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Pregnant women ‘should get £3k personal budget to cover maternity costs’

Pregnant women should be given a personal budget of around £3,000 to spend on a midwife and other maternity services of their choice, a major review has concluded.

The report, commissioned by NHS England chiefs, said maternity services needed to be made ‘more personal’ and ‘family friendly’ and that women ‘should be able to choose the provider of their antenatal, intrapartum and postnatal care and be in control of exercising those choices through their own NHS Personal Maternity Care Budget’.

However, GP leaders warned the approach was not supported by evidence and with the current staff shortages in maternity services, the approach would only benefit small groups of women.  

It comes as NHS England is pushing for wider use of such personal budgets – upfront, lump sums of NHS money for patients to spend as they choose – despite concerns they only benefit 'pushier' patients and are being spent on luxury items including summer houses and holidays, which is destabilising traditional services and being used to introduce private insurance models of health care financing.

The report by the National Maternity Review board, led by Baroness Julia Cumberlege, said that despite improvements in birth outcomes over recent years, women wanted more personal care and that giving them a personal budget would allow them more choice over where they give birth and who looks after them throughout their pregnancy.

It called for NHS England to pilot the scheme in 2017, with a view to rolling it out nationally from April 2018.

GPs could be expected to 'encourage and support' women to access the scheme, including those without internet access, the review said.

Baroness Cumberlege said: 'To be among the best in the world, we need to put women, babies and their families at the centre of their care.

‘Women have told us they want to be given genuine choices and have the same person looking after them throughout their care.’

Simon Stevens, chief executive of NHS England, welcomed the report’s emphasis on a personalised approach.

He said: ‘The independent review finds that quality and safety of NHS maternity services has improved substantially over the past decade, and most new mums tell us they are looked after very well.  

‘But it rightly argues that the NHS could and should raise its game on personalised support for parents and their babies, better team working, better use of technology, and more joined-up maternity and mental health services.'

However, some leading doctors voiced concerns about the use of budgets for pregnant women.

Dr Dan Poulter, former health minister and MP for central Suffolk and North Ipswich, tweeted: ‘Very concerned by poor value for money, destabilising of maternity care and patient safety consequences if personal budgets are introduced.’

Dr Zoe Norris, a GP in Hull and founder of the support group GP Survival, said: ‘It is pointless to give women the impression they have a choice when often there is only one local provider of services, or where their medical needs or those of their baby means they must have care delivered by a certain professional.

‘GPs across the country are already struggling to access basic services for their pregnant patients. This does not address that and instead will lead to money being wasted on a scheme that will only benefit a small minority of women living in large centres such as London.’

She continued: ‘The NHS must deliver basic, high quality services for all women in pregnancy before it can begin aspiring to non-evidence based measures such as this.’ 

Readers' comments (11)

  • Conservative Party needed to be made ‘more personal’ and ‘family friendly’ and that the citizens ‘should be able to choose the provider of their ante-election, intra-election and post-election policies and be in control of exercising those choices through their own Local Authority Personal political Budget’

    I've only changed a few words here to reflext how it may sound it this was directed at politicians. See how unreasonable it sounds??

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  • Another example of government policy being London centric. In most of the country there is only one maternity care provider.

    But what happens if someone decides to go to a private midwife, who will do the maternity care for the first 15 weeks, at a cost of £3k. Then the woman runs out of money and goes back to NHS services because they will never turn her away just because she has frittered away the money.

    Or if someone who decided to go to a private provider develops a complication and couldn't afford the extra obstetric care required from her £3k budget?

    This is all such nonsense, I can't believe the amount of time and money wasted on introducing such a daft idea. The admin that goes with it is well on top of the direct costs.

    I predict that some providers will offer more frequent visits than current NHS guidelines, to attract patients. Then when the system fails they will all be complaining they had better care in their previous pregnancy!

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  • The most utter rubbish spouted out of a grown up woman ever.

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  • This is, as other commentators have noted , essentially meaningless.

    Imagine the conversations one would have to have, maybe at the booking appointment:

    "So, how much of your budget should we set aside for post partum complications? Shall we spend £1000 antenatal, £1000 on the birth, and keep £1000 aside? Or shall we take a chance and blow the lot?"

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  • John Glasspool

    or even, "Well, I want a macrobiotic crystal therapist to do the AN care and delivery; they do it for £1k. I want to spend the rest on Skunk".

    And the red carpet of patient-centredness is duly rolled out to another FATPOA entitled-demander.

    So stupid, it could only be supported by the DoH.

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  • In our area an alternative provider has sprung up and is delivering care in the hospital's facilities.

    Expect further fragmentation of care, with increased use of 'personal budgets' and a shift to co-payment, top ups etc.

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  • So no emergency section if money gone. Agree is meaningless.

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  • In my GP role on my CCG I was involved in trying to reform the Morecambe Bay NHS Trust Maternity service after the deaths of several babies and one mother.
    There may well be problems with the Cumberledge proposals, but the current Soviet "like it or lump it" (unless you are rich enough to afford private care)offer is no longer acceptable. How patronising to assume that patients are incapable of taking responsibility for their own health,and making informed choices.

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  • Why stop at maternity care? If every individual had a personal health budget out of which all care including A&E attendances and GP visits were paid then it would alter behaviour somewhat.

    It would be a form of super-fundholding.

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  • It just doesn't work!!!
    What happens when the money runs out but the care needs don't ( or escalate?)
    Just the thing when you are trying to do more with the same budget.
    Dumb dumb dumb

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