Below is some background information followed by ideas for a submission to the consultation process - it is based on information from the various meetings, conversations and actions - many other bodies and organisations are putting in their own formal submissions but I would urge everyone to write even if it is only a couple of sentences - especially any personal examples of how Stroud Maternity helped you save the NHS money. The key contact addresses are enclosed below - the official consultation period has been extended until Monday 4th September 2006.Click here to see my recent letters to the press re health cuts.
Background information:
Stroud Maternity provides a countywide midwife led service that is widely known to be of a very high quality. The midwives at Stroud are skilled in helping women give birth within a low-tech environment, and in caring for women planning an active birth with little or no intervention. There are eight postnatal beds, two delivery rooms and a third room with a birthing pool, together with a 24 -hour helpline. There are Consultant clinics for specialist obstetric advice. The unit provides a number of fine services to complement ante-natal care including ante-natal education classes for mother and partner, Twins Club for before and after birth, monitoring of baby's heartbeat, if necessary and Ultrasound at Stroud General Hospital. It is also known for the caring quality of its postnatal care and it is possible to transfer back to Stroud after giving birth in another unit. Midwives and support staff are always on hand to help mothers establish their choice of feeding. Working with National Childbirth Trust breastfeeding councillors and breastfeeding peer support groups 75% of women go home from Stroud breastfeeding their babies.
Stroud Maternity has been threatened with closure before. In 1998 a review was undertaken and usage targets set for its viable continuation. These targets have been achieved, and Stroud Maternity is thriving. Despite a falling birthrate the percentage of women choosing Stroud Maternity has risen. In 1998 over thirty thousand people signed a petition in support of this valuable community facility. There was a county maternity review in progress but this has been paused because of the immediate financial crisis which has resulted in proposals which would centralise all obstetric services at Gloucestershire Royal Hospital.
County Health Chief Executives have now decided to propose the closure of Stroud Maternity solely for financial reasons. The Chief Executive of the Cotswold and Vale Primary Care Trust Mr Richard James praises the quality of care provided at Stroud Maternity and it is inconceivable that an acknowledged centre of excellence could be closed in a rush for financial savings. Overall news is not good re the hospital but one ray of hope is that more time maybe allowed which could lead to some services being saved.
Ideas for submission:
The PCT maintains they will save £400,000 by closing Stroud Maternity. I disagree. It has been reported that using the ‘Payment by Result’ formula which is recommended for Maternity Services by the Government, Stroud Maternity is viable and cost effective.
Closure of Stroud Maternity will mean:
* No birthing services in Stroud for the first time in 53 years, aside from homebirth
* Limited choice for places to have a baby – either homebirth or a consultant unit
* No extended postnatal stays for women giving birth in consultant units
* Potential redundancies for staff who work only in the Unit
* Projected drop in breastfeeding rates, and rise in levels of postnatal depression
* Problems of access for women and families without their own transport
Consultation process flawed
This consultation exercise has caused enormous anxiety and anger within the community. I have not found anyone from our community who supports these proposals. I understand that you have to make savings of about £40 million yet much, possible all of this debt is either historic or resulting from problems not of this areas making. In this consultation I have been unable to get an answer as to the reasons why this debt has been allowed to accumulate in this way nor why health authorities now have to suddenly balance the books despite these debts for many years.
The consultation does not give alternative options that the community can consider. One option and only one option that you are pushing through does not fit with my understanding of 'consultation'. The situation is made worse by the lack of available financial information in which we could even consider alternatives. Furthermore major re-organisation of our local health services is imminent and hasty decisions seem entirely inappropriate. I therefore do not consider that this consultation exercise is in line with the Government's guidelines.
Other key issues
- Proposals go against Government views that there should be more local centres and midwife lead units. The high quality local care is reflected in the many hundreds of personal stories and statistical evidence such as that 75 % of mothers leave the hospital breastfeeding their babies. Closing Stroud Maternity will lower breastfeeding rates and increase postnatal depression and increase readmissions to hospital due to lack of postnatal support. A larger service based in Gloucester is not able to deliver the same personal level of service.
- Evidence shows that giving birth in midwife-led, stand-alone units is safe and increases the chances of having a normal birth. Your assumption that 70% of pregnant women can be classified as moderate to high risk has been contested strongly from many sources: one expert view suggesting that 60% of women can expect a normal birth. However even if your figures are right they still show there is a very strong case for the current facilities to be retained in both Cheltenham and Stroud.
- If Stroud maternity closes, the costs to the NHS are likely to increase in the long term through unplanned homebirths, increased ambulance use to GRH, more epidurals and more ventouse and forceps deliveries and more caesarean sections.
- The closure of a neighbouring midwife-led unit in Malmesbury last year, has meant many women from the Cirencester area are also now using Stroud Maternity for birth: birthrate is rising – a record 365 births last year, including 49 homebirths. Around 44% of those were waterbirths, and around 30% of women had their own midwife as the main carer in labour. The publicity around saving the Hospital is likely to lead to further increased use.
- The proposals to cut eight midwife posts in Stroud make no sense when the number of women choosing a Home birth will increase and lead to more midwives being needed rather than less.
- The removal of health infrastructure undermines community development and regeneration efforts.
- There are huge implications of increased journeys for patients, carers and staff. Gloucester Royal is situated in a congested city where car parking is limited and expensive. The proposals will cause extra car journeys from people living outside Gloucester causing more greenhouse gas emissions. This will have an adverse impact on families and the environment. Stroud Maternity is particularly important to women who have no cars or have other difficulties in getting maternity care.
Recommendations based on the limited information available include:
- Administrating services on the three Hospital units could be amalgamated to saving money.
- Stroud Maternity Hospital must not close: viable midwife-led units should be maintained in both Stroud and Cheltenham, with obstetrics and neonatal care services in Gloucester on one site. This provides both saving of acute services ,and maintains equity of services for low risk women across the County.
Please send responses to:
The Consultation Coordinator
Cheltenham & Tewksbury Primary Care Trust
Unit 43, Central Way, Arle Road
Cheltenham, Glos. GL51 8LX
consultation@glos.nhs.uk
Richard James
Chief Executive
Costwold & Vale Primary Care Trust
Trust Headquarters, Cirencester Hospital
Tetbury Road, Cirencester, Glos. GL7 1UX
Paul Lilley
Chief Executive
Gloucestershire Hospitals NHS Trust, Trust Headquarters
1 College Lawn, Cheltenham Glos. GL53 7AG
Rt Hon. Patricia Hewitt, M.P.
Secretary of State for Health
Department of Health, Richmond House
79, Whitehall, London SW1A 2NS
email: hewittph@parliament.uk
Councillor Andrew Gravells
Chair Overview and Scrutiny Committee
Gloucestershire County Council,
Shire Hall, Westgate Street, Gloucester, GL1 2TG
andrew.gravells@gloucestershire.gov.uk
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