Personal budgets for maternity care, £3000 - good idea?

Yes. God help us!

Tribute to the commercial success of private medicine...

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Here:

Really interesting JessM.
I had one of my babies in the USA 30 years ago and although a home birth, we still had midwifery and consultant costs and given the time gap it wasn't anything like these figures.
It's still mind boggling how much you might have to spend if things go wrong.
Here is some more interesting info from the data the BBC drew on (screenshots and explanation):

Interesting link about what people pay in other countries

www.bbc.co.uk/news/business-31052665

Teacher11 if someone can't afford a 'personal top-up' what happens to them? What standards do you think would be improved? and how?

Personally feel we should look more closely at the Netherlands but don't think £3000 is going to put their fantastic infrastructure in place.

As birth is seen as a normal activity, their midwife-led births are much cheaper. They insist that their midwives are very highly trained and respect them as professionals in their own right so this means that often doctors, consultants etc aren't involved at all. They have great (according to a friend's daughter) ante-natal sessions which look at ways to reduce stress and manage pain so have much lower drug costs. Even in hospital, women who need pain relief are in the minority.

They do, however have a system called kraamzorg which means that the new mum has postpartum care and support in her own home with the newborn. In difficult situations I think this cam even be every day, all day, for a week or more. I don't know how the government manages to fund all this - maybe from the savings of so many lower-tec births?

Evidence that "creating a market" improves standards? Can you give an example?
Market driven thinking can create chaos - as in English secondary schools - heading into a situation where there will be insufficient places for demand.
Back in the day (cf Call the Midwife) there were obstetric flying squads available to assist when things went wrong with home births. Effectively 2 registrars, one obstetric and one paediatric would leap into an ambulance with emergency equipment for forceps births, fragile infants etc. This of course would deprive the hospital of 2 doctors. Imagine the mother is 40 miles away on long winding roads and the doctors could be away for some time. That must be an expensive service and possibly put mothers and babies at risk back in the maternity unit. We have a vacancy rate for doctors of 14% at the moment so resources are squeezed. And would the mother be able to pay for the cost of such a service out of the 3 grand?

It will create a market and up the ante on standards and availability. With a personal top-up my daughter might get a better deal than I did.

I think it was just a pipe dream NoSpaghetti bit like the education vouchers I suppose- fine in theory but totally unworkable. Let's hope this scheme goes the same way!

Slightly off topic I know - but in reply trisher, I would suggest that just one of them give up work (or both work part time) if they really do want to home educate. £3,000 per child isn't going to make the difference of two incomes - unless they have loads of children...

We home educated our family on two part time incomes. It did mean no foreign holidays or expensive cars etc. £3,000 per child would have been nice, but think there would have undoubtedly been strings attached and it still wouldn't have made up for loss of a salary.

The education voucher scheme was approved of by some friends, a married couple who were both teachers, they said they would just claim the vouchers give their jobs up and educate their children at home! I wonder what happens if their are problems and you need more than the £3000 care? Presumably this would go back to the local NHS, would it mean them trying to ship problem pregnancies off somewhere?

Buddie, that's exactly why my daughter had HER second baby at home. I think many people come to home birth once things seem to be very poor with the first.

ajanela, you say 'Home births will mean more emergency cover needed in case things go wrong' - I wonder why this is? Things are no more likely to go wrong at home, and possibly less so. Maybe I've misunderstood what you mean?

I would have LOVED to have had financial help with the birth of my second child which we had with the help of private midwives (two, the same two, from beginning to end). It was a real struggle financially as my husband was a student at the time - but it was the very best of births and totally stress free.

Don't know if this scheme will mean that women will actually have more choice though. I hope it does - but expect it will be more of the same.

Looks like another way to privatise the NHS

I agree this scheme will not make birth safer. The way to do that is tom make sure NHS hospitals are well-managed and that professional staff follow best practice at all times.
This scheme reminds me of the idea of "education vouchers" which has been rubbing around for decades. You give parents vouchers which allow them to spend public money on the school of their choice - public, private, alternative etc. Those in favour of "alternative education" sometimes enthuse over this idea as it would provide them with an income stream. Those running private schools likewise enthuse as it would amount to a public subsidy of their fees.
I have a sneaky feeling this is another plot to undermine the NHS maternity services in a similar way - by funnelling off some of the allocated funds to private providers.

