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Saturday, 31 March 2018

The contemporary bullying and adversarial culture of UK midwifery and Jane Greaves RM

Update: Jane Greaves reinstated!!  AND the story is covered by today's Sunday Express.

https://www.express.co.uk/news/uk/946014/jane-greaves-midwife-petition-job-sacking-unfair-dismissal-wakefield 


What is going on in midwifery in the UK?  Weekly UM hears of a midwife who has been sacked or suspended, or who has been forced out of the profession.  If these were careless, uninterested, uncommitted, lazy or rude midwives, that would be one thing.  But almost without exception, the midwives involved have a long history of woman-centredness, commitment to their profession, kindness, and standing up for services and colleagues.  

The UK is chronically short of midwives but many managers show little sign of wanting to retain those they have.  Contractual hours, policies, shift times, shift lengths, lack of study opportunities, inadequate responses to legitimate concerns and complaints from staff, favoritism and the nurturing of cliques, all combine to make the lives of many midwives very difficult, and result in a huge percentage of midwives working part-time or "taking a break" from the profession.  

Many (not all) senior posts in UK midwifery are filled by those who fit the corporate blueprint, show themselves to be loyal to the business (and Foundation Trusts are businesses run by managers and accountants from non-clinical backgrounds), not rock the boat, accept cuts sorry transformation and persuade their staff to work harder sorry smarter.  If you challenge this model of healthcare organisation (e.g. want choice for women that may require more staff, reject shoestring continuity models, oppose the downgrading of a birth centre etc), then promotion will not come your way. 

Malicious or unnecessary referrals to the NMC are made to settle scores and to consolidate power.  Threats and lies are common.  One Head of Midwifery in a northern English city recently told a midwife that she might be sued, not over clinical malpractice or neglect, but because another NHS Trust was annoyed by something she had written.  As her writing expressed an honestly-held opinion and accorded with the scientific evidence, this was palpable nonsense.  So why say it, if not to instill fear and dread, in other words to bully the midwife? 

Another midwifery manager (again in a northern English Trust, but it is happening all over the country) has sacked a midwife called Jane Greaves.  Jane has an excellent track record for caring for women and defending the service, but the manager, citing her sickness record, feels the service doesn't need her, despite the midwifery shortage in the area. A petition started by a friend has attracted over 30,000 signatures in a week.  UNISON, the union involved, appears to be hanging out the Trust to dry in the local media and this is a welcome change to the Royal College of Midwives (RCM)'s common approach of stay quiet, say nothing.  

You can sign the petition for Jane Greaves' reinstatement here:
https://www.change.org/p/mid-yorkshire-nhs-trust-support-nhs-midwife

And view the local paper article here:
https://www.yorkshireeveningpost.co.uk/news/wakefield-midwife-fired-over-sickness-record-after-suffering-kidney-infection-claims-no-time-for-trips-to-loo-due-to-hospital-understaffing-1-9075856

Needless to say, the friend has come under pressure.

So why are midwifery managers so drawn to the unkind, adversarial, and punitive approach and outcome rather than one that is solution-focused, trusting, and compassionate?  UM feels it is basically an issue of skills and knowledge as well as one of misplaced loyalty and deficient understanding of the wider picture.  

Midwifery is a global profession with a history as long as the human story and its current connection with the NHS in the UK is a minuscule part of that history and this planet, and even tinier is its shackling to the pseudo-market-orientated NHS of the 2010s.  I don't think that anyone enters midwifery to be part of the latter, we become midwives to be part of the ancient and universal energy of women and birth.   The health of that connection is shown by actions not words.  Yvonne Rowlan, the Head of Midwifery who may have personally sacked or was involved in the sacking of Jane Greaves, gave this vacuous statement to the Yorkshire Evening Post:

"We are dedicated to providing excellent patient care and supporting our staff to do this.  In every aspect of our work we adhere to a set of core values which underpin not only the care we give to our patients but also the care and respect we show to each other as members of staff."   


