£3000 personal budget for pregnant women :: NHS shake up it is not.

£3000 personal budget for pregnant women :: NHS shake up it is not. via Toby & Roo :: daily inspiration for stylish parents and their kids.

Last week the news story broke about government plans to shake up the maternity services off the back of an enquiry conducted into the deaths of several infants and a mother. The review has concluded with plans to give women a £3000 budget to help support their choice to have a birth outside of the hospital environment. The money won’t be a cash hand out, just to clarify, it will be a budget that will be utilised by the individual but controlled by the NHS, and can go towards hypnotherapy, one to one midwifery care and other similar services.

I was lucky enough to be asked to have a chat with BBC Radio York on the topic and my stand point on this is pretty clear.

I think it’s a terrible idea and a nudge towards the privatisation of the NHS, of course done in the same stealthy way politicians have been doing it for the last 15-20 years.

The problems I have with this are plentiful but my initial reaction was that, off the back of such an emotive review into what is essentially every parent’s worst nightmare, this reads very much like we are saying to women you’re safer outside of a hospital. In my experience, had I been at home with Reuben neither myself nor him, would be here today. I required additional medical treatment both during and for quite some time post labour. As a newly pregnant woman I would read this review as a way of making me dubious about NHS maternity care and encouraging me to seek alternatives, despite affirmations that it is safer now to have a baby in hospital than ever before.

Secondly and more importantly to this, £3000. Really? We need to think about the term of care we are considering here: 42 weeks. That is the typical term of midwifery care, 40 weeks of pregnancy and an additional 2 weeks post birth. That is a long time, and I can’t believe that £3000 will cover it. Even if it did, where is the funding coming from if something goes wrong? That clearly isn’t included within the personal budget of £3000 when the cost alone of an epidural would absorb that. In the review it was mentioned that the NHS pays out £560m in clinical negligence claims per annum – this seems like a very sly way to negate responsibility and thus legal liability for the care of the woman and her child. If she has chosen a home birth, had her £3000 budget and spent it on hypnotherapy etc, then finds it doesn’t go to plan and she needs to be taken to hospital… Well, that’s not your problem, Mr Health Secretary is it? Especially as she now has “more choice and control”, which encourages her to go against medical advice – after all, how can the NHS be responsible for a woman going against medical advice?

Thirdly, do we suddenly have something against our hard working professionals? Last time I checked it was a pretty decent slog through university to become a midwife, and an even longer one to become an OBGYN, so, at what point did we suddenly decide that these guys don’t know what they are talking about and shouldn’t have be able to “advise” their patients? When did we all become trained medical professionals? I find it frustrating because we already have “patients choice” and when I raised my desire to give birth at home with Edith after a successful VBAC with Toby, I was strongly advised against it, but I could have gone against that medical advice and the staff were still required to stay with me due to their duty of care. They can’t tell you they won’t turn up if you choose to have a home birth because they have told you it could be dangerous, but they will tell you to sign a form to say they have advised against it and aren’t liable should the worst happen. Who is going to determine who is eligible for this superficial budget, and if it’s just a blanket to every pregnant woman, who is going to educate us on what the costs of pregnancy and birth really are?

What I would like to see is this “budget” being used to put more midwives into the community (for women who want home births, as well as in hospitals) better training and support and more equipment – such as tilemetry, which would allow the baby to be monitored while I had a water birth after a section, something I was told there probably wouldn’t be enough of at York Hospital when I had Edie – we could change that. Not lobbied at women in an attempt to make them feel like their options are more varied and to encourage them to disregard medical advice when it’s been offered, when realistically it isn’t going to make a blind bit of difference.

This whole proposal sounds fire to me, it absolves the NHS of liability for when things go wrong, gives the impression that we are better off out of the hospital and undermines the professionals.

I want to know your thoughts! What do you think of this personal budget for pregnant women? What happened with your birth experience, did it go to plan?

