Here we go again, more maternity units scheduled for closure, yet another little side step in the ever more tangled plan that the government has for maternity services. ‘Plan’, did I call it a plan? Sorry, that is misleading, it implies that someone, somewhere has actually thought things through and is now putting forward a researched and structured package and that is something this government has been spectacularly poor in doing. Oh, they are full of ideas and promises, league tables and stars but as regard providing a firm foundation on which to build and maintain these visions they are sadly deficient.
Women and their families are promised 4* facilities, care and abundance of choice. Consultant units, low-risk units, stand alone birth centres and homebirth on demand, whatever the demand the Trusts (aka the staff) will rise to the occasion. However, now we are hearing that 9 maternity units have already closed, 5 have been downgraded, 15 are threatened with closure and a further 11 are threatened with either closure or downgrading. Why this severe pruning? Well its all down to centralisation and cost-saving. Theoretically these are laudable motives. Centralisation should lead to a consolidation of knowledge, practise and resources, ‘regional super-centres’ , whilst saving money by a reduction in building maintenance and being able to sell off, or convert to other uses, the redundant buildings. Just over a year ago the government published Maternity Matters, a national guarantee, it’s tag line is “choice, access and continuity of care in a safe service”. Well the choice is under the proviso that you are prepared to travel a larger distance; the access will be questionable and the continuity of care will involve a workforce who will, in these times of increased traveling costs, have to travel larger distances to provide the continuity, thus negating a proportion of any cost-saving.
Lo and behold though, there is a plan. Yes, unbeknowns to us mere toilers within the NHS there is a web-site, Healthcareworkforce.nhs.uk, where they have identified the ‘need for urgent workforce planning principles’ so NWP ( National Workforce Projects) have developed a workforce planning resource pack. Maternity Matters is due to be implemented by 2009, you would imagine that that us ‘on the ground’ would have been briefed in some form concerning the implementation plans/changes, after all they are only 6 months away. However I, and all my colleagues, are strangely ignorant of what our roles will be. I do find this quite concerning as, working within the community, where the government promises provision and continuity of care will be improved I do feel that I should be being prepared for the changes, but I’m not.
As I said, we need good foundations, the staff are the foundations but with lack of consultation, information sharing and cohesion we are weak.