Dr Trevor Mudge, AMA VicePresident, with Kevin Naughton, ABC Radio 'Drive'

Now, 20 years ago or even 10 years ago, it would have seemed absurd for mums to leave hospital only hours after giving birth. But a pilot scheme at the Lyell McEwan Hospital is going ahead with this plan which also provides 21 long-term unemployed young women from the northern suburbs with work, doing this at-home care. These women spend six hours a day for six days providing help that ranges from breast feeding advice to baby-sitting other children and cleaning up around the house, for example.

It's called the Mothers' Carers' Program. It's been given the thumbs up by the State Government and the State Opposition. But the Australian Medical Association has described it as appalling.

First today, to Professor Gus Decker, who is head of the Lyell McEwan Women's and Children's Hospital. Actually, we'll talk to him in a moment. We might first go to Trevor Mudge, the AMA's Vice President. Trevor, good afternoon to you.

MUDGE: Yeah, hi Kevin.

NAUGHTON: Now, what do you think of this proposal?

MUDGE: Oh well, I mean our criticism of this proposal is like every other proposal that's come in both the private and public system for reducing post-natal stay in the last decade. There is no built-in mechanism to evaluate whether it's doing harm or good. And quite honestly, I think it's time that women who just had a baby stop being victims of cost-cutting.

NAUGHTON: Do you think that's what this is all about? That it's about cutting costs? Having never been a mother, just been involved in the process, I'm not sure whether they're happier in hospital or at home and whether encouraging people to be at home with some assistance might be better for them. Is it just the issue of the mother or is there a baby issue here as well?

MUDGE: The issue is both. I think that obstetrics has moved a long way forward in the last 100 years. We've gone from worrying about mothers dying to worrying about babies dying. Fortunately now, we can prevent mostly both of those things. The focus of obstetric care now is on providing an optimal experience of the transition to parenthood for new families and that means particularly young, first time mothers.

There's, I think, a lot of evidence that the incidence of things like post-natal depression and the rate of breast feeding are very important barometers of the health of the family unit, if you like. And with the family unit under increasing stress in modern society from both partners working, from divorce, from the absence of the extended family with grandmother under your roof, to a nuclear sort of situation where the two new parents have very little in the way of support, it's very important that we don't reduce the resources that we put in to this integration of the new family unit.

Whether we do it at hospital or whether we do it at home, I don't think it matters. But we ought to evaluate which is better. We ought to give women choices and we ought to make sure that we don't reduce the resources that are put into that area.

NAUGHTON: Trevor, am I right in saying that the AMA's concern is not so much about the idea but the assessment of the idea? Is that what your objection is?

MUDGE: Surely, the AMA has no problem with the idea. Indeed, if there was some adequate evidence, estimation built into it, we'd probably support it. Afterall, medicine is evidence-based. What we are concerned about is the possibility of a reduction in resources being put into what we see as a very critical area, and that so far, in the increasing reduction of stay, the money saved has not been put in to the resources to support the woman at home. And that's what's critical.

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