emergency Alarm Birth Care platform have submitted a petition in the House of Representatives. The petition, which has been signed almost 190,000 times, calls on MPs to block Minister Kuipers’ plan for an integral rate for birth care.
The major concern of midwives in particular is that they will lose their autonomy with an integral rate. Currently, gynaecologists, obstetricians and maternity nurses have separate contracts with health insurers. As a result, they are now paid separately for the work performed. With an integral rate, these care providers will soon have to divide one bag of money per pregnant woman.
In order to do this properly, hospitals, midwifery practices and maternity care must set up so-called Integrated Birth Care Organizations (IGOs) at the regional level within which tasks and payments are arranged.
Reorganization
The idea behind this reorganization is that gynaecologists and midwives will work better together, which will improve safety for mother and child.
But there is a lot of criticism of this intention from the obstetrician. The professional association points out that the cooperation between obstetricians and gynaecologists has improved considerably over the past twelve years.
Statistics support this statement. In 2008, infant mortality in the Netherlands was still remarkably high. That is why action was taken from 2010 onwards. Dozens of obstetric partnerships sprang up and a ‘Care Standard Integrated Birth Care’ was established.
Within these associations, gynaecologists and obstetricians started to work better together. In 2018, the infant mortality rate in the Netherlands was only 10 percent higher than in Finland, according to research by the RIVM. Finland is a country that traditionally has low infant mortality rates.
Trial
“In my experience, integrated funding does not improve this cooperation any further,” says Michelle Beijerinck, obstetrician at Mundo Midwives’ practice in The Hague. She and her practice participated in a pilot to set up such an IGO with other obstetric practices and the Haga Hospital and to test working with an integrated rate.
“In those years, we mainly noticed that the administrative burden became heavier. Normally we claimed directly to the health insurer. Now that went through the IGO that represented us all. And that just worked slower and more bureaucratic.”
The collaboration on medical content did not become much more intensive, however. “Within an IGO, it is more about finances,” says Beijerinck. “So not much has changed in terms of healthcare.”
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