Statutory supervision for midwives, which has been in place for more than 100 years, is no longer necessary, an influential committee of MPs has claimed.
Midwives are unique among the healthcare professions in that their supervision arrangements are protected in law. This means all midwives get regular support with their development from an experienced senior midwife.
But the House of Commons’ public administration select committee claimed there was “no evidence” of the benefits of statutory supervision compared to non-statutory arrangements for others including nurses.
“We need to reassure midwives we want to retain what is good about midwifery but that might not necessarily mean retaining statutory supervision,” said committee chair Bernard Jenkin.
“The kind of support midwives give to each other is about how they behave and the values midwives have as a profession and I doubt very much whether it is actually to do with the statute.”
Giving evidence to the committee Juliet Beal, director of nursing for quality improvement and care at NHS England, also questioned whether there was a need for “statutory supervision.”
However, she acknowledged most midwives were deeply concerned about the idea of scrapping statutory supervision.
“There is a fear among the profession that if supervision is not statutory it won’t continue,” she said.
“I think they look at nursing colleagues where supervision, which isn’t statutory, has not been implemented in organisations because there is not enough capacity in the system.”
The committee was reviewing progress on efforts to strengthen regulation of the profession in the light of urgent recommendations made by the health service ombudsman in December last year.
These include the need to address the “conflict of interest” which springs from the fact supervisors are responsible for the day to day line management of midwives and supporting their professional development as well as investigating any concerns about quality of care. The ombudsman recommended these two roles be separated.
Mr Jenkin said the committee was frustrated at the amount of time taken to act on the ombudsman’s report and accused ministers and the Nursing and Midwifery Council (NMC) of “making a great meal of something that should just be got on with”.
But NMC chief executive Jackie Smith said the changes were far from straightforward because of the need to assess the impact on all four UK nations and the “depth of feeling around the value of supervision”.
“I don’t think anyone would doubt the benefit of supervision,” said Ms Smith. “The question here is whether it needs to be in our legislation and what’s the best way of ensuring midwives get the support they need during their practice and the public is protected.”
The NMC has commissioned the King’s Fund to look at various options for regulation before agreeing a way forward.