If the coalition is committed to families, why are maternity services being cut?

The strain of austerity is beginning to show on maternal care provision.

Recent news that the health of pregnant women and new mothers is being negatively impacted as a result of the coalition’s budget cuts strikes an odd note:  like them or loathe them, if there’s one thing you can rely on Conservatives for, it’s proclaiming their allegiance to the family. When the brutality of the cuts began to show in areas like refugee services or young people from non-privileged backgrounds no longer applying to university, there was at least the grim ring of consistency – have the Tories ever credibly claimed to care about such constituencies? Similarly, when feminist groups like the Fawcett Society demonstrated that women were facing a double-burden of the recession and government cuts in the workplace, one didn’t need to stretch one’s imagination too far to place this in the broader picture of a Conservative Party who seems to prefer women both at home and "in their place". “Families” though, were safe in the arms of the Conservatives’ paternal concern. Never mind that the whole gamut of austerity measures, from the game-changing overhaul of higher education to the cutting up of the NHS, daily and tangibly corrode the wellbeing and future prospects of parents, children, communities – families, in short, of one kind or another.  Still the amorphous ideal of the "traditional" family unit was one the governing party claims to hold close to its heart.

It’s striking, then, that the latest area in which the government’s cuts are being felt is in maternal care. Framing its concern largely in terms of children, the Daily Mail (that other "family" cheerleader) recently reported that breastfeeding rates have been directly hit by the cuts to healthcare services, citing research by health data analysts SSentif that post-natal women living in areas where cuts to maternity services have come into effect are more likely to stop breastfeeding in the first eight weeks, due to lack of available support from midwives and healthcare visitors. Given the wealth of scientific evidence on the life-long benefits, for children, of being breastfed, the logic follows that there may likely be a long-term negative impact on a future generation’s health.

The blog FalseEconomy has detailed further reasons for, and consequences of, the increased strain on maternal care provision, including demographic shifts towards later pregnancies as a reason for an increase in "complex pregnancies" taking more time for midwives, and the "knock on" effect of cuts in other areas such as violence against women provisions and services to the homeless. It cites the Royal College of Midwives’ State of Maternity Services report to lend credence to the claim that the government cuts have combined with demographic changes to stretch maternity services beyond their capacity. The Valuing Maternity campaign by Maternity Action is calling for greater commitment from the government to ensure this vital aspect of public health is addressed.

Aside from the inherent concern of the reduction in maternal care, and the worrying evidence suggesting its impact on a decline in breastfeeding, the example of the over-stretching of reduced maternal services is also a chilling reminder that no reduction of a public service happens in a vacuum. Women’s experiences of the recession are a prime example of the knock-on effect of one area of government policy to another, and how the recession and the cuts introduced under the guise of "austerity" have combined to corner women into a position of less work, less pay, fewer benefits and fewer rights. (Meanwhile urgent calls to address issues such as gender-inequities in public life and pre-recession concerns about the continuing pay gap are dismissed as a luxury "in these difficult times". As Susan Faludi outlined so eloquently in The Terror Dream’s analysis of the Bush-Blair years, that women’s concerns were dismissed along the lines of “not now dear, there’s a war on”, in the post-financial crisis era this is modified: not "now dear, it’s the austerity – but we’re all in this together"). 

Not only was this the first feminised recession in terms of the sectors hit hardest by job losses, but measures introduced under the guise of "austerity" doubly-targeted women, as women were both a larger proportion of public sector workers with jobs on the line, and some of the main users of state-provided services. (To add a further grim footnote: just as women needed financial independence the most, research from IPPR suggests that banks, too, turned on women, arbitrarily denying mortgages and other loans to female customers, using the new excuse of "new stricter regulations").

Eventually, as the new evidence on maternal health provision in the UK indicates, the knock-on effect manifests even in an area the Conservatives claim as their own: protecting the "family" and women as child-bearers. The painful cycle being played out in dominoes as one service after another is gutted by the cuts reveals the inherent flaw even in ideologically-driven cuts – while wealth may not trickle-down, corrosion of communities and services does trickle up, and into areas the Tories claim are their priority.

It also reveals what a sham it is to say you care about "families" when your policies show little if any concern for women.

