The Royal College of Obstetricians and Gynaecologists (RCOG) welcomes the Department of Health’s White Paper Equity and excellence: Liberating the NHS. It is pleased to see a sharper focus on a patient-centred care and the promise to remove bureaucracy and unnecessary targets.
There is mention of the concept of maternity networks in the Coalition Government’s reforms and it would be good to know how these would work (‘Putting patients and the public first’, p.3). The RCOG has always said that maternity networks will help improve care, modelled along the present system adopted by neonatal services. The new government must work closely with the RCOG and Royal College of Midwives (RCM) to ensure that standards are kept and women receive the services they want.
The RCOG is pleased to note that the plans include the promise to provide women with more choice, with the recognition that any choice offered needs to be informed and safe (‘Extending choice’, p.17). The RCOG emphasises that choice must be governed by clinical need, the outcome being a healthy mother and baby. Targeting women across the continuum, from the pre-conception to the post-birth stages, and especially those from socially-disadvantaged backgrounds, will ensure that quality care is provided to all. The approach must be comprehensive, and as we have mentioned before, based on a public health paradigm. This includes a range of present concerns which doctors have in women’s health, eg. rising levels of obesity, smoking and alcohol consumption during pregnancy, teenage pregnancies, delayed motherhood and postnatal depression to name a few.
It is welcome that the Government accepts that the commissioning of maternity services is not as straightforward if carried out by a consortia but needs instead to be centrally allocated ('The role of the NHS Commissioning Board’, p.32). The RCOG has mentioned in the past the difficulties with using a Payment by Results tariff in maternity services. It is therefore reassuring to see that the NHS Commissioning Board will have a central role in the commissioning of maternity services and education.
There may be future issues around consultant jobs approval and the transition for some trusts to Foundation status and the College will be pleased to advise the Department of Health on the best approach for the specialty.
RCOG President Professor Sir Sabaratnam Arulkumaran said “We are particularly pleased to see the emphasis placed by the government on consultant-delivered care and on outcomes. This is increasingly important as trusts comply with the European Working Time Directive (EWTD). The next step is to ensure that funds are available to employ senior staff in our labour wards but this isn’t easy in a time of financial austerity.
“These are early days yet and we look forward to more detail on the proposals for NHS reform to become available.”
13 July 2010
Notes
To view the White Paper Equity and excellence: Liberating the NHS, click here .