Examination of Witnesses (Questions 260-261)
TUESDAY 11 MARCH 2003
PROFESSOR DAVID
JAMES, MRS
SHONA ASHWORTH,
MRS ELAINE
PARKER, MRS
SIOBHAN HARGREAVES,
MS SHEENA
APPLEBY, MS
HELEN SHALLOW
AND MISS
ALISON FOWLIE
260. How do you break that cycle? That is one
of the problems, is it not?
(Ms Shallow) That is exactly the problem: how to break
the cycle. We want our midwives in primary care to do so much
more in order to ensure that women do not come into hospital unnecessarily
in the first place and do not fill up the labour ward when they
do not need to be there at that particular time. It is a cyclical
thing but until we can provide more midwives to reduce the enormous
case loads that some of them have they cannot entertain taking
on more duties because they can only just about manage with what
they are doing. It is a vicious circle.
Sandra Gidley
261. We have touched on midwife training but
we have not really mentioned obstetricans at all. There has been
an element of "send for the cavalry" when an obstetrician
is involved. How frequent is it that an obstetrician is actually
involved in a normal birth during training and is that part of
the training?
(Professor James) No. There are two questions there.
No is the answer to the second one. We are not involved in formal
training. At undergraduate level the medical schools have different
practices on how many normal deliveries you are supposed to attend
and so on, but for education purposes they have limited value
because they are usually on-the-fingers-of-one-hand experiences.
We do not attend normally. I am not answering the question you
have asked but one thing I wanted to mention in response to Mr
Austin's question was that, given the previous comments about
concern about the abilities of our junior doctors, what the Royal
College of Obstetricians is moving forward on is the idea of competency
training, in other words, not just saying you have passed this
exam but can you do this thing. The challenge is to try and work
out whether you can with the new appointees assess what their
real level of competency is and what they are able to do, and
I think that may be a much more helpful and practical way forward.
Andy Burnham: Could I at that point of roughly
half an hour over time thank you on behalf of the Committee for
what has been an extremely valuable session. The fact that we
have run over so much shows that we do value and appreciate the
information you have given us. Hopefully our report will pick
up possibly changing the issues you have been touching on.
John Austin: If anything comes out of your evaluation
perhaps you would let us know.
Andy Burnham: That would be very useful. Thanks.
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