Tuesday, January 02, 2007

In December 2005, Reform published a study - Maternity services in the NHS, Reform, 2005 which showed that NHS maternity services are under considerable strain. Authored by two NHS obstetricians, an NHS midwife and a leading health economist, it warned that midwife hours are falling, consultant cover is inadequate and administrative burdens are rising. It showed that reform based on choice and diversity of provision would allow the development of networks of smaller modern units which would be more convenient for mothers and better able to cater for births of different levels of risk.

The report showed that the key trend of the last 30 years has been for NHS maternity units to become larger and more centralised. The largest English unit – Liverpool Maternity – delivers over 8,000 births per year

The current NHS funding system undermines the best units. Because funding does not follow the mother to a particular unit, the most popular units can find themselves with more patients but not greatly increased resources, leading, at worst, to an increase in clinical risk.

The reform principles of choice and diversity of provision would be just as beneficial for maternity services as they have proved in other areas of the NHS, such as elective care where waiting times have fallen and value for money has increased. Real choice for mothers would lead to a shift to smaller, more specialised units provided both by the NHS and the private sector.