Fine words but empty ones in the face of loss of livelihood, vocation and workplace friendships.  Empty in the face of anxiety, stress, mental ill-health, suicidal thoughts, and depression caused by heavy-handed approaches to common and manageable workplace differences and challenges.  Empty in the face of no staff loo.

are dedicated to providing excellent patient care and supporting our staff to do this.

Read more at: https://www.yorkshireeveningpost.co.uk/news/wakefield-midwife-fired-over-sickness-record-after-suffering-kidney-infection-claims-no-time-for-trips-to-loo-due-to-hospital-understaffing-1-9075856
“We are dedicated to providing excellent patient care and supporting our staff to do this. “In every aspect of our work we adhere to a set of core values which underpin not only the care we give to our patients but also the care and respect we show to each other as members of staff.

Read more at: https://www.yorkshireeveningpost.co.uk/news/wakefield-midwife-fired-over-sickness-record-after-suffering-kidney-infection-claims-no-time-for-trips-to-loo-due-to-hospital-understaffing-1-9075856
“We are dedicated to providing excellent patient care and supporting our staff to do this. “In every aspect of our work we adhere to a set of core values which underpin not only the care we give to our patients but also the care and respect we show to each other as members of staff.

Read more at: https://www.yorkshireeveningpost.co.uk/news/wakefield-midwife-fired-over-sickness-record-after-suffering-kidney-infection-claims-no-time-for-trips-to-loo-due-to-hospital-understaffing-1-9075856

Read more at: https://www.yorkshireeveningpost.co.uk/news/wakefield-midwife-fired-over-sickness-record-after-suffering-kidney-infection-claims-no-time-for-trips-to-loo-due-to-hospital-understaffing-1-9075856
The RCM is currently more part of the problem than part of the solution, having a schizoid relationship to its members: it appears to be most comfortable with those at the top of the NHS hierarchy spending time befriending, liaising with and hobnobbing with them at all sorts of dos and events, but like a rabbit caught in headlights when confronted with the multiple problems of the thousands and thousands of its members who are not senior managers, but on whom it depends for the bulk of its subscriptions.

The position of shop-floor midwives trying to get proper representation is also often invidious.  Those who become RCM workplace representatives generally have two mutually exclusive reasons for doing so:
Either they want to climb the slippery pole, get close to management, and show how compromising they can be;
Or they want to represent and serve their colleagues and challenge injustice and unfairness in the workplace.
The latter group often become subject to the same investigatory and disciplinary processes that they have helped others through.  The RCM, often as thick as thieves with midwifery managers (whom it often mistakenly refers to as "midwifery leaders"), appears uncomfortable with its dual role as a trade union, recruits full-time officers from its own stewards rather than from a TU background, and often fails to stand up for its members as strongly as it ought.  The RCM line is all too usually to advise repentance and to show remorse and accept the punishment.

UM suggests:
  • If the RCM is serious about representing midwives, it has to pull its finger out and join with  those who are fighting to heal the toxic culture of contemporary midwifery in the UK.  The Caring for You Campaign is not biting deep as the RCM's own report shows (their December 2017 Evaluation of the CfY Campaign showed an increase in workplace bullying in services signed up to it).
  • Midwifery managers need to stop indulging in mutual self-congratulation on their various get-togethers but get down to some serious work of self-scrutiny and objective criticism.  They need to rediscover (or discover) midwifery and public service values and kindness and solution-focused approaches to their differences with midwives. 
  • There should be a complete moratorium on malicious referrals to the NMC.  
  • Midwifery managers should stop threatening and bullying their staff and stop promoting their acolytes over those whom they know are the better midwives.  They need to turn their attention from those in the corporate offices to the women they serve and the midwives who care about serving them.
Postscript
Before you all go away thinking the north of England is the midwifery pits, UM would like to pay tribute to Airedale Hospital Trust and its midwifery managers for the solution-focused approach it has taken with Yorkshire Storks Midwifery Practice to address the independent midwives indemnity insurance issues. 

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