For immediate release, Monday 4th January 2010
Commenting on the release today (January 4th) of the Conservative Party’s draft health manifesto, Cathy Warwick, general secretary of the Royal College of Midwives, said: “The RCM is pleased that maternity services are prominent in the Conservative Party’s health plans and notes their commitment to local midwifery-led services and recognition of the importance of maternity networks. It is critical if women are to have a choice of maternity services and safe care that referrals from midwifery-led services to obstetric services are efficient. The RCM also endorses the plan’s rejection of ‘bigger and bigger baby factories’ and agrees that women should not be turned away from the maternity service of their choice.”
“The RCM, however, also notes that the Government is committed to midwifery- led services, to women having choice, to user-involvement and to reducing unnecessary interventions and health inequalities. The NHS’s Operating Framework for 2010/11 stresses the Government’s commitment to maternity services and to linking payment for services to quality and patient satisfaction. The Government is also currently considering how to ensure that the payment system for services helps to deliver their policy for maternity services.
"It, therefore, is difficult to see exactly what is different in the Conservative Party’s promise for maternity services. The rising birth rate has undoubtedly made it difficult for the Government’s maternity policy commitments to be fully implemented but the RCM believes that change is starting to happen. The question is whether or not this can be sustained in the current economic downturn. Midwifery-led units are not closed because of Government policies. They are closed because local maternity service providers face an unprecedented challenge to maintain a full range of choice of services for women in the face of economic pressures.
"Without understanding more fully the interaction proposed between central government’s policy commitments and local funding and service delivery plans, it is hard to see how the changes the Conservatives are proposing for maternity services will happen.”
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For more information contact the RCM Press Office on 020 7312 3456.
Notes to editors
The Royal College of Midwives (RCM) aims to promote and advance the profession of the midwife. The RCM represents the vast majority of the UK's midwives and is one of the world's oldest and largest midwifery organisations, and celebrated its 125th anniversary in 2006. It is also a trade union. For more information visit the RCM website at www.rcm.org.uk.
Background demographic and policy information
• England is in its seventh year of a baby boom in 2008 there were 672,807 live births. (This was up 17,450 or 2.7 per cent on the previous year, and up 109,063, or 19.3 per cent, since the start of the baby boom in 2001.)
• In 2008, there were 19,639 full-time equivalent midwives.
• There were almost 110,000 more births last year than the start of the decade.
• The share of the NHS’ budget spent on maternity has dropped from 3 per cent in 1997 to 2 per cent in the most recent figures.
• The number of births has risen in every region of England in every year since 2002. Despite this, every region has had its maternity budget cut at least once over that time, and some regions have had their maternity budgets cut twice.
• Maternity Matters, the government’s maternity care policy, states that women should have a choice of homebirth, midwifery led care and an obstetrician. It outlines four national choice guarantees available for all women by the end of 2009. These related to care throughout pregnancy, birth and postnatally. The national choice guarantees described are: 1. Choice of how to access maternity care; 2. Choice of type of antenatal care; 3. Choice of place of birth – women and their partners will be able to choose between three different options. These are: a home birth; birth in a local facility, including a hospital, under the care of a midwife; birth in a hospital supported by a local maternity care team including midwives, anaesthetists and consultant obstetricians; 4. Choice of place of postnatal care. For more information on Maternity Matters, please visit: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073312
• The government’s target date for implementing Maternity Matters is the end of 2009, possibly, did not take into account the amount of infrastructure changes needed within the maternity service in order to provide women with a birth centre choice, in particular the almost unprecedented rise in the birth rate over the last few years.
• There is, however, a national shortage of midwives and the RCM is campaigning for 5,000 more midwives. This shortage of midwives may also have an impact on the ability of maternity services to offer choice.
• A succession of reports in recent years from bodies such as the Healthcare Commission and the King's Fund have highlighted problems such as the lack of midwives, contributing to 26% of women being left alone during labour and saying that they find that worrying.
• In January 2008, the Secretary of State for Health promised an extra £330m for maternity services, spread over the current and the next two financial years (2008/09, 2009/2010 and 2010/11). He also promised 4,000 more full-time midwives by 2012, with 1,000 of these appointed by 2009, and a £3,000 golden handshake for returning midwives and a national return to practice programme for midwives who have been out of the profession.
• In 2007, 26,000 women took part in a survey of NHS Trusts asking them about their experiences of maternity care by the Healthcare Commission. Areas of concern of that survey by the Healthcare Commission were: more than a third (36 per cent) of respondents were not offered any antenatal classes provided by the NHS; and during labour, a quarter of the respondents reported that they had been left alone at a time when it worried them.
• Future surveys of mothers’ experiences of maternity care were announced in October 2009, the Department of Health announced that next year it will assess the NHS’s delivery of choice in maternity care. The Department of Health has written to SHAs telling them there will be a survey of women’s maternity experiences early next year. Strategic Health Authorities have been asked to report to the DH during November 2009 on current levels of choice, continuity of care, risk management, and levels of staffing and skill mix. For more information, visit: http://www.hsj.co.uk/news/acute-care/shas-must-assess-delivery-of-maternity-choice/5007024.article
