Women can give birth at home in Liverpool using the NHS.

There is no sane case for commissioning another private for profit Maternity provider. This idea of bringing in yet another for profit provider was raised, in passing, at a health and social care select committee meeting in Liverpool this week. It follows the One to One company closing and causing significant hardship to pregnant women and to the midwives working for them.

Other bad ideas were raised at the meeting about restricting prescribing, and this took the attention at the meeting. The meeting was listening mainly to a presentation about digital innovations. The idea of another maternity provider was only mentioned in passing but it meant the Liverpool and Wirral CCG are looking at this crazy idea. Wirral CCG wrote “procurement exercise is ongoing to seek a new provider for this service”.

The idea of finding another provider was also mentioned in Warrington paperwork about the collapse of one to one. In this the letter from One to One it says

If a member of CNST becomes insolvent its membership will be terminated and, under the scheme regulations, its liabilities are treated as those of the commissioner. This is a very important provision, of which some commissioners may be unaware. It serves to demonstrate the importance of establishing the financial standing of organisations to which contracts are awarded, and also of understanding if any sub-contractors are to be used and their financial/professional standing. If insolvency occurs after the loss of NHS contracts, NHS Resolution will ask the commissioner to assume liability for claims under its own membership of CNST.”

So the NHS takes over all the liabilities of the company. The for profit company does not carry the risks at all.

The letter from One to One letter also says

As the CCGs have already given notice on the contract I understand that you will have your own exit strategy and as such One to One will continue to work with the CCGs on this until 5pm 31st July. Please ensure that your exit strategy is communicated as quickly as possible so that we can collaborate on the necessary steps within the timeframe available to us.

The NHS in Merseyside provides all kinds of  maternity care.

Home births

Midwife led units

Standalone midwife units

Obstetrician led care at several hospitals

Recently a private company operating under an NHS logo and commissioned by the local CCG abruptly stopped trading, leaving hundreds of pregnant women, new mothers and midwives in the lurch. They operated in

NHS Wirral
NHS Liverpool
NHS Warrington
NHS West Cheshire
NHS South Cheshire
NHS Vale Royal
NHS South Sefton
NHS Southport and Formby

An advert for the collapsed company

Liverpool Women’s Hospital and other NHS providers had to go into emergency mode to support the mothers and to recruit more midwives. Another company would mean this work is wasted. Job security for midwives would be again disrupted

The first home birth from the collapsed company’s list was supported by Liverpool Women’s hospital within 24 hours of the closure of the service.

Liverpool Clinical Commissioning Group who make such decisions wrote

A re-procurement exercise had already been ongoing for a number of months before this announcement, which will ensure that a new provider is in place for this service from 1 April 2020. “

So the CCG seems to have known about the company’s situation some considerable time before the collapse. Should the pregnant women not have been told?

The support mechanism for all the abandoned mothers registered with One to One was a major operation across Merseyside and Cheshire. Mothers’ notes were not available and extra scans had to be arranged.

We cannot have maternity care, or other key treatments used like this.There is only one chance of safe birth. Mistakes at birth can see life changing damage for mother and babies.Maternity has more insurance claims than any other field of medicine.

Already the UK has relatively poor outcomes for maternity, especially for poor mums and black and ethnic minority mums. We cannot have experiments to suit privatisers. We need public service ethos and for all maternity to be within the NHS research and professional education envelope and safety precautions.

Private providers operating by commission from the NHS have a history of quitting, but it is especially dangerous to have maternity in this mix. Our mothers and babies matter, not the shareholders and speculators. Commercial sensitivities should not override pregnant women’s rights to know what is happening.

We support the idea of an enquiry into what happened with One to One. No commissioning should happen before this enquiry.

We call for much better funding for the NHS maternity care, and better working conditions for midwives, with bursaries brought back and fully funded paid reentry schemes.

Continuity of care is used in the NHS with small teams and is used locally especially for homebirths and midwife lead units. Continuity of care is in no way exclusive to private providers, it is used also in the NHS. Many women were not aware of this and the collapsed company used it as a selling point

Continuity of care means that the same small team of midwives sees the woman all through pregnancy delivery and post natal care. Its not viable for allservices either in staffing terms or in finance but it is used in home births where possible.The private provider also had to change midwives when holidays, sickness ot women going into birth at unexpected times, happenned

Join us in camapigning for better maternity care across Britian on October 5th in Liverpool at the Save NHS Maternity Services National Meeting

Is Bridgewater being lined up for this contract? They have relationship with Liverpool and Warrington. Commissioning is so hidden few know. The Midwives and mothers deserve stability, not cloak and dagger action behind a screen of commercial confidentiality

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