I am so out of date with maternity services now but am sad that the experience " buddie's* daughter had isn't the norm with home births today. From having my second pregnancy confirmed by my GP I don't recall seeing a Dr again. I met the midwife and had all my checks done by her at the anti natal clinic and she alone delivered my son at home with just my H there. It was quick, easy and lovely.

One of my DDs also used a private midwife. They enjoyed the personal touch; but I was exasperated with the wretched woman as she was so half-soaked about my DD's ante-natal depression and did nothing about the fact that she spent several months in bed weeping. You may imagine that I was tearing my hair out.

I've not seen any details of the scheme but can see it may have advantages. My daughter did not have a happy experience with her first pregnancy feeling pressured rather than relaxed and natural about the whole thing. For her second preganancy she had a private midwife who still liaised with local hospitals where she had the usual scans and so on she but covered all her regular checks and, with another midwife, delivered the baby at home in a relaxed and quiet atmosphere. They built up a relationship of trust and shemet the other midwife, too, before the birth. She described the whole experience as magical. It had entailed digging deep into savings and meant other planned things could not go ahead. By them taking this decision the local NHS had one less person putting pressure on services so indirectly it helped others, too. making an informed choice may still mean a hospital birth for those at risk and no one can foresee every possible emergency that may occur but, as my mother impressed upon me, people have been giving birth for time immemorial.

I doubt whether it will be a cheque!! - probably some sort of voucher I would guess.

I hate these schemes that are designed to given the government a chance to pat itself on the back under the guise of "patient choice" - another simplistic bit of spin that makes no sense at all in practice.

I think this is a terrible idea and can only hope that it applies to England and Wales only and will not impinge on the integrated maternity services that we have here in Central Scotland. Ante natal & post natal care are provided via local GP Practices whilst most of the births are in the modern area hospital. How do you split the £3000 between these two separately funded entities? What happens if the mum has to be admitted to hospital during the pregnancy or there are complications after the birth? Is the £3000 solely for the mother's care or is it supposed to cover the baby's care too? If baby goes into intensive care and Mum has to stay in hospital to feed him/her who pays?

Pregnancy and birth have so many variables. Babies arrive early or late, back to front, upside down or even refuse to come out at all. Mums come in all shapes and sizes and ages - some have conditions or illnesses that require extra care. There cannot be a 'one size fits all' package. Under the current arrangements the cost of a complicated birth or pregnancy is evened out by the cost of the many births/pregnancies which are straightforward. It is worth noting that most private health insurance specifically excludes pregnancy/birth claims because the Insurers are not daft.

This is another hairbrained idea and administrative nightmare dreamt up by an elite (whose children will all have been born privately) who are intent on privatising/destroying our NHS to line their own and their friends pockets.

When do they get the £3000? I see the opportunity for a 'little earner' here.
You can get a coach to uk, register at a uk address, get the cheque and return home.

P.S. I agree some of the less knowledgeable and poorer end of society will be put of using the service as they will be scared they have to pay. What happens if they loose their voucher.

Also if they can manage this system and other voucher systems why can't they manage everyone having to show an NHS card (like we do when abroad) to get free access to the NHS. Then those not entitled would have to pay. (Like we do when abroad)

Sorry going off the subject.

I read they are being given a voucher for £3000 to spend on the maternity care they want. You can only choose the care you want if that care is available, no community midwife no home birth.

I thought mothers already are able to chose, hospital, GP unit or home. Many make birth plans but understandably when the going gets tough they go with what is recommended to have a safe delivery or call for the pain killers.

I presume you can use the money for private care and then pay any extra yourself. I can see the insurance companies offering maternity care cover at an extra cost with the proviso that you use your voucher. If you choose private care will you have to choose private anti and post natal care? As you say money going to the private sector.

What happens when your care costs more than £3000. e.g for a Caesarein section or long stay? Will they have to pay extra? Home births will mean more emergence cover needed in case things go wrong, will you have to pay for the ambulance? Will the £3000 have to pay for after care at home?

One TV commentator asked a Consultant if this would reduce still births, not sure how it will, was this the idea behind it?

Trying to be positive, at least the NHS will get £3000 for each patient. It could be a good thing for the private sector to invest in Maternity care taking the load off the NHS.

Lots of questions.

It sounds a bit like window-dressing to me. How will mothers have sufficient knowledge and understanding of the pros and cons of each option to make an intelligent and safe choice? And it is those mothers who do not use proper ante-natal care who will be the least likely to take this up in a considered way - and these are the mothers who should be targeted.