Transforming and Supporting Patient Care - Health Professions ...

237Chapter 10 – Profession of MidwiferyHPRAC agrees that midwives need access to appropriate tools to strengthentheir role as primary low-risk maternity care providers.Health Human Resources, Access to Care and Coordination of CareHPRAC’s scope of practice review discussed in detail the growing maternitycrisis in Canada. Over the past 15 to 20 years, demographic and other socialtrends have had a significant effect on the provision of maternity care.These trends include a shortage of maternity care providers and regionaldisparities in the provision of maternity care. There are fewer familyphysicians attending births. The number of family physicians attendingbirths has decreased by 43 percent from 1992 to 1999. By 2003-2004, only6.9 percent of family physicians billed OHIP for more than one birth. 34Obstetricians now attend over 80 percent of births. Obstetricians are seeingmore patients and are spending more time on call to address the shortageof family physicians delivering babies. There are indications that theshortage of obstetricians will become more severe in the near future. Atleast 34 percent of obstetricians are planning to retire within the nextfive years.A report released recently by the Society of Obstetricians and Gynaecologistsof Canada confirms that there is a serious crisis looming in Canada becauseof a critical shortage of obstetricians. This report was extensively coveredin the media.The problems facing obstetricians are part of a larger, more complexhuman resources struggle occurring throughout Canada's health-relatedprofessions. Cross-country shortages of family doctors, midwives,nurses and nurse practitioners have resulted in an increasing number ofobstetricians taking on bigger workloads and responsibilities thatnormally don't fall to a specialist.According to the executive director of the Canadian Women's HealthNetwork, Madeline Boscoe, “(The) problem…not only leaves obstetriciansoverworked, but also underutilizes their expertise…[and] it may preventwomen with serious health issues that require a specialist from gettingsufficient care.” 35As noted in its scope of practice review, HPRAC views midwives as playingan important role in addressing the health human resources shortage byproviding primary maternal care for low-risk births in Ontario.HPRAC’s ObservationsClasses versus Individual DrugsHPRAC is recommending a revised process for drug approvals in Ontariothat will be based on the approval of classes of drugs in regulations underhealth profession Acts. A new and expedited process for the approval ofindividual drugs within classes is also being proposed. The implementation34HPRAC. Review of the Scope of Practice of Midwifery. 80-81.35The Globe and Mail. December 5, 2008.HPRAC Critical Links January 2009