From the heart
NICE, National Institute for Health and Clinical Excellence, have released their guidelines for the care of mums and babies, they are not telling me to do anything that midwives don't already do, their glaring omission is that they don't say how many visits would be ideal, or indeed what the minimum number of visits should be, and there in lies the problem. Trusts are using this lack of advice to reduce the number of home visits to a bare minimum, and certainly less than most midwives are comfortable with.
I've set up a Google alert for Maternity Services, and it's frightening. Hardly a day goes by without some story about another maternity unit closing, and the reasons behind all of them? Funding, or lack of. I expect that if I set up an alert for any other specialist service within the NHS I would receive a similar numbers of responses all telling the same story, money and staff shortages. The answer seems to be lets close units and throw money at a new one, and during this process exceed our existing budget and so be in even bigger trouble next year. Another ploy seems to be alter traditional roles, give paramedics more responsibility, encourage nurses to take over the tasks traditionally carried out by junior doctors, and pharmacists are being encouraged to make diagnosis. There is a certain G.P who rants about this, calls professionals who take on these roles 'Quacktitioners', I am often at odds with his take on matters, and particularly the sentiments he expresses toward nurses, and on occasions midwives, but I have to say that I feel we may be on the edge of enhancing roles too far. I don't feel that distributing some tasks to non-medics is wrong, it is the cheap way it is being done. The training is the minimum necessary and then how well are these 'advanced' practitioners recompensed? I cannot speak for other professions but I do know that within midwifery, if you 'enhance' your practice, you increase your responsibilities and workload, you are not rewarded monetarily. So you see its money saving, reduce the medics workload, don't employ as many, and don't pay the 'pseudo-medics' any more to take over their tasks.
I may regret this blog later. It comes from utter frustration at the terrible state this government is pushing the NHS into, and we are helpless.