The UK’s midwifery service is facing crisis point, the General Secretary of the Royal College of Midwives warned the Blair government on Wednesday.
‘With midwifery jobs being cut, training budgets slashed and midwifery-led care under threat, there is much for our profession to contemplate and act upon,’ was the message RCM General Secretary, Dame Karlene Davis, gave more than 600 midwives in Torquay.
She also vowed to hold Health Secretary, Patricia Hewitt, to her promises just an hour after she had addressed a packed conference room.
Opening her address to delegates at the College’s 124th Annual Conference, Davis said: ‘Let me take you on a trip down memory lane.
‘Cast your minds back to 1997 and the election of Tony Blair’s first Labour Government.
‘Do you remember their theme tune – “things can only get better”?
‘After years of under-investment and neglect it seemed as though things were about to get better for the NHS.
‘We had enormous hopes and aspirations for the development of maternity services, midwifery and the NHS.
‘Fast forward to 2001, the last time we gathered together in this auditorium.
‘Five years ago, Alan Milburn, then the secretary of state for health, stood on this very spot.’
She added: ‘Back then, Mr Milburn boasted of how maternity services would share in the expansion of the NHS.
‘Now, hardly a day goes by without redundancies being announced, operations delayed, birth centres closing or under threat, vacancies frozen and student midwives unable to get a job.
‘Two years ago the prime minister described the NHS as being “safe in the patient’s hands”.
‘Now, we hear, Mr Blair has taken personal charge of the NHS and he won’t go until the crisis is sorted.’
Davis continued: ‘While much of the focus has been on England, this is an emerging issue for the rest of the UK.
‘Most NHS trusts in Wales forecast deficits, with an estimated overspend of £32 million.
‘In Scotland, the combined overspend of four Health Boards stands at £90 million.
‘Much of the present crisis is of the government’s making.’
The RCM leader added: ‘The government would have you believe there is no crisis, that funding difficulties are a storm in a teacup.
‘The Secretary of State makes the point that spending on the health service will increase from £35 billion in 1997 to £92 billion by 2007.
‘The Prime Minister, in a recent speech, also reminded his audience that deficits represent just one per cent of the total NHS budget.
‘In his view, there is no crisis – just serious challenges.
‘Well Mr Blair, midwives face redundancy, staffing establishments are being cut and recruitment to vacant posts frozen.
‘As a result, maternity units cannot deliver one-to-one care for women throughout their pregnancy.
‘You might call this a challenge – I’d call it a crisis!
‘Birth centres are closing or under threat, home births cancelled and services centralised.
‘This is denying women choice over the type of maternity care they receive. That is not a challenge, Mr Blair, it is a tragedy!
‘My idea of a challenge would be to give every woman a choice over where and how they have their baby.
‘Ensuring every woman is supported by the same midwife throughout her pregnancy – that is a challenge!
‘And delivering these commitments by 2009 – that has to be the biggest challenge of all!
‘The good news is these are the challenges the government set out in last year’s manifesto!’
She added: ‘So just what has happened in the last year?
‘Well credit where it’s due – the government has come up with all sorts of wheezes.
‘It instructed primary care trusts to stop providing services and concentrate on commissioning instead. It has had to backtrack on that idea.
‘Then, after PCTs had spent millions on aligning their boundaries with local authorities, it decided to halve the number of PCTs.
‘Now it has streamlined and reorganised Strategic Health Authorities. According to the Department of Health press release this will, and I quote, “strengthen the architecture of the local NHS”.
‘Birth centres are closing and the NHS cannot provide women with one-to-one care, but look on the bright side – the architecture of the local NHS has been strengthened!
‘This obsessive tinkering with structures, while services are being cut back, is a distraction, a waste of taxpayers money and about as useful as a peashooter in a pit of alligators!’
Calling on delegates to harness the fighting spirit that midwives display in abundance, Davis said: ‘NHS employers are still dithering over the outcome of the unsocial hours review.
‘Some trusts are manipulating job descriptions or diluting skill-mix in an attempt to evade their obligations under Agenda for Change.
‘Others are attempting to scapegoat Agenda for Change as the cause of their financial mismanagement.
‘Like the profession, the RCM face new challenges and we recognise the need to adapt and to innovate.
‘Today I can report back on the progress we are making in transforming the shape of your College and the way we go about our business.
‘It is change for a purpose – change to help our profession steer a forward course through the turbulence that is buffeting the NHS.’