Feeling the
squeeze
A
REPORT to be published this week by the Royal College of Midwives (RCM) will
call for the Government to employ 5,000 additional midwives in response to
record birth rates and a workforce ripe for retirement. Nottingham’s midwives (names have been changed) tell David Cornish that conditions
are already unsafe, unrealistic and unfair.
THE STORY SO FAR
· January 2010 – David Cameron makes pre-election pledge for 3,000 more midwives.
· February 2011 – Health Minister Anne Milton backtracks on pledge, telling the Commons: “Complete and absolute focus on staffing numbers is totally ridiculous... We are determined that staffing rates should be calculated purely on how many staff are needed to provide safe, quality care.”
· October 2011 – RCM release annual birth rate statistics, indicating that an additional 4,700 midwives are required to keep up with a ‘rocketing’ birth rate.
· September 2011 – East Midlands is identified as the worst affected area in England, requiring 41 per cent more midwives. The month also sees the RCM release a survey of the heads of midwifery in England. Over a third anticipate that they will have to cut staff in the next 12 months. Nearly two-thirds comment that their staffing levels are not enough to cope with the demands on their services.
· November 15th-16th 2011 – RCM annual conference and publication of new report on the state of midwifery.
“I think it’s
more common for it to be unsafe than safe now. More often than not you find
yourself working a thirteen hour shift without a single break for a drink of
water. You finish your day thinking ‘Wow, I didn’t kill anyone today’. I’ve
felt that I’ve given substandard care.”
Kate Drewson has
been a qualified midwife for just over two years, and now works on the
maternity unit of the Queen’s Medical Centre, Nottingham. Stressful days are
standard practice for Kate, working in the most understaffed region of England.
Before the health trusts of the East Midlands can ensure mothers receive safe,
high quality care, 600 additional midwives are required.
Sophie
Bellinger also works at Queen’s. Having qualified this year, she knows no
alternative to the staffing shortages. “We’re supposed to have two 20 minute
breaks during our 12 and a half hour shift, but we rarely do.”
It
soon adds up. Over the course of a month Sarah recorded that she had worked the
equivalent of two shifts in missed breaks. Not only did she miss out on pay,
but she couldn’t guarantee that she was giving ‘safe, quality care’.
“Yesterday
I didn’t have a break all day. It was like a traffic jam. I was caring for six
women. It’s unrealistic that one midwife can provide care to so many women and
so many babies. Mistakes are being made, but it’s because of the work load we’re
being expected to handle.”
Sarah
Tebbton, a midwife at Nottingham City hospital, holds similar concerns: “It’s
not just because of the number of babies being born, it’s also the change in
the health of the nation. We’re seeing far more complicated and high-risk
pregnancies as a result of obesity, smoking, and older mothers. These
complications result in more time being spent with those women, while healthier
mothers have less contact with their midwife.”
THE
midwives are unanimous as to where the responsibility for the staff shortages
lies: the Government. Kate feels that they’re dodging the issue: “They say we
shouldn’t focus on staffing numbers – but that’s not true. So many of the
problems we face result from a lack of staff. There are midwives qualifying and
not getting jobs. They aren’t putting money into the pot.”
For
Sophie, the solution is a straight forward one: “More midwives means mistakes
aren’t missed and we avoid a dangerous care environment – it’s pretty simple.”
Changes
to the pay structure have added to frustrations, as a ‘money saving’ scheme
introduce this year altered the way in which overtime is paid. In order to work
the extra hours required to cover for the gaps left by staff shortages, midwives
must first sign up to the organisation NHS Professionals. This results in all
overtime work being classified as a second job, which is subsequently taxed a
greater amount. For midwives in Sarah’s position, the changes don’t add up: “It’s
costing both us and the Government more to pay for extra shifts – why don’t
they just put the money in
for more midwives?”
JEANNE
TARRANT is the RCM’s regional manager for the North East of England, and is
only too aware of the problems the staffing shortage is creating. She hopes
that these concerns will be addressed by the Government after the publication
of the RCM’s latest report at next week’s annual conference in Brighton:
“We’re
very disappointed by the way we have been ignored by David Cameron. He hasn’t
come close to his pre-election pledge for 3,000 new midwives – I’ve no idea
what he based such a figure on.”
With
nearly twenty years of midwifery experience, Jeanne hasn’t known conditions
like those currently faced by the nation’s midwives: “We simply can’t continue
with the Government’s current level of investment in midwives given the rising
birth rate and the numbers due to retire.”
Having
declined to take strike action, the RCM can do little more than send out an
SOS. Earlier this year, an E-Petition was posted by the general secretary of
the RCM, Cathy Warwick, calling for action from the Government to prevent the
cuts to the NHS from damaging maternity care.
100,000
signatures are required before the Commons debate the issue of employing 5,000
more midwives. The number of signatures currently stands at 15,639.
“We
desperately need people to sign the petition,” says Jeanne. “What I see is
midwives working really hard. They’re on their knees, and the RCM doesn’t want
them to think that their efforts are in vain.”
