There has been a lot in the news recently about a scottish midwife, Anne Duffy who resigned from her job and is now claiming constructive dismissal by her employers. I’ve been interested in the outcome as the decision, it seems to me, will come down to interpretation of the NMC rules.
As yet a decision hasn’t been reached concerning Anne Duffy’s case, so why am I writing about it now? Well, in the news today was a report about a couple whose baby sadly died as a result of no midwife going out to their home for the birth and the fact that a settlement has been agreed with the Trust.
In Scotland Anne Duffy was the midwife in charge of the maternity unit, which meant that she was the most experienced available midwife, when a call came in that a seriously ill, pregnant woman needed air lifting from an island to the hospital. After a discussion with other staff members she went off in the helicopter, when her actions were discovered she was disciplined and as a result she resigned. Report here.
So, on the one hand we have a case where a midwife attended and was disciplined as a result and on the other hand, we have a case where a hospital failed to provide a midwife, a baby died, and the Trust have, I assume, admitted fault and made a settlement with the parents.
There are differences here, in one a midwife failed to follow hospital procedure, but fulfilled the professional requirement to provide care, and as a result was disciplined and in the other a hospital failed to provide care and have admitted fault. Can anyone else see the double standard here?
The Huddersfield baby death does bring up the homebirth and midwife staffing issue again though. There must be more to this though as there was already another homebirth underway, there was only one on-call midwife and she was already at the other homebirth so why didn’t the parents come into the hospital?
It is 3 years since Jamie and Louis the twins were born, and it has taken me that long to finish their birth samplers. I hang my head in shame, the previous grandchildren all received their cross-stitch pictures within a few weeks of their birth, but completing the boys cross-stitch has been an epic. I blame it on the boys and Izzy all being born in 2007 and me going into overload as far as my embroidery is concerned, that or discovering games on the internet! Oh well, at least I had them finished and framed ready for their 3rd birthday. Now I’ve just got to get started on Evie’s and then Joshua’s.
The boy’s birth samplers
Thanks to the school holidays Hubby and I have been inundated with the rugrats, in fact Hubby was brilliant last weekend, giving up the opportunity to play on a championship golf course to help me look after 5 energetic children who had come for a sleepover. His comment, when they had returned to their parents, was ‘ Lets just do one family at a time in future’. He’s not a bad judge, absolutely exhausting.
The sleepover gang (Evie had just popped around)
Still on the grandchild front, and just so that he isn’t left out, a photo of Joshua plus the birthday boys.
Today a man knocked a daughter’s door to let her know that he had been alerted that everyone in her area was on the wrong tariff for their gas supply. He asked if he could check her bill and then he could see if their tariff was the wrong one and, if it was, he could alter it for her there and then. Having checked her bill he said that they were being wrongly charged for their gas and that if she just gave him a few details he would sort the paperwork out. He copied all the relevant info from the bill and then asked daughter for her bank sort code. She questioned why he wanted it, he said it was just so the direct debit could be amended. At first daughter was uncertain and declined releasing the info to him. He responded by saying that he couldn’t understand her reluctance as he could easily find it out just by enquiring at the bank, she gave it to him. Then he asked for her bank account number, she said that she was feeling reluctant about continuing and was not prepared to give it to him. He phoned his boss (???????) who said not to worry, they could sort it out anyway. With that he passed the paperwork to daughter and requested that she sign it in two places. The paperwork was entitled ‘Contract Agreement’, daughter asked him to leave, harsh words were exchanged.
This was a Scottish Power salesman and the only reason daughter knew this was from reading the paperwork, she is not with Scottish Power nor any of their affiliates but his approach had been to portray himself as a representative from her energy supplier. Seems that Scottish Power have not cleaned up their selling tactics.
Daughter phoned her partner as she was disturbed by the man’s behaviour once she had refused to sign, she had felt intimidated. The representative was lucky that he was not visible an hour later as SIL came home from work to ‘have a chat with him’. I’m just hoping that the company are calling on all homes locally, we only live 2 miles from daughter, and I’ll feel really happy if ‘James’ knocks on my door, he won’t though and neither will Scottish Power.
In The Guardian today was an article guaranteed to court fevered discussion, ‘Women have a right to a homebirth’. The authoress, Jemima Kiss, introduces the article with the suggestion that the health service should value natural births and not to allow the loss expertise in these in favour of caesareans, she has my support there. She is also quite correct in her assertion that women have the right to a homebirth, my question is ‘ Is it right that women have the right to a midwife attended homebirth in today’s cash-strapped maternity services?’ Any woman can choose to give birth at home, but NHS Trusts do not have to provide a homebirth service, apparently. It’s all nit-picking though because, if Ms B sent her partner round to my house and he told me that she was in the later stage of labour and they wanted my help, then I would have an obligation to attend and provide care ( NMC Midwives and home birth 2006).
Currently maternity services are incredibly stretched, and it’s not going to get any better. Many maternity units are desperately short of staff, Oxford being just one of them. Low-risk units are closing, Paulton in Somerset, Wycombe in Buckinghamshire and Tiverton in Devon purely because of staff shortages in the obstetric unit they are linked to. A homebirth requires 2 midwives, 2 midwives who will be needed elsewhere. If the homebirth happens at night those midwives will have already worked all that day, who will cover their work the next day? In reality how safe, how ‘on the ball’ will a midwife be when s/he has been working 24 hours? If it happens during the day who covers the work, especially if 2 midwives have already been out at another home birth the previous night? The answer is that clinics may be cancelled, pre-arranged appointments put off and any midwives who are working that day will end up very stressed and going home late. Another factor is, suppose the midwives were called out to homebirth 1 at 6pm and returned home at 2am then another woman wanting a homebirth called them out at 2.30am, it happens, and it is happening more and more frequently due to government initiatives and articles like the one in The Guardian.
I’m sounding negative about homebirth, I love homebirths but I am becoming increasingly concerned about the arrangements and staffing for their provision. Other aspects of community midwifery are really suffering due to cutbacks, childbirth preparation classes are being abbreviated, postnatal home visits are being withdrawn but a small number of women are able to command how the service functions on a 24 hour basis. I am horrified to hear me saying this but ‘ Until the maternity services have enough resources to ensure a safe provision FOR ALL then a homebirth option should be withdrawn’.
Hubby has got shingles. It started last Sunday when he reported that he had a real pain in the side (other than me) but nothing was visible, except there was a ?mole which we hadn’t noticed before. I sent him to the G.P’s on Monday so that it could be checked, G.P said that the mole was fine and the pain was muscular. Tuesday evening Hubby was very,very uncomfortable, so I inspected his side again and there it was, a nasty little shingles rash. Next morning he was back at the G.P’s, if you can start Acyclovir within 72 hours there is a chance that it can reduce the severity of the virus so early prescribing was imperative as I was desperate he would no be too poorly. I sound so caring, but actually I was being really selfish because we had plans for a weekend break. Friday morning came and I had made the decision we would not go away, he was so uncomfortable that his sleep was disturbed and I felt that it was unkind to expect him to leave his comfort zone (chair in front of the telly) just because it was our wedding anniversary. We went though, totally his decision and, despite his shingles and my post-op discomfort, we did have an enjoyable couple of days away, we are both absolutely shattered now though!
I was reviewed by the doc on Thursday and have been declared unfit for work for a further 4 weeks, had not seen the new ‘sick notes’ before, I do think they are better though as they give the doc an opportunity to give advise about the conditions under which the patient may return to work so they should have the ability to reduce the length of sick-leave.