Midwife banned from practising

A former midwife has been permanently banned from practising midwifery.

The Victorian Civil and Administrative Tribunal found that previously registered midwife Dianne Jean Macrae had engaged in professional misconduct while providing care to patients at Bacchus Marsh Hospital; a decision was made that she should never practise again. Macrae is one of 38 practitioners at the hospital under investigation or who have had actions taken against them.

The outcome was welcomed by the Nursing and Midwifery Board of Australia (NMBA) and the Australian Health Practitioner Regulation Agency (AHPRA), who referred Macrae to the tribunal. It is the first tribunal outcome from AHPRA’s investigation into matters relating to Bacchus Marsh Hospital (Djerriwarrh Health Services). Other practitioners have been dealt with by the NMBA through other regulatory actions.

In February 2016, AHPRA and the NMBA launched investigations in relation to the care provided by individual practitioners at the Bacchus Marsh Hospital during the period of October 2011 to February 2013. The investigations included Macrae, a registered midwife, who was employed as an Associate Nurse Unit Manager (ANUM) by the Djerriwarrh Health Services at the hospital:

• On 3 March 2016 the NMBA decided to impose conditions on Macrae’s registration requiring her to practise only with supervision.
• On 9 September 2016 that action was escalated to an undertaking from Macrae that she would not practise at all.
• On 13 July 2017, Macrae surrendered her registration, which means she is no longer able to practise as a registered midwife.
   

The NMBA referred a series of allegations to the tribunal on 1 May 2018 relating to Macrae’s performance as a midwife. The allegations included:

• failure to carry out clinical assessment and care (inadequate interpretation of foetal cardiotocography (CTG)
• failure to recognise and respond to an urgent situation
• inadequate clinical records.
   

Macrae admitted all allegations.

The tribunal found that Macrae had engaged in 10 instances of professional misconduct under the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law). The tribunal noted each practitioner has individual professional responsibility to work in accordance with the relevant standards and codes. Moreover, many of the proven matters related to incompetence, which falls outside of the working conditions.

The tribunal reprimanded Macrae and accepted an undertaking from her that she would never apply for registration as a midwife again.

Background

Overall, AHPRA opened 101 matters in relation to reported stillbirths and neonatal deaths at the Bacchus Marsh Hospital (Djerriwarrh Health Service). As of 18 October 2018, 84 matters relating to 38 health practitioners have been finalised.

For the 38 practitioners whose matters have been finalised, more than half were able to be closed without the need for regulatory action. This includes practitioners who have surrendered their registration or who had already undertaken steps towards remediation, which a National Board considers sufficient to manage any ongoing risk to the public. For example, when a practitioner has completed education or training that addresses any gaps identified in their skills or knowledge.

For those matters where further action was taken:

• six practitioners were cautioned
• five practitioners had conditions imposed on their registration (including those who were cautioned and had conditions imposed)
• five practitioners were referred to a panel hearing or the Victorian Civil and Administrative Tribunal.
   

Generally speaking, when an investigation is ongoing into conduct of a serious nature by a registered health practitioner, the investigation can continue even if a practitioner surrenders their registration and is no longer practising. Matters that are referred to a tribunal are considered to meet the threshold of ‘reasonable belief’ by a National Board that the practitioner has behaved in a way that constitutes professional misconduct.

Image credit: ©stock.adobe.com/au/Cari