Funding gap puts maternity reform at risk.
This story appeared on the front page of the Guardian today. It concerns Professor Cathy Warwick, the new general secretary of the Royal College of Midwives. She says about the money supplied to ensure the delivery of the Maternity Matters strategy,
“It looks to us like in many parts of the country the money has gone to PCTs but not been released to heads of midwifery. If we speak to the Department of Health they say the money is there, and if we speak to midwives they’re saying that their PCTs are saying they haven’t got the money, so there’s a disconnect.”
There are comments at the bottom of the story (although a tiny number compared to a story about the bailout of banks published later!) that were quite interesting and I didn’t want to forget. So here are a few extracts:
nhsmanager says:
“The NHS pays a tariff to hospitals for each contact with a patient. The price for next year for a normal birth is £1,174 rising to £3,626 for a Caesarian Section with complication. The price for an antenatal check up (10 to 15 minutes) with a midwife is £65. I would suggest that these are very high levels of payments and money is not the problem. How it is used is the problem.”
LynW gives some of the background:
“Only two things are surprising about the original story. First, that it’s being published at this time of year (a “maternity crisis” is usually summer copy - there always is one, so papers and specialist publications go back to it when they’re short of material over the holidays). Second, that anyone would seriously think Maternity Matters might be implemented. It was a document that repeated, practically word for word, pledges made in the Tories’ Changing Childbirth report, without trying to establish what had happened to that. And it was put out by a minister, Caroline Flint, with no intention of hanging about long enough to find out what would happen to it. There is no policy pressure for change (where is maternity in this year’s Operating Framework?) Money never goes into this area. Doctors and midwives can’t agree on what good care looks like, anyway. There are good IT systems, but few trusts have deployed them (the subject of a recent Healthcare Commission report). And nurses anyway seem reluctant to use other people’s notes, however recorded. Meanwhile, patients don’t have enough information to exercise proper choice, and tend to go home grateful, whatever. Still. A regular story to look forward to each Christmas.”
PCSimon gives a personal story:
As someone whose wife gave birth a couple of weeks ago and spent a week in hospital in total, I have nothing but praise for individual midwives but some major problems with the system..
1) As mentioned above, shifts are far too long - the shortest shift seemed to be 12 hours long and many did not leave on time as they stayed to make sure mothers and babies were OK. No-one voluntarily works these hours - please can the NHS sort this out!
2) There are simply not enough hospital midwives. Our baby had to have injections in a special care unit every 12 hours. In the middle of the night my wife couldn’t find a midwife, tried to take the baby herself, and ended up stuck in a goods life (Carry On had nothing on this). We also took 8 hours from getting the all clear to getting out of the hospital - mostly time spent waiting for a midwife - and at a time when everyone was complaining about a shortage of beds!
3) The transfer of information is shocking. Every 12 hours a new midwife took over my wife’s case and each time started by asking her the same basic questions - they did not know any of the baby’s history, the fact that he had been in special care, etc. When we finally left, we basically wrote his medical records from scratch with yet another midwife. Obviously, this is a consequence of lack of time and people - if they had more time they could spend 30 mins at the start of each shift passing on information.
4) On a similar thread, the use of IT was tragic. Rather than being used to help speed up information transfer they were a massive drain on time. Everything was firstly handwritten - then midwives spent hours typing up their notes. Please - either get some skilled typists to write the notes up - or get some decent handheld computers that can be used to put notes directly into the system!”
You must be logged in to post a comment.