The King’s Fund report looking into the safety of the maternity services has come out, this is just a shortened version, but I found it quite illuminating when you read between the lines. I loved how it started as this really sums the situation up –
Giving birth in England remains safe in spite of neglect by senior managers and pressures on staff, according to a major new report.
Well if those who hold the purse strings, and ultimately decide staffing levels are not responsible for the service being safe, who is it down to? They have answered it by highlighting the pressures on staff. The pressures are there due to the neglect by senior managers. However, I don’t believe that they should carry all the blame, the DoH and Government are just as much, if not more, responsible. It is they who keep throwing initiatives out, promising the public this level of care, that access to services but at the same time the budgets are not increased sufficiently for the facilities and staff to be provided, in fact monies are effectively cut by the Trusts in an effort to stay within the Government decided budget. The report actually states that the ‘boards that oversee NHS Trusts have insufficient focus on maternity services’ and I believe that this is true, as long as mortality and morbidity remain low they are not prodded into taking action but the report does ‘call the the Trusts into action’ as it goes on to advise that ‘we could do better for mothers and their babies’.
I have blogged so much about the hand-to-mouth provision of care within the service. The obstetricians and midwives struggle to ensure that the service is ‘safe’ and on the whole we do well but women do not only want a service that is safe, they want the service that government, books and the media has lead them to expect. It is this that causes the majority of moans we read about on a regular basis, difficulty seeing a midwife when they want to, not only when it is scheduled; lack of attention from staff when they are in labour, on the wards or back home. Not enough help with breastfeeding, having to wait for painkillers and worse. On labour ward it would be lovely to provide one-to-one care but if there are more women than midwives that can never happen and attention will always be paramount for the high-risk cases. On the ward the problem is that if the ward is half full of women who have just had a major operation, C-Section, the staff are going to be more concerned about their post-operative recovery, that is a safety issue, the others demands on their attention, though hugely important, are not life-threatening.
So lets hear it for the staff on the ground because although they are under resourced they are still providing a safe service.