“We are going to make our midwives’ lives a lot easier… we will increase the number of midwives by 3,000.”
David Cameron, January 21, 2010
The background
Writing in the Sun before last year’s election, the Prime Minister made a promise that has come back to haunt him.
Groups like the Royal College of Midwives had long been calling for a boost in numbers in the profession to help ease the pressure on Britain’s overworked maternity wards. They still say we need an extra 4,700 midwifes “to deliver safe, high-quality maternity care”.
Mr Cameron’s 3,000 fell some way short of that but was better than nothing.
Unfortunately though, since coming to power, the Prime Minister has refused to back up his promise.
He was pulled up on the pledge at Prime Minister’s Questions last month and said: “We do need more midwives, we do need more resources and we are making sure they are going in.”
Note the absence of the magic number of 3,000.
Scenting blood, Labour MPs grilled Health Minister Anne Milton about the midwife promise in the Commons. She told MPs that concentrating on staffing levels was “totally ridiculous” and said the Commons should focus on the “bigger picture”.
Is this another Tory policy pledge destined to end up stillborn?
The Analysis
There was something of a fanfare from the Department of Health this week as Andrew Lansley gave the Commons what appeared to be good news on maternity care.
He said: “As part of our plan to modernise the NHS, we are committed to giving mothers the support and care they need throughout their pregnancy, birth and after birth.
“So in addition to our plans to increase the number of health visitors by 4,200, we are sustaining the record number of midwives in training this year, and in the next year. This will help mothers get the care they want.
“Already since May 2010, the number of midwives has increased by 296. And last year there were a record 2,493 midwives in training. For 2011-12, there will be a total of 2,490 planned places available.”
Notice that the promise of 3,000 extra midwives has been quietly dropped.
Why? With training places at a record high, and a sudden surge in the numbers of new midwives employed in the NHS, surely ministers should be optimistic that Mr Cameron’s target can in fact be met.
Now, you might assume that Mr Lansley was talking about two different pools of NHS workers here: “In addition to our plans to increase the number of health visitors…we are sustaining the record number of midwives.”
You might reasonably think that trainee midwives go on to deliver babies and health visitors visit new mums and other people in their homes – two different, equally important jobs.
The problem, according to the Royal College of Midwives (RCM), is that there is potential for double counting here.
Something that is not widely known about health visitors is that they are also trained midwives or nurses first. They go on to become health visitors after further training.
So, as the RCM understands it, if the government wants to create 4,200 new health visitors, they will either have to encourage people working as midwives now to change job, or fast-track newly-trained midwives.
Either way, the numbers of people actually helping to deliver babies could actually fall, according to Sean O’Sullivan, the RCM’s head of policy.
He told FactCheck: “We are concerned that the drive to recruit more health visitors will potentially deplete the existing workforce of midwives if it’s not also accompanied by a target to recruit more midwives.”
The Verdict
Either Mr Lansley breaks his promise on health visitors or Mr Cameron breaks his on midwives, but it appears that they can’t have it both ways.
It looks like the Government’s made its decision.
FactCheck pressed the Department of Health on whether they would honour Mr Cameron’s pledge to boost midwives by 3,000 and they said: “The Government is committed to training the numbers of midwives we need to meet the demands arising from the birth rate, but we also have to make sure our plans are based on the most up-to-date evidence.”
We also asked how many people being trained as midwives will go on to become health visitors.
A spokesman replied: “There is no estimate and this information is not collected centrally.
We asked if the department had any power to ensure newly trained midwives won’t become health visitors instead of practising as midwives? The reply was: “No – it is rightly an individual’s choice as to what career path they choose.”
The spokeman added: “To become a health visitor an individual can come from any nursing background, not just a background in midwifery. The majority of applications for health visitors come from the nursing profession.
“Therefore, it would be completely inaccurate to link our commitment to increase the number of health visitors by 4,200 with sustaining a record number of midwives in training.
“It is important to note that midwives would have to undertake another year of studying before they could even choose to become a health visitor.”
