Midwives are in the news today on both sides of the Irish Sea. In Ireland, it has emerged that midwifery staff at the Midland Regional Hospital in Portlaoise had written to two Irish government ministers in 2006 expressing concern over staffing levels at the hospital. In the 2006 letter to then minister for finance Brian Cowen and then minister for health Mary Harney, the hospital’s midwifery staff said they had “a real fear” that a mother or baby will die in their care before these issues are addressed. In the letter, seen by RTÉ’s Investigation Unit, they also said they had made their concerns known to management on a number of occasions but that nothing had happened.

The letter was written prior to all of the deaths of four babies examined in last night’s documentary ‘Fatal Failures’. The babies died in similar circumstances over a six-year period at the hospital. They were all alive at the onset of labour, but died either during labour or within seven days of birth. The Irish Health Service Executive has apologised unequivocally to the families.

In an unrelated development, RTÉ News also reported on the last baby being born at Mount Carmel Hospital in South Dublin on the day that 200 staff members have been made redundant. Another 128 staff will lose their jobs over the coming weeks. Staff attended a mass this evening to mark the closure of the hospital. Afterwards around 20 staff said they were planning a sit-in at the premises. The provisional liquidators confirmed that 572 maternity patients have been affected since the hospital went into liquidation last Friday. Four babies were born today and the final arrival was a girl.

In Westminster, the House of Commons Public Accounts Committee, like its Oireachtas counterpart, is playing an important role on the issue of health services, especially maternity. Channel 4 News reports that in a damning investigation into the state of maternity care, the Public Accounts Committee criticised both the British Department of Health and NHS England for being unable to tell it who is accountable for “ensuring something as fundamental” as whether the NHS has enough midwives. It said it had gathered evidence that “many maternity services are running at a loss, or at best breaking even, and that the available funding may be insufficient for trusts to employ enough midwives and consultants to provide high quality, safe care”.

The report added that “although there has been a welcome increase in midwives, there is still a national shortage in Britain of some 2,300 midwives required to meet current birth rates. Pressure on staff leads to low morale and nearly one-third of midwives with less than 10 years’ work experience are intending to leave the profession within a year. Over half of obstetric units do not employ enough consultants to ensure appropriate cover at all times.

The committee reported that rates of infection among new mothers, infection to the baby and injury to the baby “are all higher at the weekend”. It added: “Although there have been substantial improvements in levels of consultant presence on labour wards in recent years, over half of obstetric units were still not meeting the levels recommended by the Royal College of Obstetricians and Gynaecologists at September 2012.”

Labour MP, Margaret Hodge, who chairs the committee, said: “The vast majority of women who use NHS services to have their babies have good experiences, but outcomes and performance could still be much better. Despite an overall increase in the number of midwives there is still a shortage of 2,300 that are required to meet current birth rates – a truly worrying figure. What’s more, the Department of Health and NHS England struggled to tell my committee who is accountable for ensuring something as fundamental as whether the NHS has enough midwives. As things stand, there is evidence that many maternity services are running at a loss, or at best breaking even, and that the available funding may be insufficient for trusts to employ enough midwives and consultants to provide high quality, safe care.”

Royal College of Midwives

Royal College of Midwives logo

Cathy Warwick, chief executive of the Royal College of Midwives (RCM), said: “Maternity services are many thousands of midwives short of the number needed to deliver safe, high quality care. The birthrate remains exceptionally high and as this and the National Audit Office report states, births are also becoming increasingly complex. This puts even more demands on midwives and maternity services. We are seeing areas such as antenatal and postnatal care in particular suffering because trusts often do not have enough midwives to provide consistent and high quality care before and after pregnancy.”

RCM Chief Executive Cathy Warwick  Photo: © Jess Hurd/RCM

RCM Chief Executive Cathy Warwick Photo: © Jess Hurd/RCM

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She added: “At the moment there seems to be a gap between the actual cost of maternity care and the amount of money hospitals get to provide it. This cannot continue and maternity services need to see the money they receive meet the cost of care. If this does not happen I fear services will be cut, choice will be reduced and care will suffer.” Details of the RCM’s report on the state of maternity services in the UK (2013) can be found here and the full report is available here. It was launched in London on December 11th.


bbcPlenty of questions remain about the extent of payouts made to senior executives at the BBC during the tenure of Mark Thompson as Director General. One Conservative MP Chris Heaton-Harris quoted in The Guardian said today’s hearing by the Public Accounts Committee at Westminster was “the most bizarre game of whack-a-mole I’ve ever seen in my life, where you hit something down and it throws up another load of questions”.

