-----Original Message-----
From: The normal birth research list
[mailto:[log in to unmask]] On Behalf Of Joan Cameron
Sent: 20 November 2006 14:56
To: [log in to unmask]
Subject: Re: Maternity document by 'Reform'
The 'Reform' website http://www.reform.co.uk/website/home.aspx shows
that it is a fairly right wing 'think tank' group. Although it is 'non
party', the Directors have been closely affiliated to the Conservative
Party in the past. The Advisory group includes MPs from all parties,
albeit from the right wing of the labour party and lib dems as well as
people from academic and business backgrounds. Jim Thornton is a member
of the Advisory Council.
The Reform group is looking for interns who have 'sympathy with our
principles'. Perhaps some enterprising individual should apply and then
we could find out more about their principles?
Joan Cameron
>>> "Macfarlane, Alison" <[log in to unmask]> 20/11/2006
14:18:39 >>>
I have had a quick look at the 'Reform' document and will look at it
more closely when I have printed it out. Where did it come from and what
is it's status? It is interesting that its publication date is 2005, but
it is being pushed around now. There is another document about setting
up loads of private cancer care centres around the country and charging
patients directly for using them which has been in the news.
Before looking at what the document says there are questions about who
is behind this 'independent' think tank and where it gets the money to
maintain offices in an expensive part of London. It seems aligned with
the anti-NICE campaign which is currently being waged by the
pharmaceutical industry, but I could find no mention of funders on its
web site, apart from invitations to become one.
I see that the report has drawn heavily on Miranda Mugford and my book
'Birth counts: statistics of pregnancy and childbirth' second edition
published in 2000 by TSO and sought more up to date data on some
subjects, although the fact that the authors haven't managed to copy my
surname correctly off the cover doesn't fill me with confidence about
their attention to detail.
They have followed our practice, developed by Miranda and used in both
editions, of relating wte staff to numbers of women and babies they have
to care for. They haven't looked at regional differences for midwifery
staffing. This is difficult because of ever-changing boundaries. I did
update the analyses as far as possible for the House of Commons Health
Committee report but haven't grappled with the 2002 boundaries. This
showed a drop in reported numbers of wte midwives per maternity
nationally when the occupational classification changed in 1995,
followed by a rise nationally up to 2001. Regionally, it showed that the
East, South East and London regions were below the national average for
England and the other regions were above and rose up to 2001.
As far as counting consultants and others in O & G, they acknowledge the
difficulties in knowing how much is O and how much G. The rise is part
of a much longer term trend. An even greater challenge is to assess the
ipmact of the reduction in junior doctors' hours and the restructuring
of training grades.
Their treatment of small maternity units suggests they don't understand
the data problems and haven't asked people who do.
A great deal is made of the Euronatal study, which many people think is
of poor quality, to put it politely. Despite this, when one of the
authors, Jim Thornton, was editor of BJOG, he not only acepted it but
made it the first article in the issue but also put out a highly
political press release.
In international comparisons of mortality, the authors use OECD data,
which do not take account of differences in the way data are collected,
notably differences in countries' cutoffs for including very preterm
births in their statistics. This has been and still is being addressed
in the EU peristat project.
The authors question ever larger maternity units, which seems
reasonable, as this is an evidence-free policy being driven by
extraneous factors. They present their alternative as a plurality of
less big maternity units run by private organisations. This leads us to
think that these might be ever so cosy and individual, but perhaps, like
independent treatment centres', these will be run by chains of
multinational companies and will strain scarce NHS resources.
Anyway apologies for this UK-biased email, although the Reform web site
shows it is international, well it operates in a selected set of
countries including France, Germany, Russia, the Ukraine, Colombia and a
few states of the US.
Alison Macfarlane
Alison Macfarlane
Department of Midwifery
City University
24 Chiswell Street
London EC1Y 4TY
Phone (0) (44) 207 040 5832
Fax (0) (44) 207 040 5866
Email [log in to unmask]
________________________________
From: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]] On Behalf Of Jane
Sandall
Sent: 18 November 2006 21:02
To: [log in to unmask]
Subject: Re: Consultation draft: Safer Childbirth: Minimum Standards for
Service Provision and Care in Labour
Dear Paul
I have recently come across a very interesting report which is
attached.
I amnot sure about the reccommendations, but the analysis of trends in
midwifery and obstetric staffing is very interesting. In a nutshell it
says that, since changing childbirth in 1993, midwifery WTEs have
reduced, obstetric WTEs have increased (this does not include training
WTEs) and scope of midwifery practice has increased. No wonder
midwives
are feeling under pressure.
I agree, that it really is very important that this consultation is
responded to.
----- Original Message -----
From: Paul Lewis <mailto:[log in to unmask]>
To: [log in to unmask]
Sent: Thursday, November 16, 2006 7:10 PM
Subject: Re: Consultation draft: Safer Childbirth: Minimum
Standards for Service Provision and Care in Labour
Dear Jane,
I have received a copy from the RCM and am in the process of
reading it through. I do have some real concerns that the previous
document was mainly about jobs for the boys and very little emphasis
was
put on the ratio of midwives to mothers. The need for one to one care
in
labour is paramount in my view and this should be argued for. What I
do
not wish to see is yet again a further increase in medical staff and
the
promulgation of the medical model which by default, and in spite of
the
rhetoric, appears to impact low risk women along with the rest.
Best Wishes and Hope to see you around soon - Paul
Professor Paul Lewis
Academic Head of Midwifery & Child Health
Tel No: 01202 (9) 67270
[log in to unmask]
-----Original Message-----
From: The normal birth research list
[mailto:[log in to unmask]] On Behalf Of Jane Sandall
Sent: 16 November 2006 09:09
To: [log in to unmask]
Subject: Consultation draft: Safer Childbirth: Minimum
Standards
for Service Provision and Care in Labour
Consultation draft: Safer Childbirth: Minimum Standards for
Service Provision and Care in Labour
The Royal College of Midwives has been working with the Royal
College of Obstetricians and Gynaecologists (RCOG), the Royal College
of Paediatrics and Child Health (RCPCH), the Royal College of
Anaesthetists (RCA) and other stakeholders on updating the joint
RCM/RCOG publication Towards Safer Childbirth (1999). The draft
document
is now out for consultation and is available on the RCM website at
http://www.rcm.org.uk/views/pages/viewsView.php?id=30
<http://www.rcm.org.uk/views/pages/viewsView.php?id=30n>
This is a vitally important document and your comments are
essential in shaping the final version. Please download and complete
the response form and return it to Mervi Jokinen, Practice and
Standards
Development Advisor, Royal College of Midwives, 15 Mansfield Street,
London W1G 9NH. email: [log in to unmask] tel: 020 7312 3535
Deadline for receiving your feedback: 10th December 2006.
Dr Jane Sandall
Professor of Midwifery and Women's Health
Health and Social Care Research Division
King's College, London.
Waterloo Bridge Wing,
150 Stamford Street,
London, SE1 9NH
Tel: 020 7848 3605
Fax: 020 7848 3764
e-mail:[log in to unmask]
http://www.kcl.ac.uk/schools/medicine/research/hscr/sandall.html
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