by Katherine Hales, National Coordinator of the Association of Radical Midwives
After a meeting of the campaign group in July 2018 we hoped to progress our campaign by investigating the regulation of other professions, especially those who are allied to healthcare and medicine. We are aware that the Health Care Professions Council (HCPC) regulates both paramedics and physiotherapists among 16 professions and that the number of midwifery registrants is similar to the number of both of these professions. As a consequence placing midwifery regulation under the HCPC may seem a feasible alternative to regulation alongside nurses who number 287,100 FTE, as against 21,900 FTE midwives (October 2017).
To further our aims, we arranged to meet with Marc Seale CEO of the HCPC to better understand their view of regulation and how regulation of the professions within their remit differs from the way in which the NMC regulates midwives and nurses. Three members of the campaign group met with Mr. Seale and Communications Officer Anna Hill on September 20th and it became apparent that there are some clear differences in regulation between professional groups like physiotherapists and that of nurses and midwives. This is due to the way in which educational and professional standards are set.
Professions within the HCPC have standards of education and practice set by their professional bodies. For example, the Chartered Society of Physiotherapy plays a major part in defining the parameters of the education and practice of their profession while those of nurses and midwives are set by the NMC, our regulator and not by our professional bodies – the Royal Colleges of Midwifery and Nursing. This can be interpreted as a considerable loss of agency in influencing our professional parameters and a loss of confidence in ourselves as a group with professional expertise in practice.
This deficiency is amply demonstrated in the almost unopposed loss of the Midwives’ Rules which compromises midwives’ ability to be advocates for women’s choice when this may not comply with the guidelines and policies of their NHS Employer. The loss of supervision has left midwifery without clear and effective leadership and it is deemed sufficient that we are led by the Chief Nurse Jane Cummings.
The distinctiveness of midwifery as a profession separate from nursing is not considered an important matter to the NMC.
Ultimately the stark reality of the imbalance in numbers of registrants in the midwifery and nursing professions means that midwifery may be marginal and even an aggravation to the structure of the NMC. This may only be exacerbated by the recent requirement for the NMC to regulate nursing assistants.
We are taking forward the campaign to raise awareness – with social media posts, leaflet and postcard campaigns and connecting with midwives and women.
To separate midwifery regulation from the NMC requires primary legislation and government time at present is at a premium – but with a groundswell of argument and opinion from the public and midwives we may succeed. We need a confident, well led and regulated profession to implement Better Births and increase midwives’ confidence and retention in the profession.
Katherine Hales, ARM National Coordinator.