KEY POINTS:
By what bizarre reasoning did Wellington's Capital and Coast District Health Board arrive at its decision (now rescinded) to reduce demand on its hospital's post-natal ward by offering women a $100 incentive to take their babies directly home from the delivery suite?
Certainly the bribe was in the
form of a supermarket voucher that could not be redeemed for alcohol or tobacco. And it was available only when the birth had been straightforward and the baby was well. It was not available for a first birth or a caesarean delivery. But it never should have appeared.
The national Maternity Services Consumer Council co-ordinator, Lynda Williams, points out those most likely to take such a "bribe" would be those who most need close observation and help. If they have to be paid to bypass the post-natal ward there is probably good reason they would prefer to be in it.
Women giving birth usually go home within 48 hours of a routine delivery. They have two days and nights to get accustomed to the demands of a new baby with midwifery nurses in attendance. A shortage of midwives seems to be the reason the Capital and Coast board approved the payment for women who were discharged after just six hours' rest in a delivery suite.
There must be several better ways to cover the shortage in a hospital by making more efficient use of the specialists available. A crude bribe to maternity patients (sorry, consumers) is not only heartless but ineffective.
Something similar has been tried at least twice before, by Waikato Health and the Auckland maternity information service in the 1990s. Both offered women much more than $100 for baby-related costs if they went home early. The schemes are said to have no noticeable success in emptying post-natal beds.
It is a credit to young mothers that they look askance at this sort of payment. Those having second or subsequent births, to whom the latest offer was made, know the benefits of post-natal care and obviously find it well worth the $120 Waikato Health once offered or the $180 that was available in Auckland.
But the offers, when declined, amount to a charge for post-natal beds. Those who turn it down are effectively paying for their right to a normal stay. The principle of free healthcare in this country is particularly sacrosanct where maternity services are concerned.
Childbirth was expressly excluded from the National Government's short-lived attempt to introduce general hospital charges early in the 1990s.
Pregnancy, as we are often told, is not an illness and birth is a natural procedure which, many in its professional services say, needs minimal medical assistance. But that hard-nosed attitude should not extend to reducing care by "bribery".
That word prodded Capital and Coast Health to cancel the voucher offer yesterday. Chief executive Margot Mains said it was unacceptable to have a policy that could be seen as bribery. "I can assure the public that this was never the intent, but I do recognise the potential does exist for people to construe it as such."
While the payment has been pulled, the aim of encouraging certain mothers to leave hospital early remains. Ms Mains gave an assurance that the board would not discharge a woman and her child unless it was completely safe to do so. Even women wanting to stay in hospital for "social reasons", though clinically ready to go home, would be accommodated if possible.
That is possibly going too far. The decision to discharge can be made on professional grounds alone, free of sentimental or financial inducements. Nobody needs them.
