23 June 2014

Should pregnant women be given a £3,000 birth fund by the NHS?


Pregnant women should each get a £3,000 budget to buy their own NHS services, says a radical review.

A major study of maternity services will today recommend the budget which could allow them to appoint their own midwife.

Mums-to-be should be given a pot of around £3,000 which could be spent on NHS services to ensure they get the care they desire, the authors said.


Under the “radical” proposals, women would be told about all local providers of NHS care and the services they offer.

They would then be able to make decisions about how and where they receive care.

Read more: Pregnant women take up pole dancing

For instance, women may chose a provider who ensures continuity of care from the same midwife throughout pregnancy, birth and postnatal care, the authors said.

But there was no explanation as to what happens if pregnant women go over their budget. 

The authors of the National Maternity Review likened the scheme to controversial personal health budgets where people with long-term conditions are given a say over how NHS money is spent on them.

The Mirror highlighted last year how the personal health budgets scheme was open to abuse, with people using their budgets to buy holidays, computer consoles and even a summer house.

But today’s review authors said that only accredited providers would be eligible under this scheme.

Officials say the proposed move aims to give women more choice over how and where they have their babies - a key decision considering half of maternity services in England are deemed “inadequate” or “require improvement” in terms of their safety.

Cathy Warwick, chief executive of the Royal College of Midwives, welcomed the proposals.

She said: “The review contains some radical elements. Amongst these are the concept of providing far more care in community settings outside our acute hospitals, the introduction of NHS Personal Maternity Care Budgets, a Rapid Resolution and Redress Scheme for Birth Injuries and a discussion of how the maternity tariff may be constructed differently.”

“All of these have the potential in different ways to make a significant difference to the way maternity services in England are delivered.”

The review also raised alarm over some aspects of the safety of maternity services, even though there have been drastic improvements in the last decade.

At present, hospitals are not always putting their hands up and admitting when something has gone wrong, the authors said.

They said: “It is clear that under-reporting of safety incidents is widespread.

“Safety is inconsistent across maternity services, and there is scope for significant improvement in many.”

They added: “The quality of maternity services has been improving but not all are provided to a consistent, high level of quality.

“The safety of maternity services must be improved. The number of unsatisfactory safety assessments and frequency of audit findings of poor care indicate a clear need for improvement.”

Elizabeth Duff, Senior Policy Adviser at the National Childbirth Trust, who was a member of the review team and chaired one of the working groups, said removing maternity inequalities

This is a major challenge which must be tackled as mothers and babies who live in poverty have a far greater risk of slipping through the safety net. NHS England must now act on these recommendations to turn the rhetoric into reality. We recognise that the Review has taken place at a time of austerity but there is good evidence to show that the positive actions recommended can bring both clear benefits and cost savings in the longer term.”


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