Many costs NHS trust has not accounted for
IT was interesting to read Bob Waterton’s letter in the Mercury on Saturday, March 13 (“Costings for healthcare proposals don’t add up”).
I too have been concerned about the inadequate response of UHL NHS Trust to my questions related to their claims about the cost of the St Mary’s Birthing Centre in Melton.
It took them about two months to produce bland and generalised statements with no explanation as to what elements they were taking into consideration when calculating costs per birth at the centre.
Recent research has shown that costs per birth in stand-alone midwife-led units such as St Mary’s are actually lower than in other types of units.
According to the Trust, however, the cost per birth at St Mary’s is 33 per cent higher than in the alongside units at the General and Leicester Royal Infirmary.
It is impossible to know but I suspect that their calculations are ignoring the fact that St Mary’s also provides a much-appreciated postnatal facility for up to eight new mothers, the costs of which should be excluded from the comparisons.
Sadly, information about the future of post-natal care has been seriously lacking throughout the consultation period.
The consultation document itself did not make clear that the proposed transfer of the St Mary’s Centre to the General hospital site on a trial basis does not include the post-natal facility and very vague statements have been made about what postnatal care will be provided, if any.
In addition, it was stated in one meeting that the proposed unit at the General would cost nothing to establish. If, as it seems, it will be located in the current alongside unit, there could be a problem in the future if the new unit is found to be very successful.
The current alongside unit is, I believe, located on land which they are proposing to sell off so, at some time in the future, a considerable amount of money will have to be found to equip a new building as a standalone midwife-led centre, if the unit is to continue.
It appears that such a development has not been included in the costings.
The length of the proposed trial for this unit and the criteria for success also appear to be in question.
UHL NHS Trust have promised to set up a review body involving mothers, midwives and other stakeholders.
I can’t imagine that many expectant mothers or new mothers will have the time or inclination to be involved in such a review body and I wonder who the other stakeholders might be.
It seems to me that, if the Trust are sincere about getting the views of women affected by the changes, they need to commission someone to conduct independent research into the views and experiences of those women and that would involve a further cost which they have not allowed for.
In conclusion, it appears to me that there are many costs that the Trust have failed to take into account or, perhaps, that they have not been completely open about what their real plans are.
Elizabeth Warren, Evington