New Focus for Children and Maternity Services

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The way maternity and children's services are delivered is going to have to change, if we want to provide the best possible care for mothers, babies and children, argued Dr Sheila Shribman, the UK's National Childrens' Tsar, today.

Publishing two reports into the future of children and maternity services, 'Making it Better for Mother and Baby' and 'Making it better for children and young people', Dr Shribman said:

"Our top priority is to provide safe, high quality care for all women, children, and their families as a whole. We want to offer parents and families world class care and facilities based around their specific needs. To get to this point, the reality is we are going to need to organise ourselves differently, with easier access to midwives in the community and more choice of where to give birth.

"Delivering the best possible services for all women and their babies will mean that changes will have to take place. This is about changing and improving services, not closures or cuts but sometimes it will mean difficult decisions".

Health Secretary, Patricia Hewitt said:

"I welcome this report. Mothers and their partners need to be confident that they can choose how and where to have their babies, safe in the knowledge that everyone is working to deliver the safest birth possible in a high quality and responsive service.

"This report sets out how we can consider developing our maternity services to ensure this is possible everywhere."

The report details how all women should be offered the choice of a range of services, of a home birth, a midwife led birth or consultant led birth. Added to this, any women giving birth at thome should have the assurance that if something goes wrong, she can be transported to a consultant led unit safely and quickly.

In future, women and their partners will be able to go directly to a midwife, rather than having to approach their GP first. This should mean that women will enter the maternity care system earlier and be able to take advantage of all support and tests such as twelve week scanning and screening.

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The guiding principle for maternity services will be that "all women will need a midwife, but some need a doctor too". This will ensure that midwives will be more widely recognised as the the experts in normal pregnancy and birth and have the skills to refer women or their babies for more specialist care if necessary.

Dr Patricia Hamilton, President, Royal College of Paediatrics and Child Health (RCPCH):

"The RCPCH welcomes this report and the focus on the needs of children and young people. The National Service Framework for children was a great step forward but its standards are still not being implemented. The College hopes that today's statement and the expected report of the Healthcare Commission will be a wake-up call to those who resource paediatric services.

"We want children and young people to have quality services delivered to an agreed and sustainable standard, as close to home as possible and healthcare networks are key to achieving this."

RCOG Vice President, Professor Shaugn O'Brien said:

"These aspirations require a combination of reconfiguration and expansion in the number of consultant obstretricians, midwives and other specialists, to ensure a safe environment in the delivery ward.

"Patient choice must be balanced by the commitment to provide the highest quality of care throughout pregnance and in the post natal period and should be available to all mothers and their babies.

The reports detail how historically maternity and children's services have been planned around local geography, existing configurations and available NHS buildings. Subsequent changes were undertaken in a piecemeal fashion and the report argues that women, babies and children deserve better, planned more appropriate services.

Explaining how the proposed changes would improve children's services, Dr Shribman went on:

"We now place a greater emphasis on what young people, children and their parents want. Children who need to attend hospital must be treated in facilities designed for them, with attention to the needs of adolescents as well. The NHS has always changed and will go on changing as medicine and children's needs change. Reorganisation is about the service you get, not the buildings or beds you think you might lose."

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