Breedagh Hughes: looking back
After 21 years at the RCM in Northern Ireland, director Breedagh Hughes is stepping down. She reflects on her experiences and the changes that have evolved.
I was appointed in April 1997, in the middle of clinical grading, just after the maternity unit in Newtownards had closed and just before Tony Blair’s New Labour was elected. Midwifery education in Northern Ireland (NI) transferred into Queen’s University and our first midwife-led pilot projects were under way.
In 1998, my colleague Mary Caddell joined Anne Marie O’Neill and myself in the NI team and we began our campaign for women’s choice in relation to pregnancy and place of birth. The new Northern Ireland Assembly (NIA) was elected in June and NI’s midwives lobbied for better pay.
In 1999, the maternity unit in Dungannon closed and the NIA was suspended, leaving us in a policy vacuum – some things clearly haven’t changed!
Campaigns and manifestos
The Jubilee Maternity Hospital in Belfast merged with the Royal Maternity Hospital in early 2000, and as the alongside midwife-led unit opened in Craigavon, we began our campaign to have freestanding maternity units (FMUs) established in NI as part of a comprehensive regional strategy for maternity services.
The NIA finally got up and running in 2001 with Bairbre de Brun appointed as first health minister, and the thorny issue of abortion was first raised in the NIA. Ruth Clarke was appointed as the first midwifery adviser in the Department of Health and in a spirit of optimism we published our first RCM manifesto for NI. However the NIA collapsed again in 2002 and remained suspended until May 2007.
In 2003 we saw the introduction of direct-entry midwifery training and as the CS rate shot up to 24%, we intensified our campaign to introduce midwife-led care in an attempt to offer women an alternative to hospital-based obstetric-led care. Downpatrick maternity unit closed in 2003, however 2004 saw direct rule health minister Angela Smyth, give us the go-ahead to develop FMUs in NI as Agenda for Change was introduced across the UK. The maternity unit in Magherafelt closed in November 2006 as centralisation of maternity services continued.
The years 2005-07 brought the Review of public administration with a major review of the health service in NI, however by 2010 all RCM branches in NI were co-terminus with the new health and social care trusts. In 2007 the NIA was reconstituted and NI finally acquired a local supervising authority midwifery officer.
MSWs and industrial action
MSWs were introduced in 2009 and the first FMU opened in Downpatrick in 2010, followed by the FMU in Lagan Valley in 2011. Our long-awaited Maternity strategy was published in 2012 and the Mater Hospital FMU opened in 2013. RCM members in NI took industrial action for the first time in our history in 2015 and we finally got abortion guidance from the Department of Health in 2016 after 12 years of court proceedings. We affiliated to the Irish Congress of Trade Unions in 2017 and the NIA collapsed again a short time later.
Throughout my time with the RCM in NI we’ve hosted visits from three RCM general secretaries, five RCM presidents and HRH The Princess Royal. I’m leaving in the middle of a year of wonderful celebrations to commemorate the centenary of the Midwives (Ireland) Act, but I know that with Karen Murray as my successor, midwives, women and their families will be in safe hands in the years ahead.