[Tuesday 23 February]
The latest proposals to give pregnant women a £3,000 ‘personal budget’ – recommended by the Maternity Services Review – on the pretext of offering more choice are a formula for chaos.
Keep Our NHS Public is adamant that this proposal – as with other ‘health voucher schemes’ in the past – is nothing more than a pretext for large-scale privatisation which would fragment and reduce core services even further.
Worse than that, the need for a multitude of providers to out-bid each other so they can offer the services in the first place then spend further sums on lavish marketing to entice women to them can only waste what are already over-stretched budgets.
This will yield not the promised improvement in maternity standards – sorely needed in places, all admit – but a polarisation of them, as midwives are tempted away from what remains of the core NHS service to handle less complex cases, leaving urgent or complex births to the NHS.
Dr John Lister, Secretary for Keep Our NHS Pubic, said:
‘The so-called “independent” review of maternity services chaired by Tory peer Baroness Cumberlege has predictably shown itself to be nothing more than a pretext for privatisation.
‘Its proposals would fragment an already over-stretched midwifery workforce, take vital funding away from mainstream maternity services, and potentially force more NHS maternity services to close or centralise, bringing more anguish to women who would have to travel further to give birth.
‘The proposal to fragment maternity services by giving pregnant women a £3,000 “personal budget” to spend as they wish is indeed a formula for chaos and destabilising core maternity services. The obvious danger is that as women are given funding to spend as they wish on “one-to-one midwifery”, more and more midwives will be encouraged opt out of high-pressure work on busy maternity wards, and opt instead to offer services privately.
‘It is bizarre to see the Royal College of Midwives, which only 4 months ago was complaining that overstretched and under-staffed maternity units across the country were closing their doors for lack of staff, has for some reason welcomed these latest proposals, which in the current climate of frozen and inadequate NHS funding can only make matters worse.
‘The proposal has all the disadvantages of other “personal budget” and “NHS voucher” schemes – in that it opens the way to individual “top-up” payments, widespread full-scale charging for health care, and private health insurance.
‘Like personal budgets it would take money from core budgets for services, without evidence or systems to ensure it will be spent appropriately – and leaving an under-resourced service to deal with all the more demanding cases – and those that develop later complications.
‘This policy is as illogical and unrealistic as the government claims that an NHS that is already billions in deficit, and facing cuts to balance the books, can implement 7-day working with no extra staff or funding.
‘In this case the main beneficiary is likely to be a newly created private sector midwifery service, run by NHS-trained midwives.’
Keep Our NHS Public’s Campaigns Officer, Alan Taman, added:
“What concerns me is the need “competing” services will now have to address in enticing women to use them: marketing costs money. Lots of it, on this scale. Where does that come out of? Also the need to out-bid one another to secure the service in the first place.
‘What a splendid mis-appropriation of public funds that could have gone into making maternity services safer, instead of more “appealing”.‘
Keep Our NHS Public was formed in 2005 and has a broad-based, public membership. There are 46 local groups, plus a national association. It has the explicit aim of countering marketisation [1,2] and privatisation of the NHS by campaigning for a publicly funded, publicly provided and publicly accountable NHS, available to all on the basis of clinical need. It is opposed to cuts in service which run counter to these principles. Further details: www.keepournhspublic.com
KONP’s Campaigns and Press Officer is Alan Taman:
07870 757 309
 Davis, J., Lister, J. and Wrigely, D. (2015) NHS For Sale. London: Merlin Press.
Leys, C. and Player, S. (2011) The Plot Against the NHS. Pontypool: Merlin
Lister, J. (2008) The NHS After 60: For Patients or Profits? London: Middlesex University Press
Owen, D. (2014) The Health of the Nation: The NHS in Peril. York: Methuen, Chapter 4.
Player, S. (2013) ‘Ready for market’. In NHS SOS ed by Davis, J. and Tallis, R. London: Oneworld, pp.38-61.
 The belief that ‘competition is always best’ does not work when applied to healthcare. A comprehensive and universal health service is best funded by public donation, which has been shown to be far more efficient overall than private-insurance healthcare models
[Davis, J., Lister, J. and Wrigley, D. (2015) NHS For Sale. London: Merlin Press. Chapters 2 and 8.
Lister, J. (2013) Health Policy Reform: global health versus private profit. Libri: Faringdon.
Pollock, A. and Price, D. (2013) In NHS SOS, ed by Davis, J. and Tallis, R. Oneworld: London, 174.]