BBC News | HEALTH | Pregnancy service 'under threat'

The NHS needs an extra 1,300 consultant obstetricians and gynaecologists in order to provide adequate labour ward services, experts warn.

The Royal College of Obstetricians and Gynaecologists (RCOG) says the staffing shortage has been exacerbated by a government initiative to improve patient care.

Junior doctors are on wards to train, they should not be left to make difficult decisions they are not qualified to make

Peter Bowen-Simpkins, Royal College of Obstetricians and Gynaecologists
It says 200 extra consultants are required to meet guidelines that NHS Trusts must ensure labour wards have a minimum of 40 hours of consultant cover by April 2001.

Another 1,100 are needed to provide a full consultant-based service.

The RCOG has issued a report on the future structure of obstetrics and gynaecology entitled 'A Blueprint For The Future'.

Other recommendations include:

an increase in the time consultants spend with patients during outpatient appointments
the establishment of emergency gynaecological admission units, early pregnancy assessment units and day-assessment units for obstetric complications
increased use of multi-disciplinary service delivery - including extending the roles of midwives and nurses to take over some duties held by Senior House Doctors

Overhaul

Mr Peter Bowen-Simpkins, a spokesman for the college, said: "It is vital that women receive the highest standards of care.

"But that is not always possible if consultants have commitments elsewhere such as running antenatal clinics or undertaking gynaecological surgery at the same time as on-call for the labour ward.

"We need to overhaul the way obstetric and gynaecology services are delivered.

"Junior doctors are on wards to train, they should not be left to make difficult decisions they are not qualified to make. That is the job of the consultants."

But Mr Bowen-Simpkins stressed it will take 10-15 years to reach the total target of 2,500 consultants.

He said: "Specialist training is required, it can't happen overnight. It's important that investment in the field is maintained.

"Maternity services must not be left behind in the reform of the NHS.

These recommendations are not just needed to improve patient care, but to maintain current standards.

"They will also reduce the potential for litigation against NHS Trusts should complications arise during childbirth."


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