That was the comment from one member of the public at SaTH’s Board meeting on 29th June. It’s all too clear that health bosses haven’t got a clue about the needs of rural areas.
The meeting nodded through a disgraceful paper – a plan to close the three rural maternity units – Oswestry, Bridgnorth, and Ludlow – for the next 24 weeks. This is apparently in order to do a favour for mothers in rural areas, because ‘regular temporary disruption of services is disruptive’. We’ve been telling them that – and that the closures are massively unsafe!
The proposals leave women forced to travel to Shrewsbury or Telford, and with local antenatal and postnatal care reduced from a 24/7 service to a daytime only 9 to 5 service. Inpatient postnatal care is immediately lost. Women can supposedly opt for a home birth – but campaigners already know of women being told this isn’t an option because there aren’t enough midwives, while (after a Ludlow woman recently waited 2 ½ hours for a midwife to attend her home birth) others will be reluctant to take the risk. The future for the Units after the 24 week closure remains unclear.
Bobbie Brown, Co-ordinator of Save Bridgnorth Maternity Unit, explained why she thinks SaTH is talking nonsense:
For months, SaTH has used the excuse of high levels of staff sickness to justify destroying rural maternity services. From their own report, approved by the Board today, this appears to have been an excuse. Today’s report says that sickness rates in the Maternity Service are lower than the rest of the SaTH (3.79% against the overall 4.08%). It also states that ‘These figures have remained fairly steady’. There’s no excuse here for them having used sickness rates to justify the repeated closure of the rural Maternity Units.
Really oddly, the report identifies the issue of staff taking short-term rather than long-term sickness, as long-term sickness ‘gives more opportunity to plan ahead’. This is just about the regular day to day planning that any manager of any workplace gets on and deals with! To use this as an explanation for closing three Maternity Units for most of June is just bizarre.
And the current vacancy rate is 2.1% – low by NHS standards. It looks like a fair number of staff are working their notice, and you can hardly blame them – but staff shortages cannot possibly account for the battering dished out to rural Maternity. SaTH claimed in its 28th June news release that there’s a fall in the number of midwives prepared to work overtime or temporary bank shifts – but we know midwives who have been trying for months to get permission to work extra shifts!
Let’s be clear – SaTH has chosen to close down our Maternity Units. Frankly, I don’t believe a word they say any more.
Gill George, Of Shropshire Defend Our NHS, highlighted another problem:
They say that 85% of women are using the Consultant-Led Unit and that’s why they have to close the three rural Maternity Units. We think they can’t possibly have read the 2016 national recommendations in ‘Better Births’. Everywhere else in the country, work’s going on to give women more choice – to invest in accessible midwife-led care for women with low-risk pregnancies, so they can give birth close to home. It beggars belief that SaTH is closing midwife-led units to move more and more resources to the Consultant-Led Unit. This is the complete opposite of what the national policy requires them to do.
The reality is that these are cost-driven cuts. They decided back in April 2016 to close the rural Maternity Units to save £1.5 million. This is the latest and most brutal attempt we’ve seen so far. We keep beating them back, but they’re doing everything they can to avoid listening to mothers in our rural communities.
Ally Hiles, Coordinator of Save Ludlow Maternity Unit campaign, gave birth to baby Amelie at home on 7th May, because Ludlow Maternity Unit was closed. The on-call midwife turned up an hour after Amelie was born. Ally issued a stark warning to health leaders:
You put my life and my baby’s life at risk. Now you’re choosing to do the same to many, many other mothers. The journey times from our rural areas to get to Shrewsbury or Telford are just too long – Shrewsbury Hospital is 30 miles away from Ludlow. Taking away rural Maternity Units is as dangerous as it gets. I’m putting you on notice, everyone on the Boards of SaTH and Shropshire Clinical Commissioning Group. There is a tragedy waiting to happen here. If a mother or baby dies or suffers harm, we’re coming after you.
And Liz Grayston, of Save Oswestry Maternity Unit campaign, summed up the mood of campaigners brilliantly:
We fight, we respond… We march, united across Shropshire.
Maternity campaigners will be marching in Oswestry on Sunday 9th July, assembling 10.30 am at Bailey Head.
To excuse this blatant policy choice by lying about staffing is appalling. I fear for the women and their babies as this is not going to provide the service they need.
As a Midwife working on the Delivery consultant unit I can quite assure you that these are not lies , midwives are dropping like flies ! From the sheer stress and workload each shift there is always someone off sick . We work 12 hour shifts flat out looking after very high risk women, without a break there simply are not enough of us . Even with the closures we are still short staffed . Although I feel for the women in rural Shropshire not having the choice they want to deliver in their local unit they are generally low risk and do not require one to one care as do the high risk women. ! Believe me I work there I know what’s going on !
This is really valuable information, Elizabeth, and yes I believe you. It is of course inexcusable for clinical staff to be working 12 hour shifts without a break, inexcusable for people to be dropping like flies, and that screams out to me ‘Not enough staff’.
One of the problems is knowing what’s real, because the stories keep changing. A decision was taken by the SaTH Board over a year ago to close the MLUs because they supposedly cost too much, and there have been successive waves of assault on the MLUs – I won’t bore you with the detail. The public insistence from SaTH has ALWAYS been that there are enough staff in the maternity service and there are no difficulties recruiting. MPs have been told that there ARE difficulties with recruitment. Closures of the MLUs always used to be justified on the basis of ‘high demand’ and ‘unexpected staffing issues’. This suddenly changed a few weeks ago to ‘staff sickness’ – and common sense led to a guess this was stress related. Then the paper that went to the Board on Thursday reported unremarkable sickness rates, lower than the rest of the Trust, and ‘fairly steady’ rates of sickness too. They also claimed a vacancy rate that was extraordinarily low. It was a report that really surprised me – but this is the official account given to the Board. And that’s therefore the data we used in our press release after the decision to close the MLUs.
We heard an account recently of a midwife who wanted a permanent contract – but was turned down on the basis that reorganisation or cuts were set to lead to fewer midwives. That really worries me. I also feel very strongly that it shouldn’t be a choice between midwives for the Obstetric Unit OR midwives for the MLUs, but enough midwives for ALL settings. We’ve got women in rural areas now being told they can’t have home births, losing a lot of their local antenatal and postnatal care under current plans, and we’ve had two cases in the last few weeks of women giving birth unsupported because Ludlow MLU was closed and the on call midwives were based too far away to get there in a timely way. That’s not fair to those mothers, and not fair to the midwives either. The vast distances of rural Shropshire create a level of risk for mothers that is leaving women really frightened.
I think so much of what happens in the NHS now is cost-driven – and I say that as a retired clinician who knows and talks to a great many health workers. One problem with closing the MLUs is that capacity is being taken out of the system, Delivery and Postnatal beds, and that puts more pressure on a service that’s already over-stretched. We need a whole range of maternity settings, of course – and the money to staff them properly and support those staff properly, and promotion of the low risk settings to take some of the pressure off the Obstetric Unit, and a higher proportion of those births going out to the community…. And I reckon we’re stronger if there’s a united fight for those things.