NHS midwives deal with three births at once

Midwives are "overworked and overstretched", sometimes caring for three women in labour at the same time, according an expert.

Since 2001 there has been a 16 per cent rise in birthrates yet there are vacancies for midwives in every part of the country, according to the Royal College of Midwives. The Government has pledged 3,400 extra full-time jobs (4,000 including part-time workers), but research for the Darzi review into the NHS shows a shortage of 4,288 midwives. The shortfall is estimated after comparing it with the NHS "gold standard" for safer childbirth, which demands one midwife per 28 births. London has the worst shortages with 1,150 more midwives needed to meet a 20 per cent rise in the birthrate.

Louise Silverton, deputy general secretary at the RCM, said: "Women keep hearing about Government policy statements, such as one-to-one care from a midwife, but they are not getting that sort of treatment in many areas. "Our members are telling us that they are overworked and overstretched and are running between beds dealing with, in some cases, three women at once." The RCM added funding for maternity services has been cut by $110 million. Miss Silverton added: "The maternity services have long been described as a postcode lottery - but our regional NHS responses paint a shocking picture of just how loaded that lottery for maternity care is."

By next year ministers have promised women will be able to choose whether to have their child in hospital, at home or in a midwife-led birth centre. The Government has promised $660 million of extra funding for maternity services over three years.

But, according to Miss Silverton, research shows nine out of 10 maternity units do not know where their share of the œ330 million had gone, and it could have been diverted into other services. She said: "It is not enough for the Government to say it has put money into maternity services, but then fail to make sure the money actually goes where it is supposed to." The Department of Health said: "Our maternity services are the safest they have ever been. We are committed to improving outcomes for both mothers and babies."

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'Pointless' NHS complaints system to be made less rigid

The Department of Health has promised to overhaul the system for making complaints about NHS care after a survey found that more than two thirds of patients think that the process is pointless. The report by the Patients Association described the NHS complaints system as "cumbersome, variable and takes too long". Of nearly 500 patients polled, 69 per cent said that they had wanted to complain about the healthcare they had received in the past five years.

For those who complained, 29 per cent described the process as totally pointless, 20.5 per cent as pointless and 19 per cent as slightly pointless. Only 2 per cent said that the experience had been "very useful". More than four fifths (81 per cent) believed that there was not a culture of openness in the NHS when errors occurred and that staff were not encouraged to report mistakes.

The association's report concludes: "While patients will always accept that errors will occur in any health service, what they will not accept is the fact that staff are not open about admitting such errors occur."

On the matter of recent MRSA outbreaks and other healthcare-acquired infections, 47 per cent of patients blamed NHS trust managers. Nurses and cleaning staff were blamed by 16 per cent of respondents, and 10 per cent believed that doctors were responsible.

Three quarters of respondents felt that trust in doctors and nurses has decreased compared with five years ago. As a result, 96 per cent said they believed that patients questioned the actions of doctors and nurses more than they used to.

The Department of Health said it would be reforming the system so that patients' concerns were taken seriously. An official said: "We know that people find the current complaints system confusing. Some may also avoid complaining because they feel too intimidated or worry about damaging their relationship with their GP or social worker. This must change. "We are introducing a streamlined approach that will remove the need to follow a rigid set of procedures and replace them with a more open, flexible and personal service." If patients fail to resolve complaints at a local level they can forward their concerns to the Healthcare Commission, the NHS regulator.

The Patients Association called for NHS trust boards to be publicly accountable for an "open, transparent and timely resolution of complaints". It also wants an end to system where standard complaint responses vary depending on the region. Katherine Murphy, the group's communications director, said: "Every complaint matters. Ignoring complaints results in wasted resources, frustrated patients and cynicism about the system."

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