Battle over future of West Midlands maternity services rages on
Plans for a radical overhaul of maternity units across the West Midlands have led to rallies on the streets and calls for politics to be taken out of the health service. Health Correspondent Alison Dayani investigates why changes designed to protect the most at-risk babies have split opinion.
The West Midlands was tarnished with having the worst death rate for babies in the country just six years ago.
This horrific statistic prompted an overhaul of the maternity system, creating super centres for critical care while maintaining local units with less specialist care, which have gradually started to make an impact.
But more than half a decade on, more changes are afoot after new regulations aimed at saving more tiny lives were announced by the Government.
Hospital chiefs are looking at downgrading smaller maternity units at Solihull Hospital and Sandwell Hospital, in West Bromwich, to only cater for non-complicated births in order to meet these requirements that the most weak and premature newborns must have access to highly-trained resuscitation from specialist staff within 10 minutes.
That has led to a number of protests from people demanding their local hospitals do not lose important services.
But Dr Alison Bedford Russell, who heads maternity services across Birmingham, the Black Country, Worcestershire and Hereford as the clinical lead for the South West Midlands Newborn Network, explains that transferring more expectant mothers with complications further to centres of excellence it will ultimately save lives.
“We could drive forward standards if we didn’t have the politicians,” says Dr Bedford Russell. “They have got involved with the Solihull’s maternity issue now.
“This region had the highest death rate for babies in the country when hospitals worked separately, so six years ago, the network was created so babies could be sent to the most suitable hospital in the region with staff who constantly deal with difficult cases and have an expertise.
“At the moment, somewhere like Solihull Hospital has no on-site paediatrician and two or three times a week we have to send staff to go and collect a newborn who needs help at Heartlands neonatal unit and that takes them away from the unit.
“If more mothers with difficult births came to Heartlands instead, it would mean we can provide tip top care if things go pear-shaped. It’s not about money but about the quality of care.
“There used to be small neonatal units looking after very sick premature babies once every other month. Would you want to go to somewhere where staff are not used to dealing with it or somewhere where they deal with several critically ill babies every day?”
Birmingham Women’s Hospital, in Edgbaston, and Heartlands Hospital, in Bordesley Green, are the only two that can cope with the most critically ill newborns with level three intensive care cots highly trained specialist staff used to dealing with the most sick babies every day.
The majority of other hospitals have level one special care or level two high dependency.
Dr Bedford Russell said new regulations have surfaced along with a background of rising birth rates, a national shortage of neonatal nurses and a lack of intensive care cots and investment putting pressure on caring for critically ill newborns.
“There are still not enough qualified people to man every unit,” she added.
“New junior doctor working hours mean doctors are less experienced. We used to get foreign doctors but there was variable quality and it would range from brilliant to the dregs and that wasn’t good for the mothers or babies as we want a uniform service for all.
“Charity Bliss recommends a nurse to baby ratio of one to one but hospitals are lucky if they have half a nurse to a baby and that is at specialist units like Heartlands, but how do we suddenly get more specialist nurses, they don’t grow on trees.
“There is a mismatch at the moment over what specialities nurses will go into. We desperately need more midwives and more neonatal nurses to be trained. These nurses have to be able to give first class special care and we have to get the skills in the right place
“The intensive care occupancy level runs at 100 to 120 per cent, although it would be better around 70 per cent, but we move heaven and earth to make sure we can accommodate a baby that needs the most urgent care.
“Extra cots have been added and we now have a total of 36 - five intensive care cots, three high dependency cots and 28 special care cots - at Heartlands now.
“We want to make a difference and making these changes is a step in the right direction.”
Not everyone feels the changes are a move in the right direction, particularly in Solihull where protesters have gathered, including Maggie Throup, Tory prospective parliamentary candidate for Solihull, Meriden MP Caroline Spelman and the shadow health secretary Andrew Lansley.
Ms Throup wants to see paediatric services and enhanced maternity services introduced at Solihull rather than taken away.
“We will fight to the bitter end to ensure Solihull families have the maternity services locally they really deserve,” she said.
“It is vital for the NHS Trust to reconsider its plans and look to reintroduce paediatric services at Solihull Hospital. Any proposals to decrease services must be thrown out in favour of improving services at out hospital.”
