Staff and funding shortages blamed for surging birth unit closures

The funding model for maternity care and a stalled pay equity claim are being blamed for a raft of private birthing unit closures across the country.  
Evolution Healthcare, which owns and operates Birthcare in Parnell, confirmed this week it would not longer accept births in the facility from the end of the year. 
“Birthcare will close its three primary birthing suites from 31 December this year due to consistently low monthly bookings for primary birthing and will instead focus on providing post-natal stays for new mothers, newborns and whānau,” group chief executive Simon Keating says.  
“We feel that by focusing on high-quality post-natal care, we will provide for an extremely positive Birthcare experience while expanding our offering to mothers from the broader northern region.” 
Health NZ Te Whatu Ora’s Danny Wu said there was an increased trend of people giving birth in a hospital setting, so the decision by Evolution made sense.  
However, the reason for hospital numbers might not always be down to choice.  
In order to birth at a primary unit, the person needs a lead maternity carer – or midwife – of which there is a severe shortage. 
The most recent figures show more than 1000 midwives are needed – about 40 percent of the total workforce. 
This means people may have wanted to give birth in a primary unit but couldn’t because they did not have a midwife, forcing them to use the hospital midwifery services.  
Vanessa Shirlow, chief executive of River Ridge East birth centre in Hamilton, confirmed she had to close half the centre for two reasons: they can’t compete with the pay rates Te Whatu Ora midwives get, and the lack of sufficient funding from government.  
River Ridge is one of 11 employers involved in a current pay equity claim for midwives.   
The 11 birth centres, which employ about 120 midwives, are all independently run, but rely on funding from Te Whatu Ora. The claim is being done in good faith, with no guarantee the extra funding will come at the end. 
Te Whatu Ora has already settled a pay equity claim with its own midwives, meaning midwives employed by the Government are paid more than those in the birth centres – despite the funding coming from the same place.   
Shirlow said midwives were leaving the birth centres across the country, not because they wanted to leave their working environment, but because they can earn more working directly for Te Whatu Ora.
“If we can’t get the Government to fund our facilities to enable us to match the pay rates that are being paid to Te Whatu Ora midwives, we won’t be able to recruit and retain our staff, which means we can’t operate … we have closed half our facility because of staffing.” 
“The funding model is complex, but if you look at the hospitals, they get funding regardless of how many people use what is needed, so for example, the postnatal ward at the hospital, they are funded for their available beds every day, all day, whereas we are funded only if someone is using our service, which means it’s very hard to make decisions about staffing, you have to be extremely adaptable.  
“We are expected to staff our facility as if we could potentially have 16 women and 16 babies here, plus birthing clients, 24/7. But we only get paid for whoever’s here at the time. So if we only have four women staying here, but we’re staffed to be able to have 16, well, it is very difficult to make it work.” 
Just last month Ōamaru Hospital, which contains the Ōamaru Maternity Centre, transferred into Health NZ control due to “unique financial and clinical challenges”. 
For the past 25 years the hospital had been owned and operated by Waitaki District Council via Waitaki District Health Services. 
As its sole shareholder, the council was told Health NZ would not be renewing its contract for services earlier this year, and so made the call to negotiate the handover.  
The council’s mayor Gary Kircher confirmed the pressures around pay equity and funding in the birthing unit played a part in the overall financial viability of the hospital.
Shirlow said the cost to Health NZ to take on the operations of the NGO birth centres around the country would far exceed what was needed, by way of fair pay and funding, to continue to operate as current.  
“It so frustrating and it’s soul destroying to be working in this environment at the moment.” 
A number of private primary birthing centres have closed in recent months including the Waihi Birthing Centre run by Waihi Lifecare in September last year, the Birthcare facility in Huntly, St George’s hospital maternity services in Christchurch and Te Awakairangi birth centre in Lower Hutt.