OFFERED:
Fabulous boutique room, freshly painted, king size bed, 24-hour
staff, pool. REQUIRED: vaginal delivery of a perfect baby.
Of
course, you'll be lucky to make it through the doors of this little
piece of heaven within the NHS. If you have any hint of a
complication you'll be sent packing to your standard local
obstetric-led maternity suite. Oh, but hold on – there's no room at
the inn: all of the obstetric-led units have been shut!
Don't
get me wrong, I am all for natural childbirth, women should be
supported to give birth at home or in a midwife-led unit; let's make
sure every baby's first moments are skin-to-skin, suckling at the
breast. But the harsh reality is that the sweet, sweet words from NICE are nothing more than a whispered lullaby to lull women into
thinking that they have a heart and that they've listened to mums and
midwives. With a shortage of nearly 5,000 midwives nationally and a
maternity service in tatters thanks to countless hospitals being
downgraded there is no way that a move to a midwife-led model of
maternity care is a serious proposition.
So,
let's get serious. Women need an individual service tailored to their
needs. Home birth requires two midwives to be present but is
otherwise cheap as chips and has very good outcomes for mums and
babies (within reason). Birth Centre delivery requires one midwife,
with very little intervention, is slightly more expensive and also
has good, reliable outcomes for mums and babies (within reason).
Acute Obstetric care is on a graded scale of expense with increasing
intervention and has good outcomes for mums and babies (within
reason). Reason, skill and medical training decide where it is most
appropriate for a woman to give birth. In a service where the mother
is at the centre of care, this should be a fairly straightforward
decision – but in a service where profit and a confusing web of
tariffs, CQUINS (and I'm not talking disco here) and penalties take
centre stage, then the woman and her ever-expanding waistline are
left to the mercy of a lottery of the market.
NICE
can say what they like but the Department of Health are no longer
accountable for our care and with the advent of the CCG they have no
control of a national maternity strategy. When asked in a recent government report the Department of Health was not able to name a
national policy for maternity. It's still Maternity Matters, by the
way, Jeremy.
The Health and Social Care Act untethered the Department of Health from
the NHS. It claimed to hand over power to the Clinical Commissioning
Groups, but in reality they are at best confused and at worst rife with corruption. All of this while introducing an open market that is
spiralling out of control. The result for women is that maternity
services are floundering. In that government report it was found that
the Department of Health is no longer responsible even for such basic
and fundamental aspects of care such as how many midwives are
employed by the NHS. So, who is? No one.
With
Public Health banished to the savaged hinterland of the Local
Authority there is no longer a powerful body integrated into either
the NHS or the CCGs to ensure that local commissioning of maternity
services is in line with Department of Health Policy. Even if they
knew what that is. By breaking up the NHS, the Department of Health
has made it perfectly clear that it is not remotely interested in
having a public health policy at all. They prefer to focus on forcing
hospitals into becoming Foundation Trusts as quickly as possible.
Jeremy
Hunt and his cronies may not care about boring epidemiological
studies and evidence-based care, but for us mums the fragmentation of
services is a catastrophic blow to choice, continuity of care and
equal access to healthcare. With the desperate shortfall of 4,800 midwives and almost half (47%) of UK hospitals lacking
enough consultant obstetricians, along with a steady baby boom in
England over the past decade, there is increasing strain on maternity
services. Midwives and obstetricians look after women with much more
complex needs. The Coalition, UKIP and other misguided souls push an
identity parade of people to blame: Immigrants (the Polish get a hard
time despite working legally, paying taxes and so therefore no
different from Mr and Mrs Smith born and bred in Tunbridge Wells);
The Poor (to listen to George Osborne and Iain Duncan Smith one could
be forgiven for thinking that eugenics may well be on the cards for
the next election manifesto); The Needy (we might as well kick the
disabled while they're reeling from ATOS); and finally, The Labour
Party (they gave those pesky women far too much with their tax
credits, Child Benefit, Children's Centres and Maternity Matters).
Amid
the frenzied dismemberment of the NHS we are hurtling towards an
insurance-based system for our maternity care, which embraces
intervention rather than holistic, aromatherapy and massage amongst
caring midwives handy with a birth stool. We need to ask ourselves,
do we seriously want to live in a society in which only the
super-rich can afford to have babies while the rest of us lucky
enough to have health insurance count the pennies to calculate
whether we can afford for the stork to pay us a call?
Never
forget that pre-NHS women died in their droves in cavernous lying-in
wards or for want of an experienced midwife. The idea that all women
are going to have the opportunity to lie-in in a luxurious birth
centre would be a joke if it weren't so utterly terrifying that the
back-up intensive obstetric care is being closed down. We mothers
need to fight and fight hard for our hard-won maternity services. We
need to join together and fight
those seeking dismantle the NHS and fight them we shall: we shall
fight them on the labour wards, we shall fight in the midwife-led
units and we shall fight in the birthing pools; we shall never
surrender. We shall go on to the end.
