Abstract
David Nicholson, new Chief Executive for the NHS, stated in his first speech (Carvel, 2006) that it was now time to deal with the ‘wicked’ issues of maternity services while announcing far-reaching reforms which will close maternity units and help to relieve the NHS's £512 million deficit. He said ‘redesigning’ services will ‘improve’ care and these improvements will come about by ‘concentrating key services in fewer hospitals’. He is confident that the public will support the changes if ‘doctors’ are won over to give their ‘support’. Will doctors support centralisation of maternity services? Of course they will because the professional dominance will continue and maternity care will become more medicalized. Obstetric practices thrive in the mass consumer market rather than the small entrepreneurial units of midwifery-led birth centres.
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