CASTLEMAINE Health has confirmed a review of its maternity services recommended further suspension of birthing services.
In a statement issued this evening, Castlemaine Health says a draft report recommended a new model of maternity care be implemented, along with new clinic and governance processes.
"The reviewers advised that it would present an unacceptable risk to reopen the service until the critical recommendations are addressed," the statement says.
It comes after a GP obstetrician employed at the service said staff believed they could implement the recommended changes without having to suspend services.
"We will be putting in additional resources and doing everything possible to resume birthing at Castlemaine Health as soon as possible," the Castlemaine Health statement says.
"However, the health and wellbeing of our mothers and babies is paramount.
"We will be guided by the progress of the implementation plan in making our final call on when our local mothers will again be giving birth in Castlemaine."
The health service's statement says the report "makes clear that implementation of the recommendations is needed to ensure the service is safe, viable and sustainable for our community's mothers and babies for the future."
It says the review examined the procedures, policies, clinical practice protocols and maternity clinical governance systems that determine the capacity, capability and safety of a maternity service.
"A recommendation implementation governance group and a number of working groups will be established to progress the revised model of maternity care, along with a consumer group," the statement says.
It says Safer Care Victoria and the Department of Health and Human Services have offered to be part of the recommendation implementation governance group in a monitoring and support capacity.
Bendigo Health also offered significant support.
The statement quotes the reviewer as having said: "This review should be taken as an opportunity to become a standard setter in the provision of best care in maternity within a clearly defined capability that is representative of many similar sized units across Australia."
Castlemaine Health says it will "continue to sustain our current antenatal services locally during this period."
"We will also develop pathways with Bendigo Health to enable women to return to Castlemaine Health shortly after birth to receive the rest of their hospital care," the statement says.
"There will be no job losses while we work together to resume our birthing service."
The statement confirms the report was considered by the health service's board of management in a special meeting on Monday.
The board made an in-principle decision to accept and endorse the draft report and its recommendations "to ensure a return to a safe maternity service".
BIRTHING services at Castlemaine Health might be suspended for a further six months, with a staff member among those calling for transparency.
GP obstetrician, Dr Frankie Harkin and her colleagues in maternity services were told on Tuesday a review had recommended a change to the model of antenatal care for women at Castlemaine Health.
Dr Harkin said the change - moving towards a shared model of care with midwives and GP obstetricians - was something midwives and GP obstetricians at Castlemaine Health had been seeking to implement for some time.
"It's the recommended model of care for low-risk women. We all totally support it," she said.
But Dr Harkin said the reviewer's recommendation was to suspend services while the transition took place - up to six months.
"We disagree with that recommendation because we feel we have already started implementing changes in the last few weeks, since the recent suspension of services, as well as there being some recent staffing changes," Dr Harkin said.
Birthing services at Castlemaine Health have been suspended since May, with July 1 flagged as the date for reinstatement.
Dr Harkin said she and her fellow GP obstetricians felt there was a real catalyst for change at the moment - a real momentum.
"We feel we can make this change now, while staying open," she said.
"We have a real fear that if the service is suspended for six months we risk losing staff, we risk losing community confidence in the service, and there is a chance the service might not re-open, ever."
Dr Harkin said the review's draft report, which has yet to be made public, consisted of three options other than further suspending the service to allow for changes.
They included bringing the service down to a Level 1, which would not allow for births, and re-opening with a transition to midwifery-led care and the other changes recommended.
Reopening without making any changes was also one of the options, Dr Harkin said.
She said a previous attempt to move towards a shared model of care, which "did not receive much support from management at the time", was part of the reason the reviewer had recommended a further suspension of services to allow for the transition.
Confirmation of the options presented to staff and the likelihood of a further suspension of services was sought from both Castlemaine Health and the Department of Health and Human Services on Wednesday.
Neither responded by 5pm today.
We will not accept a further suspension. There is a viable alternative... and we know the doctors and midwives are prepared to work hard to make this successfulArabella Davison, Support Birthing at Castlemaine Health
Dr Harkin said staff in Castlemaine Health's maternity services had been disappointed by a "lack of transparency from the board and the executive."
She said the women she and her colleagues worked with had been disappointed by how the health service had been communicating about what was happening.
"Some women have heard about the changes through Facebook," Dr Harkin said.
"I hope they [the board and executive] provide a full and open justification for any further suspension, if that's what they choose to do."
Dr Harkin said she didn't fully understand the trigger for the review, which was commissioned by the board.
She was not aware that it was in response to any poor outcomes.
Staff had been told it was about the safety and sustainability of the service, and the findings Dr Harkin had been made aware of all highlighted really positive things.
They included the dedication and passion of the maternity service's staff, positive statistical outcomes, and appropriate levels of transfers to bigger hospital when required.
Expectant mothers would be forced to travel - a journey Dr Harkin said could be up to or over an hour for many people.
"That impact is felt quite deeply by all of us, the midwives and the doctors," she said.
"We're really upset on behalf of the community for that reason."
As a practitioner still in the early years of her obstetrics career, Dr Harkin said a further suspension of services would also impact her professionally.
"It's heartbreaking because I've just moved to this community, I've put down roots in this community, I've just established my caseload of pregnant women and was becoming quite established at the hospital doing births," she said
She would be faced with either having to move, or losing work in obstetrics.
Support Birthing at Castlemaine Health spokesperson Arabella Davison said the community was "100 per cent" behind the maternity services staff.
If the GP obstetricians and midwives could see a way to start implementing the review's recommendations now, without further suspension of services, Ms Davison believed the health service should be working towards it.
"If we are offering exceptional care, why not build on those strengths?" she queried.
She questioned how Castlemaine Health expected to attract a Clinical Maternity Lead while services were suspended.
The position was created to oversee implementation of the review's recommendations and "ensure the service is operating in-line with the appropriate quality and safety standards."
Castlemaine Health started advertising for the position yesterday.
The Castlemaine Health board is expected to decide on the outcome of the review on Monday.
Support Birthing at Castlemaine Health is planning to take action at midday tomorrow in support of continued services.
"What is recommended is not a 'pausing' of services. It is a long, slow unravelling of an essential service," Ms Davison said.
"Castlemaine Health is not listening to the community it serves. We will not accept a further suspension. There is a viable alternative... and we know the doctors and midwives are prepared to work hard to make this successful."