Escalating crisis in maternity care in UK
25 September 2013
Last month, the Royal College of Midwives (RCM) revealed new figures detailing the shortage of midwives in England. The statistics not only show the crisis in maternity care, but in the National Heath Service as a whole as a result of continuous attacks aimed at privatizing the services.
RCM, the professional organisation of midwives in the UK, estimates that currently England is short the equivalent of 5,000 full-time midwive posts. Two regions, the North West and South West, have recorded an actual fall in midwife numbers over the past three years.
By comparing the pace in the increase in midwife numbers to rising child birth rates, the RCM projects that it will be the middle of the 2020s before the shortage of midwives is eliminated by increased recruitment. However, RCM’s estimations and projections do not take into account the attacks on the NHS by the Conservative/Liberal Democrat government and its Labour predecessor. This assault on health care is set to have a detrimental effect on midwife numbers and maternity care, as with all other patient care and services across the UK.
The coalition government has intensified its attacks on public health provision by cutting £20 billion out of NHS’s budget. Accident and emergency units, maternity units, children’s heart units and most of the hospital trusts are under sustained pressure to slash services and staff numbers as a result of this unprecedented reduction in NHS funding.
This is not the only way in which the NHS is being cut back. Clinical Commissioning Groups (CCGs) came into effect from April under the Health and Social Care act. The CCG’s are run by General Practitioners (GPs) and are able to buy care from private providers—further escalating the privatisation of the NHS services.
Last year the NHS watchdog, the Care Quality Commission (CQC), warned that one in three maternity units in the South East has too few midwives, and almost one in four in London was also affected by shortages that can damage the care mothers receive.
Overall, one in seven of the 141 hospital trusts that provide maternity and midwifery services in England does not have the recommended one midwife for every 28 births, the CQC said.
Antenatal and postnatal care are both affected due to too few midwives in most regions in England, with almost one in 20 (4.8 percent) of midwifery posts vacant.
Acknowledging this crisis in maternity care, a spokesperson for the NHS regulator said that it 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.”
Figures obtained under the Freedom of Information Act by the Sunday Telegraph revealed 66 NHS Trusts closed their doors a total of 1,795 times to mothers-to-be in 2011 and 2012. Expectant mothers are increasingly being forced to travel—in some cases very long distances—so as to have a place to give birth. This is becoming a common occurrence due to the lack of midwives or beds in their nearby maternity units.
Prime Minister David Cameron promised to increase the number of midwives by 3,000 before the 2010 general election, along with other sham claims to defend and improve the NHS. But the figures compiled by the RCM show the number of jobs has increased by just 145 since 2010 and thousands of other NHS posts have been slashed.
Although there is an increase in places in Universities for midwifery students, most of the NHS trusts do not want to employ more midwives due to financial pressures.
In April during a live radio programme on the BBC, Deputy Prime Minister Nick Clegg of the Liberal Democrats was accused by a midwifery student at King’s College London of deception.
“We know there’s a chronic shortage of midwives in this country and your government keeps saying we’re investing in 5,000 more student midwife places,” she said. “But wouldn’t you say it’s true you’re largely deceiving the public, the taxpayer and us student midwives because trusts don’t have the money to employ us?”
There were 45 students training with her, but they had calculated there had been jobs in nearby trusts for only 20 of them.
Maternal mortality ratio (MMR), or the number of maternal deaths during pregnancy and childbirth per 100,000 live births, is a sensitive indicator of the quality of the services in a country. The UK has fallen to 33rd place in the Global MMR league table, while the MMR increased from 10 per 100,000 in 1990 to 12 in 2010. The figures again underscore the tragic consequences of the erosion of maternity services.
Shockingly, MMR in London has risen from 9.1 per 100,000 live births in 2005-2006 to 21.6 per 100,000 in 2010-2011, largely due to problems in the maternity services and shortage of midwives.