VARIATIONS IN MIDWIFE STAFF NUMBERS ACROSS THE COUNTRY – BROUGHAN

Deputy Broughan recently asked the Minister for Health to report on the staffing levels of midwives in HSE maternity units and hospitals; the number by which these staff numbers fall short or exceed the Birthrate Plus metric and for a statement on the matter.  In a reply to that Parliamentary Question received this week, Deputy Broughan was provided with information which says that the level of staffing had increased to 2,087 (in January 2019) up from 1,911.15 (2016) but that the variance in the recommended ratio is different across the 19 maternity hospitals across the country, with some hospitals exceeding the recommended ratio and others falling short.

The Birthrate Plus metric is a tool which says that there should be a ratio of 29.5 hospital births to 1 midwife or 35 births to 1 midwife in community settings. The PQ reply to Deputy Broughan stated: “The HSE Midwifery Workforce Planning Project Report modeled on Birthrate Plus methodologies was published in April 2016. This Report recommended a range of midwifery staffing ratios across the 19 maternity services taking into account the variability in working arrangements and clinical practices between the different sites and services.  On foot of the publication of the Report in 2016, it was identified by the HSE that an additional 196 midwives, in both clinical and non-clinical roles, were required across the maternity services. To address this acknowledged deficient an additional 100 WTE midwives were approved and funded in 2016, whilst a further 71.45 WTE were approved and funded in 2017. All of these additional posts would have been incorporated within the base staffing of each maternity service and as such would have been advertised, recruited and filled. Akin to the existing cohort of midwifery posts in place, these additional posts would have been subject to staff turnover and fluctuations in fill rate that is consistently managed in an on-going basis by all maternity services.

With the commencement of the National Women and Infants Health Programme in the HSE in 2017, a programme charged with driving the implementation of the National Maternity Strategy, a further 77 WTE midwifery posts were approved across the 19 maternity services in 2018. This last tranche of posts included specialist perinatal mental health midwifery posts, advanced midwifery practitioner posts and 52 WTE registered midwifery posts to enable the development and delivery of the midwifery supported care pathway in all 19 services.

The HSE’s national employment census as of 31st January 2019 recorded a total of 2,087 WTE midwives in employment in the HSE. This figure encompasses all grades of midwifery personnel, both clinical and nonclinical. This figure will not include those posts that are in the process of being actively recruited into and filled nor would it include other staff who may be directly involved in the provision of maternity care in the 19 services such as theatre nurses, general nurses and ultrasonographers from a radiography professional background as these will not be classified and returned under a midwifery heading.

This active employment figure compares to a national figure of 2,089 WTE midwifes as recommended in the 2016 Workforce Report. Whilst it is noted that there are variations across the 19 services when assessed against their individually recommended Birthrate ratios, as referenced previously all sites are actively recruiting with the midwifery employment numbers presented being dynamic, with employment levels fluctuating up and down in each of the maternity services during the course of any given year.”

Deputy Broughan says “It is welcome that action was taken after the HSE Midwifery Workforce Planning Project Report in 2016 which stated that an additional 196 midwives were required across maternity services. This is an example of a targeted recruitment drive which seems, in the most part, to have been successful funding provided for additional posts approved. The main concern now is that disparity between maternity hospitals is reduced and that each hospital has the recommended number of midwives per birth, as well as the hospitals having the proper facilities to care for newborns and mothers. Of course, this week, we heard from the ‘Our Maternity Hospital’ Campaign in a briefing hosted by Deputies Roisin Shortall and Brid Smith and learnt that the Vatican are still deciding about the proposals for the planned National Maternity Hospital.”