Privatisation of midwifery?

Midwives magazine: Issue 1 :: 2012

A private company has become the first to win a full maternity care contract from the NHS. Rob Dabrowski looks at the implications.

In Edwardian times, some midwives were reputedly prostitutes, paid in gin for their services. Then came the landmark Midwives Act 1902, which regulated the profession and changed the face of midwifery. 

Now a former NHS midwife has claimed that her private company winning a contract to provide maternity care is the ‘biggest thing to happen in midwifery’ since the revolutionary act, 110 years ago.

Joanne Parkington is the founder of One to One, which has signed a three-year deal with NHS Wirral to provide services to women in the local area.

It offers an alternative to NHS services and claims because its midwives are based ‘in the heart of the local community’, they are better placed to deliver care and provide support.

It also gives women access to their midwife from 8am to 8pm every day, with a midwife on call 24 hours a day.

‘I actually think this will help save midwifery,’ claimed Joanne. ‘I think it’s gone very much into an obstetric model and we need to reclaim what midwifery once was.

‘I’d say that the NHS has been given an opportunity for over 20 years to provide this model of care. If we can provide it in a private model, then that’s the way we need to look forward.

‘We just happen to be a private company and I don’t think the NHS can provide this level of health care. I’d say it’s quite revolutionary, or at least it has the potential to be.’

She added that One to One is in talks with a university and looking to create its own educational model and is also hoping to expand across the North West – and then England and Wales as a whole.

But, with many health professionals – and members of the public – worried about the creeping public sector privatisation under the Conservatives, there is concern that this is bad news for the NHS.

Cathy Warwick, RCM chief executive, said: ‘We are in close contact with One to One, who have been very willing to share their business model and ideas with us.

‘The RCM very much welcomes innovation and change, but we must remember the vast majority of maternity care is provided in the NHS, and the RCM believes that this should continue to be the case.

‘The RCM understands that the One to One midwifery practice is providing continuity of midwifery care to a small group of women.

‘The RCM supports models of midwifery care that offer women continuity and which can improve health outcomes for the mother and baby.

‘Such models of care can also be offered on the NHS and much more effort should be made by policy-makers to ensure this is the case, including ensuring adequate midwifery staffing and fair remuneration for staff.’

An NHS Wirral spokesperson said the move means women are ‘free to choose the type of service and location of birth which they feel best meets their needs’.

Unite’s general secretary, Len McCluskey, said the union is ‘very concerned that as private companies take over more and more services in the NHS, the profit motive will take priority over patient care’.