The NHS replies to the Matlock Mercury only scratch the surface of the issues surrounding the decision by the Derbyshire County Primary Care Trust, and now apparently Chesterfield Royal Hospital, to close the Darley Birth Centre.
The Review on reconfiguration which is the PCT’s name for closure is a finance based document and yet there is only one short paragraph on the costs of births at Darley. Both the Review and the reply are lamentably lacking in factual details. The cost of birth at the centre varies with every telling. It does not take into account the additional costs after closure. The mid-wives at Darley will be needed at the hospital or for home birth, being the only two options left for mums-to-be. Their wages will still need to be paid.
During the last closure home births rose dramatically and with it the cost of two mid-wives at each birth and the cost of travel and time. Birth in a mid-wife led centre would appear to be more economical on both. Finance will still be needed for the ante-natal and post-natal clinics and a drop-in centre, wherever they are situated. Does the PCT expect mums-to-be to travel further distances for these very important visits whatever the weather?
The weather was used as a reason for cancelling the Open Day at the Birth Centre at the beginning of December. Does the PCT expect women to go to Chesterfield to give birth “whatever the weather”? The NHS reply states that it does not seem sensible or wise for mums-to-be to be travelling in less than ideal conditions. Birth cannot be cancelled like an Open Day. Incidentally it was cancelled before the bad weather.
The plan to host an alternative date in May is news to all concerned as was the news that at the time the PCT had already announced its intention to consult on closure. The public and stakeholders were not informed until a later date and one stakeholder, Matlock Hospitals League of Friends, has still not been favoured in receiving a copy of the Review.
All the NHS answers seem to return to the over-emphasised declaration about publicity for the Birth Centre by Chesterfield Royal Hospital. Certainly publicity was excellent in every way when the centre was re-opened by The Dowager Duchess of Devonshire. There were brightly coloured posters leaflets and flyers. The Chesterfield Royal Hospital spent a large amount of money upgrading and refurbishing the accommodation and the League of Friends were encouraged to fund the installation of the birthing pool.
The number of births rose in the immediate following months but have inexplicably slowly dropped since. Promotion seemed to drop and the next round of publicity only occurred after the PCT was considering closing the unit.
Yes, information on the centre can now be found within a website and YouTube video, but too late to influence the present number of births. This information is of no use to mums-to-be unless they meticulously search for a stand-alone birth centre, since they do not know where to look unless helped by their mid-wife.
The argument again returns to the knowledge of the mid-wife. The service run by Chesterfield Royal Hospital may well provide mums-to-be attending the hospital with a leaflet which includes Darley Birth Centre, but it does not seem to spread to the rest of the county and to the community mid-wives. Much correspondence has been received from women about not being given the option, from being discouraged from using the option and about mid-wives being completely unaware of the option. No wonder the births have dropped in number, giving the PCT a reason for closure.
It is so easy to close a unit and not look for savings elsewhere or to consider the cost of change, patient choice and the demise of a centre of excellence.
The replies do not take into account the quality of service at Darley and the high satisfaction of mothers who have given birth there. A post-natal stay for even a few hours longer allows women access to a level of instant and continued breast feeding and the emotional support that hospital units do not currently provide following birth. Mums need the extra support at the start if they are to continue the all important breast feeding. What will be the cost to the PCT due to the higher rates of Post-Natal Depression and the cases of gastroenteritis etc caused by the lowering of current breast feeding rates? An increase in the number of births at Chesterfield Royal Hospital could shorten the stay and provide less support following birth.
Chesterfield Royal may boast of its birthing pools and sound-proof rooms but these cannot be reproduced at a home birth where it is more important to diminish sound from the rest of the family. However, there is a birthing pool at Darley with the additional benefits of excellent service in a friendly helpful atmosphere. It is this that has produced so much correspondence supporting the “Don’t Ditch Darley” campaign.
Matlock Hospitals League of Friends