Reading “Closure”

Reading “Closure”, Becky Reed and Nadine Edwards account of the sabotage of the Albany Midwifery Practice (AMP) by managers at Kings College Hospital enraged me, made me cry, and woke me up in the night. It is just as well that Tim Smart, former CEO at Kings doesn’t drink in my local or he’d find my pint dripping over his head. Tim had to resign his subsequent role as Chairman of Southern Health after only 4 months in post due to dodgy shenanigans. This mediocrity on legs oversaw the closure of AMP, a midwifery service of proven excellence. His picture is here in case you find yourself next to him on a train and feel like having words.

There are other people who I’d like to have words with. Two I’ve actually met, unaware of their role in the persecution of AMP – Geraldine Walters, Director of Nursing and Midwifery at Kings who ended up at the NMC, (wouldn’t you just know it?) where I met with her, and Roland Sinker who was CEO at my last NHS Trust, Cambridge University Hospitals. I wish I’d known then what I know now.
Walters is still on the NMC register and I’m sorely tempted to put in a referral for bringing the profession into disrepute.

Other people involved whom I have taken a severe disliking to are Mike Marsh, obstetrician (two on the GMC register), Leonie Penna, obstetrician (not on GMC register under that name), Linda Sherratt, midwife (not on NMC register), and Katie Yiannouzis, midwife (not on NMC register). You see how this has made me angry mad and a little crazy mad, now I’m checking on registrations.

If you haven’t read “Closure”, do. It will truly educate you about the state of the UK maternity services and the behaviours of those who run them. But the reason why this book has affected me so much is, I realise, that it is the story of all of us. All the midwives who qualified in the 70s, 80s and 90s, especially those who are likely to visit this blog. The small maternity units we worked in, the home-birth teams we set up, the birth centres and midwife-led units we worked in or set up, the continuity of care schemes we got off the ground, the independent practices we founded, the Sure Start projects we put heart and soul into – how many of them still exist? The AMP has closed and so too have countless women-centred, physiology-focussed, relationship-based ways of working and places of working which served women and communities and where midwives were happy working. What have we left? Birth factories and a few constantly-under-threat alternatives to those mega-units.

How many demonstrations, meetings, press releases, posters, media appearances, petitions, marches, occupations, fund-raising events, briefing papers, placards etc. have we collectively organised and/or attended over the last 40 years to save these services? And with what success? The herding of women into huge units, has continued unabated and contrary to all the research evidence. A meaningful relationship between a woman and a midwife is becoming almost as rare as hen’s teeth.

Midwives who did great work and who were the true leaders of midwifery have seen their work paid lip service to and then been shuffled off the stage – Caroline Flint, Lesley Page, Helen Shallow, Katherine Gutteridge – all set up continuity schemes or birth centres that were undermined. There are loads more of you who did your best to give women what they want and who saw their efforts meet similar fates.

Just 40 years ago, there were many maternity units with fewer than 2000 births a year. How many are left? Practically none. The South London Hospital for Women, Harpenden Hospital, Dulwich Hospital, Whitby Hospital, Malton Hospital, Bromley Hospital, Eastbourne Hospital, Grantham Hospital, Pontefract Hospital – these are just the ones I can think of off the top of my head as I write – all closed despite vigorous campaigns to save them.

Birth centres – Darley Dale, Penrith, Huddersfield, Calderdale, Salford, Wakefield, Melton Mowbray, Leicester, Bristol, Trowbridge, Newport, Halcyon (Birmingham), Jubilee (Beverley), Cheltenham – all these are closed and this is just from the first page of a google search and my tired brain. As for continuity of care schemes – are there any still thriving? Are there any home-birth teams not having to constantly fight for survival? Or independent midwives not under NMC investigation?

So that is why I feel that Closure is such an important book as it reminds us that this is not about research evidence, what women want, what communities want, and not even about money. This is about power and misogyny and we can no longer be under any illusion, thanks to Becky and Nadine, that these are not the driving forces behind the organisation of maternity care in the UK.

I have no answers but I do know we can’t collectively roll over and play dead, we have to come out of the corner for the next round. Better prepared.

Anyone know where Smart drinks?

Deborah Hughes