Follow Heather McRobie on Twitter as @heathermcrobie.

 

A young boy is weighed after being born in an NHS maternity unit in Manchester. Photograph: Getty Images
Photo: Getty
Show Hide image

David Cameron's prisons speech could be the start of something good

If the Prime Minister puts his words into action, then this speech could mark the beginning of a big shift on prisons policy. 

David Cameron’s speech condemning prisons as violent and failing could herald a seismic change in policy. He is absolutely right to point to the waste of money, effort and lives that characterises today’s prison system. He is also right about the direction of travel that needs to be taken and some of his ideas are at the very least worthy of discussion. The most important reform was missing, as none of his aspirations can happen unless the sheer number of men, women and children in prison is cut, and cut radically. Sentencing reform is the lynchpin.

The detailed proposals will be scrutinised as they are rolled out over the coming months, but the urgent over-riding challenge is to cut the prison population. Last week the number of men in prison increased by 185, and in the last four weeks the prison population has gone up by 684 men and women. Prison overcrowding is not standing still, it is rapidly deteriorating.

Chris Grayling closed 18 prisons and wings, reallocating the population into the shrunk estate. He cut prison staff by more than a third in each prison. The result was overcrowded, understaffed, violent prisons full of drugs and very disaffected staff trying to control frustrated prisoners on restricted regimes.

I was expecting some thinking on who we send to prison and what we do with them when they are incarcerated to create the conditions for radical reform. I was disappointed as the proposals were oddly reminiscent of things that Labour tried and contributed to this mess in the first place.

Labour was very proud of building lots of new prisons, hoping that they would build their way out of an overcrowding crisis. What happened of course was that new prisons were filled even before they were completed so the old prisons couldn’t be closed. Today we hear that £1.3 billion will be spent on building ‘reform prisons’ that will pilot new ways of working. My worry is that they will become warehouses unless the sheer number of prisons is restricted and resources are allocated to allow for just the sort of flexibility being proposed.

Giving governors more autonomy sounds good, and I support it in principle, but they always used to have their own budgets with discretion to choose how to spend it, including commissioning education and other services. It is no good having increased autonomy if they are constantly firefighting an overcrowding crisis and not given the resources, including well trained prison staff, to implement new ideas.

We already have league tables for prisons. Every few months assessments of how prisons are performing are published, along with regular inspections and independent boards monitor conditions. Reoffending rates are published but this information is less robust as prisoners tend to move round the system so how can one establishment be accountable.

I was pleased to hear that work inside prisons is going to be a key reform. But, the Prime Minister referred to a small project in one prison. Projects with desultory training in the few hours that men get to spend out of their cells will not instil a work ethic or achieve work readiness. Prisoners get a pack of cereals and a teabag at night so they don’t have breakfast, are not showered or clean, are wearing sweaty and shabby clothes.

Every day men and women are released from prison to go to work in the community as part of their programme of reintegration. This is extremely successful with incredibly few failures. So what is the point of adding extra expense to the public by tagging these people, unless the purpose is just to feed the coffers of the private security companies.

There are imaginative ways of using technology but what was being suggested today looks as though it is just adding restrictions by tracking people. That would be neither creative nor effective.

David Cameron is looking to his legacy. I fear that I could be listening to a Prime Minister in five or ten years bewailing the dreadful prison conditions in institutions that are no different to today’s overcrowded dirty prisons, except that they were built more recently. He will have achieved a massive investment of capital into expanding the penal estate but, whilst there will be more prisons, even the new jails could be overcrowded, stinking and places of inactivity and violence.

I want the Prime Minister to look back on today’s speech with pride because it achieved humanity in a system that is currently failing. I would like to see a prison system in decades to come that is purposeful, with men and women busy all day, getting exercise for the mind, body and soul. I would like to see prisons that only hold people who really need to be there because they have committed serious and violent crimes but whose lives will be turned around, who achieve redemption in their own eyes and that of victims and the public.

My job is to hold him to account for this vision. If what he announced today achieves radical reform and changes lives for the better, I will cheer. I will be watching.

Frances Crook is the Chief Executive of the Howard League for Penal Reform.