Perhaps it wasn't surprising that the focus of media attention following the launch of Better Births - the NHS Maternity Review for England was the issue of NHS Personalised Maternity Budgets. After all it is probably the most political and different idea in the report. However, in my view, it has resulted in a predictable distortion of what the Review actually says and in a limited understanding of its content.
I would urge women, maternity staff and all those interested to either read the full report or look out for a The Royal College of Midwives (RCM) briefing which will be up on the website in the coming week. Having done that please make up your own mind about a report which will I hope have a major influence on the quality of maternity services for women.
Once you do that I believe you will see that the report's focus is on improving the quality of local maternity services for all women making them more personalised and ensuring they can get to know a small team of midwives they know and trust. You will also see that the challenge of making the recommended changes is acknowledged in the report and that, very importantly, the need for sufficient midwives is noted as a prerequisite to implementing continuity of carer. I pressed this point throughout the discussions and it was accepted. The RCM will continue to campaign, in women's interests, for safe staffing and to end the shortage of 2600 midwives in England.
So the idea of Personalised Budgets is merely one small lever in trying to make the changes happen. It is an idea that still has to be fully thought through, tested and evaluated.
This does not of course mean that the idea exists without any framework at all. As you read the report you will see that women can only 'buy' services from accredited providers who have to meet specific standards around both governance and financial security. On top of that all accredited providers will have to participate in maternity networks to train with other providers and to agree uniform guidelines and standards. The 'hoops' to be jumped through are likely to be pretty tough - some may say 'too tough'.
I of course have not been party to discussions in NHS England or in Government but I as a member of the review team I can vouch for the fact that, at no point did our discussions touch on privatisation as a means of improving quality. In addition, although we always had to be mindful of the need for efficiency (it in itself being an element of quality), saving money was never the primary focus of our discussions.
I would also note that contrary to some of the reporting I have seen the RCM did not 'welcome' Personal Budgets. We welcomed a comprehensive women centred report.
The RCM's position on Personal Budgets is that we do not oppose piloting these budgets but we unequivocally believe in universal access to high quality services, will not give our support to them in the future if they worsen the inverse care law and will be monitoring their introduction carefully. We will also work to ensure that as we work with others to develop new models of service delivery midwives are always properly rewarded for their work.
So I would urge caution about extrapolating from headlines to reality. Consider the full report carefully. I hope that having done that you will be excited, although possibly challenged, by the prospect of actually doing something to ensure high quality care across the Board.
I think this report is a triumph for women but hey - that's only my opinion!