A controversial decision in the Northern Territory has sparked concern: a midwife, restricted from unsupervised practice, has been awarded a substantial government contract. This situation raises serious questions about patient safety and the role of regulatory oversight. Let's dive in.
Claire Marks, a Darwin-based midwife, secured a $1.1 million contract from the NT government to establish 'Midwives in Darwin.' This service aims to fill the void left by the closure of the only private maternity ward in the region. However, here's where it gets controversial: at the time the contract was awarded, Ms. Marks was under investigation by the Nursing and Midwifery Board of Australia. The board later imposed conditions on her registration, including a requirement for supervision.
These conditions are not trivial. They also mandate that Ms. Marks engage an approved mentor to address her care management and maternal observations. These observations are crucial for early intervention in emergencies. A spokesperson from the Australian Health Practitioner Regulation Agency (AHPRA) confirmed that such conditions are imposed to protect the public.
Ms. Marks, while acknowledging the conditions, has expressed confidence in her ability to practice safely, stating she doesn't believe any harm was caused to women or babies in her care. She maintains her practice aligns with evidence-informed care and best practices. But what does this mean for the safety of the public?
The NT government's contract with Ms. Marks is for a 12-month period. She will serve as the director of the service, overseeing a team of midwives expected to join in early 2026. The NT Health Department has declined to comment on whether they were aware of the investigation at the time of the contract award or why they proceeded with it. They've also avoided questions about the appropriateness of a practitioner with registration conditions running a government-funded midwifery service. This lack of transparency raises eyebrows.
The Australian Medical Association of the NT (AMA NT) has voiced serious concerns. John Zorbas, the president of AMA NT, questions how the supervision requirements can be met while providing the service. He emphasizes that healthcare providers must adhere to registration conditions, regardless of whether they work in the public or private sector.
But this is not the only problem. The AMA NT has also raised concerns about the content posted on Midwives in Darwin's social media. One post stated that 'the further you birth away from the delivery suite the better the outcomes,' a statement Dr. Zorbas labeled as 'simply false.' This brings up the question of whether the social media posts of the practice align with scientific evidence. Other posts on the Midwives in Darwin social media page state "there's a difference between hospital policy and evidence-based practice" and "between what your midwife has to say and what she wants to say."
Ms. Marks, with 13 years of midwifery experience, returned to Darwin during the COVID-19 pandemic. She previously worked at Royal Darwin Hospital (RDH) and then started her own private midwifery practice focusing on homebirths. Midwives in Darwin will initially offer midwife-supported births at RDH for privately insured women, with the hope of expanding to include homebirths.
What are your thoughts? Do you believe the NT government made the right decision? Should there be more transparency in this situation? Share your opinions in the comments below.
