« Midwifery in East Timor | Main | Midwifery practice development tool »

Another birth centre closure in the UK

It seems the struggle to provide woman-centred midwifery care will never end. Just as we are inching closer towards midwifery only maternity hospitals and caseload midwifery care across the board in Australia, we hear that many similar units in the UK are under threat of closure, despite Government policy that clearly voices support for this option of care.

One lesson that was learned the hard way in Australia some years ago, is that if these units are funded separately, and especially though a special purpose grant, then they are vulnerable to closure because they appear as a separate line item in the maternity budget of a hospital. When finances are tight and the accountants are looking for services to cut, a separate line item for midwifery care is very obvious and presents and easy target. Bitter experience with the sudden closure of a wonderful program in one of our regional areas due to a whole hospital over-spend taught midwives that these programs must be funded within the existing budget if they are to survive the hard times.

In the UK, each small Trust or PCT (and there are dozens of them) controls the purse strings for all the services in its area and centralised policies (such as the Government’s public commitment to midwifery services) can be ignored if the local managers want to provide other services as the expense of midwifery care.

Here is an extract from the press release issued by Mary Newburn of the National Childbirth Trust in the UK in response to the latest assault on services for women:

The National Childbirth Trust (NCT) has today expressed its dismay over the proposed closure of the third largest midwife-led maternity unit in the UK. Stroud Maternity Hospital has been told that it will be closed within the year due to the financial constraints of Cotswold and Vale PCT.

Mary Newburn, Head of Policy Research at the NCT said:

'Government policy states that the NHS should provide choice over place of birth and specifically highlights midwife-led units and birth centres to be available as an option.

'If the Government is to fulfil its pledge to ensure women have a range of maternity choices available to them then action must be taken to halt the closure of midwife-led units and birth centres. Stroud Maternity Unit is the latest in a long line of birth centres and midwife-led units that have been closed - temporarily or permanently - or that are facing closure. The proposed closure of Stroud is therefore yet another example of how Government policy is failing to be implemented.

'Closing birth centres rarely saves money so should not be targeted when action is taken to correct an over-spend. We'd like the Secretary of State to issue a clear statement that maternity services should not be cut back when other hospital departments fail to keep to budget. The major cost of providing maternity care is the cost of midwives' salaries, estimated to be around 85%, and midwives are needed to provide one-to-one care whether the women uses a birth centre or a hospital unit.

'In addition, we'd like to see the midwife-led units and birth centres that have been closed in the past three years reopened.'

The NCT believes that more than 13 birth centres and midwife-led units in England and Wales are currently either closed (temporarily or permanently) or are facing closure. Five units in Scotland are also under threat including Aboyne Community Midwifery Unit in the Grampians. This is despite the Scottish Executive's Framework for Maternity Services, which states that 'women have the right to choose how and where they give birth.'

I will be back in the UK in 2 weeks and I will no doubt hear more of these problems when I am there. The frustration level amongst midwives in the UK must be at al all-time high (and probably rising!).

Posted by andrea at May 30, 2006 11:22 AM