IMUK’s Judicial Review of NMC Decision: A Guest Blog

On 18th and 19th October, members of IMUK (the membership organisation for independent midwives in the UK) will bring to court their judicial review of the Nursing and Midwifery Council’s decision that their indemnity cover is inadequate.

In January Birthrights wrote to the NMC to express concern about the decision stating that their actions “appear designed to cause maximum disruption and damage to independent midwives and the women they care for,” adding that, “we do not believe that these are the actions of a responsible regulator.”

Ahead of their court date, IMUK Chair Jacqui Tomkins has shared her thoughts and hopes in this guest blog. 

I became an independent midwife almost 20 years ago. It has been an overwhelming joy to be able to determine my own volume of work and to work with women and families that I can take the time to listen to and get to know very well. This has also been hugely beneficial for my family who know that I will be at most of the big family events we want to share but if I do have to miss the occasional celebration they are to be found helping me pack the car inan excited state as I get ready to help another family welcome in their newest family member. 

I work with a collective of like-minded midwives who provide me with a wealth of knowledge and skills that are fast becoming lost to us as a profession and ultimately to women. We have a supportive network that holds us and lifts us when it’s needed and allows us all to thrive in a supportive and emotionally intelligent environment. It’s not all unicorns and rainbows but it is a safe space to work within and its the way forward for a lot of midwives who need to feel they can provide the care they have been trained to give with the time needed in order to give it. 

This way of working is so important to me, my colleagues and the women we work with as we all value the relationship that is at the centre of this very important life event. The women I have helped look after in the past and the present are shocked to understand that this right to choose for them, but also for midwives, is at risk of being lost forever. So many women have been telling me that they feel they have nowhere left to turn as for various reasons they feel they cannot use the local maternity providers. As Chair of IMUK I have also been hearing about how some of those women have made the difficult decision to birth alone during this enforced period of redundancy for self employed midwives. This is the most terrible consequence of the decision made around insurance supposedly and in the name of public protection as these woman had not set out to do this. 

As an organisation we are ready to move forward and resume our plans to help with the training of student midwives and help the government to deliver the vision of “Better Births” by supporting pilot NHS groups and continuing to work closely with NHS England. 

Overwhelming throughout the struggle for independent midwifery to survive, my concern has been both for the midwifery profession generally but also the thousands of women per year who seek out our care. This woman centred model gives women a skilled and safe option for their care, with a guaranteed assertion that they will know who is coming to support them on the day and that they trust that person implicitly to be able to turn up and of course will respect and protect their carefully thought out choices. 

The importance of clinical autonomy is fast being eroded within employed models and self employed midwives understand that this is the thing we must protect and enshrine within our profession at all costs. That is not to say we do not work collaboratively with other health professionals, we are very skilled at communicating our clients needs and best interests so will be making appropriate referrals and accompanying women when they need to make alternative care plans for their pregnancies and births. 

 

Midwives are fast becoming a scarce commodity so it makes no sense to remove the right to be self employed from the profession. We need help and support to be able to continue to practice and for there to be an understanding that these issues highlighted in court this week are not about safety but about finances. Finances that have been confirmed by two independent actuarial firms to be perfectly adequate for our scope of practice.

Four years ago when this board of IMUK decided not to accept the future in front of us, we had only midwifery experience between us.  Since then, the team and our members have been joined by supporters and experts from all walks of life, almost all of them having previously benefitted from independent midwifery in some way.  We have become very knowledgable about insurance, both its benefits and its restrictions, we have experienced the political arena, press and legal worlds all of which have given us surprising new life skills but most of all I’m proud of how far we’ve come as a small group of health professionals with a big problem and my hope is that next week we will find out that it has been enough.