Scotland's Maternity Crisis: Why safe maternity staffing levels are desperately needed

Safe staffing equals safe care. It’s that simple - and it’s why our manifesto calls for a national midwifery workforce plan for Scotland.

Look at the maternity inspection reports coming out across Scotland and it’s the same story every time - staff doing everything they can, but stretched too thin, with no real room to learn or develop. Scottish midwives already have the least protected learning time of anywhere in the UK.

Read more here: Scotland's Maternity Crisis: Nearly 40,000 midwifery shifts left unfilled across Scotland

You can see the knock-on effect in how services get covered day to day. Boards are told to cut bank and agency spend, but they’re not given the support to recruit enough midwives to make up the difference.

There’s barely any agency cover left in Scotland, so bank shifts are what’s holding the rota together - extra hours often on top of a full-time job.

I had high hopes that maternity inspections and the Health and Care (Staffing) (Scotland) Act 2019 would trigger real change now these pressures were finally being seen. Instead boards reject staffing requests they themselves say they need, citing ‘service redesign’ - another word for cuts when there’s nothing left to trim. That’s why safe staffing has to sit at the centre of the Scottish government’s independent review, not get tacked on as a footnote.

Read more: Scotland’s maternity review must lead to action, not another report

We want a fully funded workforce plan covering every part of maternity services, from the first scan through to postnatal care. There has to be clarity on what different services actually need, whether that’s a community hub, a district general hospital, or a large central unit.

Subscribe today to the Scotsman’s daily newsletter

This review can’t be a reason to delay action that’s already overdue. Legislation exists that was supposed to guarantee safe staffing. It isn’t being honoured. Instead boards use the term ‘over establishment’ when workforce plans make clear the real problem is that the establishment itself is set too low.

Read more: Scotland's maternity services have hardly improved in the 50 years since I gave birth

We need a funded workforce plan now, not after a review. That means fully resourcing the Ministerial Nursing and Midwifery Taskforce too. It would go a long way toward fixing our skill mix and learning time problems. Our call for Directors of Midwifery, so midwifery is heard directly at board level, keeps being danced around, even as more layers get put between midwifery and the board, increasing risk.

Now the Programme for Government has announced a reduction from 14 health boards to two. Whatever the structure looks like going forward, a midwife needs a seat at every table where midwifery and maternity decisions are made.

Read more here: Scotland's Maternity Crisis: A week-long series exposing nationwide problems and giving voice to families

Midwives and maternity care assistants across Scotland are holding services together through sheer commitment. Women and babies deserve better than a system that relies on that commitment to paper over shortfalls in staffing and resource. High-quality care needs sustained investment and the biggest investment of all is the workforce. Value it by making sure the midwifery community can thrive, develop, and have time to care.

To any expectant parent reading this and feeling worried: midwives will do everything they can to make your experience positive and memorable, just as happens across Scotland every day. That commitment has never been in doubt. What needs to change is what stands behind it.

Jaki Lambert is the director of the Royal College of Midwives in Scotland