When I
criticised the Chief Executive of the Trust which is taking over the Mid-Staffordshire
NHS trust and closing down maternity at Stafford Hospital, I called him sexist
for suggesting that mum’s could have their children at home.
This article
in today’s ‘Observer’ explains why – there just aren’t the midwives to do it;
“The NHS's
chronic shortage of midwives will last into the mid-2020s, despite ministerial
pledges to improve maternity care amid a continuing baby boom, according to new
figures.
The
calculations, by the Royal College of Midwives (RCM), suggest that the gap
between the number of midwives the NHS in England needs and the number it now
has will not be closed until 2026. The shortage is certain to force maternity
units to close suddenly and lead to some mothers receiving inadequate care
before, during or after giving birth.
Belinda
Phipps, chief executive of the parenting charity the National Childbirth Trust,
said women giving birth between now and 2026 would be let down as a result of
the shortfall. "It's extremely frustrating to think that we'll have to
wait 13 years before mothers are getting the level of support they need.
Childbirth is so important that they shouldn't have to wait that long. A whole
generation of mothers and babies will not get the support they need."
She
criticised ministers for not taking maternity care more seriously. "Given
the government's understanding of the importance of the first 1,000 days of
parenthood, which starts at conception, it's disgraceful that they aren't
acting more quickly to ensure that women get proper support in those first
1,000 days from midwives. The rhetoric is there about that period, but it looks
like they're not backing it up with action," Phipps added.
The Care
Quality Commission (CQC), the NHS care regulator, last year warned that one in
seven of the 141 hospital trusts in England that provide maternity services did
not have enough midwives. Maternity care was "emerging as a problem area
for a number of NHS trusts, due to midwife numbers not increasing in line with
demand and an increase in complex births, owing to risk factors such as
maternal age, weight and co-morbidity", it said.
The acute
shortage is leading to the temporary closure of both some hospital maternity
units, forcing mothers-to-be to go elsewhere when they are already in labour,
and some midwife-led birth centres. The Trowbridge Birth Centre in Wiltshire
shut on 15 July for 12 weeks until 29 September because of staffing problems
there and at maternity units nearby. Women now have to travel 13 miles to
Chippenham's birth centre.
Trowbridge's
midwives are now working both there and in the Princess Anne wing of Bath's
Royal United hospital to help fill gaps in the rotas. Earlier this year the CQC
voiced concern that the Princess Anne wing had "not enough qualified,
skilled and experienced staff to safely meet people's needs at all times".
Great Western NHS Foundation Trust, which runs all those units, is recruiting
more midwives to tackle the problems.
The
projections are uncomfortable for David Cameron who, before the 2010 general
election, voiced concern about staffing problems in NHS maternity units and
pledged to recruit 3,000 more midwives. However, official NHS figures showed
that the number of qualified midwives in the NHS in England had only increased
from 20,132 in May 2010 to 21,410 in April this year – a rise of just 1,278 in
three years under the coalition.
Cathy
Warwick, the RCM's chief executive, welcomed the increase in midwives but said
the NHS is still 4,501 below complement, based on the ideal ratio of one
midwife for every 28 births in a year – a figure the Department of Health
accepts. While there are likely to be 697,893 births in England this year,
there are 21,356 full-time equivalent midwives, which means each one handles
32.2 births. It needs those other 4,501 midwives to guarantee both safety and
quality of care, Warwick added.
The RCM's
projections show that, if the rising birthrate seen between 2010 and 2012
continues at the same rate, and the number of midwives in the NHS keeps growing
at the rate seen recently, the shortage of midwives will fall from 4,501 to
2,276 in 2020, then 811 in 2024, before finally disappearing in 2026, although
the ratio of 28:1 will be achieved slightly earlier, in 2024, the analysis
shows.
The
Department of Health says it has taken action to ensure 5,000 midwives are
being trained. But the RCM says numbers in post are not rising accordingly
because hospital trusts are not hiring as many as are needed. In April, deputy
prime minister Nick Clegg, confronted by a student midwife on his radio
phone-in, denied that ministers were "deceiving" voters by
emphasising the 5,000 training places, but admitted that some trusts were too
cash-strapped to boost their midwife numbers.
Labour
claimed the RCM's figures showed the prime minister had broken his
"cynical" pre-election pledge and that mothers were being failed.
"On David Cameron's watch we're seeing maternity units downgraded or
facing closure as hospitals struggle with NHS budget cuts. The lack of midwives
has left some units with no alternative but to temporarily shut their
doors," said Diane Abbott, shadow health minister.
"New
mums are being badly let down. David Cameron needs to get an urgent grip on the
staffing shortages across the NHS. One in 10 hospitals is understaffed as
almost 5,000 nursing jobs have been lost since the election. The time for
excuses is over. Patients cannot afford for the government to ignore expert
warnings," Abbott added.”
Neil Harris
(a don’t
stop till you drop production)