At the end of a three hour hearing by the committee, former DG Thompson and the Chair of the BBC Trust Lord Patten disagreed over who knew what about the executive payoffs. In July a report by the National Audit Office found that in nearly a quarter (14) of 60 cases it reviewed, the BBC had paid departing senior managers more salary in lieu of notice than they were contractually entitled to. A total of 150 senior managers had received severance payments totalling £25m. A supplementary report published a week ago confirmed that 22 former executives received £1.4m more than what the Corporation was contracted to offer in the severance payoffs agreed in the three years to December 2012 (NAO). The NAO said weak governance arrangements had led to payments that exceeded contractual requirements and put public trust at risk. The BBC Trust accepted at the time there had been a “fundamental failure of central oversight and control” at the Corporation.

nujlogo_burgundySpeaking before the PAC meeting the General Secretary of the National Union of Journalists Michelle Stanistreet said “this sorry tale is one of a management that became out of touch with its staff and with the ethos of public service broadcasting. The BBC should have put the interests of licence-fee payers first, rather than fill the pockets of its own”. In total more than £25m was given out in redundancy payments to executives.

The written evidence presented in advance to the PAC by former DG Mark Thompson, Lucy Adams BBC HR Director, Andrew Scadding BBC Head of Corporate Affairs, Marcus Agius, non-executive director, BBC Executive Board and former Chairman of the BBC Executive Board Remuneration Committee, as well as by the BBC Trust can be found here.

Margaret Hodge MP Photo: BBC News

Margaret Hodge MP Photo: BBC News

The PAC Chair Margaret Hodge MP described the appearance by the BBC executives as “grossly unedifying” and said it could only “damage the standing and reputation” of the BBC. “At the best I think what we have seen is incompetence, a lack of central control, a failure to communicate. At its worse we may have seen people covering their backs by being less than open”, she said.

Former BBC Chair Lord Grade told Newsnight the Corporation had “a lost sense of the value of money”.



BBClogoLooking at the story about the BBC Trust chairman Lord Patten calling the size of severance payments made to senior BBC managers a matter of “shock and dismay”, I wondered why it had taken so long for the ‘gatekeepers’ of the Corporation’s standards to realise what was going on. Seven years ago a senior NUJ official in the broadcasting sector warned about how BBC executives were “bathing themselves in a Jacuzzi of cash, while staff are experiencing a drought”, at a time of staff cutbacks and reductions in their pension benefits.

Speaking in 2006, Paul McLaughlin added that even though the Corporation had capped bonuses at 10% of basic pay – down from 30% two years ago – salary increases meant that senior executives have still seen their total remuneration packages grow significantly. Mr McLaughlin said that as a result senior BBC managers were guaranteed a fixed annual increase in their overall pay and bonus package of 15%. Under the previous bonus scheme, he said, they could get a bigger rise, in theory, but this was more dependent on hitting performance-related targets.  nujlogo_burgundy

Over the last three years, (2003-2006) basic BBC executive pay has gone up by more than 30%. That’s at a time when the BBC is claiming there is no money and the annual pay deal they have offered this year is below inflation“, the NUJ representative said.

Today the BBC reports the evidence given by Lord Patten to the Public Accounts Committee at Westminster. Interesting to note the comments by Lucy Adams, Director of Human Resources: when asked about why there had been overpayments (severance payments to executives that went beyond contractual terms), she said “the overwhelming focus was to get numbers out of the door as quickly as possible”. I’m waiting to see the report coming up now on Newsnight.

Chair of the Public Accounts Committee Margaret Hodge MP who had earlier been grilling Lord Patten and the new DG Lord Hall, told Jeremy Paxman the equivalent of half the cost of running Radio 4 (£25m) had been spent by the Corporation on exiting 150 senior executives. Now the blame game is starting.

But one former executive did the right thing: former director of archive content Roly Keating gave back a payment of £376,000 on the basis that it was not authorised “fully and appropriately”.