H x


  1. Avatar March 14, 2016 / 6:55 am

    I think they have done this because hospitals are so full. My local maternity hospital has had to be closed 4 times already this year for being full. I know I would rather have my baby in a hospital were I know I’m safe if anything goes wrong

    • Harriet March 14, 2016 / 10:57 am

      Quite possibly Michaela. H x

  2. Avatar March 3, 2016 / 12:15 pm

    £3000 really doesn’t sound a lot of money. I’m a little naive to all this and assumed if you wasn’t having a hospital birth you’d be paying for everything yourself anyway, i.e a birthing pool or a private nurse and so on. I guess I learnt something during this not only about the issues of the budget they’d like to bring in but the fact it is all NHS run when you have a home birth. Great post

  3. Avatar March 2, 2016 / 9:13 pm

    I had both in the hospital and was very glad of it. My labour was long both times and ended up in tears and a lot of blood loss so I cannot fathom having that in the house and even feeling safe.xx

    • Harriet March 5, 2016 / 4:15 pm

      I would have loved to be at home but it was just as well I wasn’t – I just don’t want to ignore the professionals and give the wrong impression to women! H x

  4. Avatar March 2, 2016 / 2:32 pm

    Personally I had 3 very good experiences with the NHS and my own pregnancies and births so this really doesn’t appeal to me at all! I don’t get why things always have to change!

    • Harriet March 5, 2016 / 4:17 pm

      I can see why they want to change things, but I really feel this is the wrong way to do it! We need to put the funding in to midwives and improving services, not telling women that they should be able to allocate their own funds. H x

  5. Avatar
    March 2, 2016 / 9:13 am

    I’m still not sure what they mean by all of this, it’s all a bit sudden isn’t it? Personally my maternity and birth care experience was horrible, I wish to this day that things were different, I would happily take the offer to have one to one midwife care and even to go private! x

    • Harriet March 5, 2016 / 4:19 pm

      I would love the offer of one on one midwifery, but that shouldn’t be given to someone without medical training – who determines who gets that money and whether or not you can have midwifery care or need to be under the consultants care. H x

  6. Avatar March 2, 2016 / 8:28 am

    I can’t lie, all this privatisation of the NHS malarkey confuses me, I can’t say I have enough knowledge about it to feel my opinion is valid, I’m ashamed to say. But from someone who had an absolutely horrific labour after needing mental health care and treatment for hyperemesis gravidarum while pregnant, I definitely want to be able to have my next under the care of the hospital and know I can give birth in a place where I feel safe…. x

    • Harriet March 5, 2016 / 4:20 pm

      Oh what a shame you had such problems with HG and mental health Ally, I’m sorry to hear that. There isn’t enough done for people who have your experiences, but this ins’t the way to go to support them better. Or at least not in my opinion haha!

  7. Avatar March 2, 2016 / 7:29 am

    What a great idea!! This will give ladies a flexible choice of how they want to give birth. I understand your points too though.

    • Harriet March 5, 2016 / 4:22 pm

      See I disagree Jodie, you already have choice, all this says to me is that you are in charge of your own medical care and how you fund it – where does the money come from when/if something goes wrong. The NHS won’t be able to support it. What I’d like to see is this kind of money being put into more training and better care for ladies that do want home births etc, but not ‘here you go, have £3000, that won’t go anywhere.” H x

  8. Avatar March 1, 2016 / 3:59 pm

    It’s all good and well offering this to women to help with busy labour wards but they need the midwifes to make it work. They’d be better off spending the money on training

    • Harriet March 5, 2016 / 4:22 pm

      Thats how I feel Lisa! H x

  9. Avatar March 1, 2016 / 12:22 pm

    I think your point on it being spent on midwives is a better solution. Our first birth was in hospital which was “fine” our second was a home birth and with that had certain restrictions. So much so that if our son was born a day later we might have had to have a hospital birth as the midwife was away on leave and they didn’t have anyone to cover! Madness now I look back.

    I think the point of it undermining the hospital professionals is true too.

    On the whole ot does sound okay but I’d think more would need to be investigated and tweaked to make it beneficial.

    • Harriet March 5, 2016 / 4:25 pm

      I agree Martyn, it needs to be more inclusive and explain things better – all for putting the money into making care for women who choose the alternatives better and easier, but I don’t think this will help. For example, you want more water births available, buy Telemetry for each unit and plow some money into training, don’t just falsely suggest £3000 will be enough to enable that care, it won’t be. H 🙂

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