Leader comment: Forward plannng vital for the NHS

A new report from the Royal College of Midwives warns that Scotland's maternity services are coming under increasing pressure. Picture: Christopher Furlong/Getty Images
A new report from the Royal College of Midwives warns that Scotland's maternity services are coming under increasing pressure. Picture: Christopher Furlong/Getty Images
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It is incumbent on every public service to look to the future with prescience and put in place a plan that can anticipate changes in need and demand, but such a task is particularly vital to the NHS.

Visionary thinking is in short supply at the best of times, and given the underfunded health service’s current travails, there are some who might argue that concentrating on its present problems would be a wiser use of what are limited resources. Such a view, however, is short-sighted and in the long run, counterproductive.

One example of where forward-looking is desirable, if not essential, is Scotland’s maternity services. The Royal College of Midwives (RCM) has warned that the existing system is coming under increasing pressure from a variety of factors, such as high birth rates, an ageing workforce, and increasingly complex births. The latter of these has its own complexities. In its newly published annual report, the RCM attributes the spike in difficult births to the fact more mothers are either older or obese.

More than a fifth of pregnant women in Scotland are now obese, which can require additional care as well as resulting in more testing births; the number of births to women in their late thirties, meanwhile, has shot up by more than 2,000 since the turn of the millennium, with a increase of 1,000 in births to women aged 40 or older.

It requires only the subtlest shifts in lifestyle changes to bring about a seismic impact on a service such as the NHS, but when these gradual little shifts and tilts occur at the same time, the result can be overwhelming.

It poses a profound question which health practitioners and politicians alike must address – how do you prepare the health service accordingly for the years and decades ahead?

There is, of course, no straightforward answer, but if there is one general conclusion to be drawn from the RCM’s research, it is surely that the way in which we think about health provision must become more expansive.

The statistical evidence underlines the need for obesity to be tackled in order to lessen the burden on maternity services; in doing so, the entire NHS stands to benefit, and we will become a fitter, healthier society with a more productive workforce.

In the wake of the RCM report, it is likely that the debate will centre around the staffing pressures within the system. This is a crucial issue, given that midwives aged 50 or over now make up 41 per cent of the workforce, and it is imperative that it is tackled.

But at the same time, we must not lose sight of the bigger picture. Scotland as a nation is changing and so too is the profile of expectant mothers. We must support every woman who passes through Scotland’s maternity unit and ensure they – and their babies – receive the best care possible.

Bolstering staff numbers will go some way towards meeting that goal, but judicious planning will make life a lot easier for everyone.