And when we run out of obstetric cream?

This report of life in the soon-to-be-liberated NHS comes from a community midwife in the South-west who wishes to remain anonymous.

I normally work as a community midwife, but when I’m on call (primarily for  homebirths) I am extremely likely to be called into the labour ward when it is busy.  As it always seems to be at the moment.  Before Christmas I was called in on a very busy shift.  It seems that every time I go in to the hospital all the equipment and supplies have moved to a new store cupboard, so I am well used to having to ask my colleagues where something is now kept.

I needed a tube of KY jelly to examine the woman I was looking after.  When I was last in labour ward,  small sterile tubes were kept in each delivery room – one tube being opened for each examination.  Apparently they are very expensive.  For this reason the decision had been made by someone (who knows who?) to order larger tubes.  Each woman could be allocated one tube for her use throughout labour and a massive saving made.  Okay, I didn’t need to know the long managerialist argument for the change, I just needed to know where I could get the KY jelly – large or small tube, I didn’t care.

Oh, there’s none left.  We’ve run out until the end of the year!  Whoever had calculated the massive savings hadn’t appreciated that many women only have one examination, or that the large tubes might get contaminated or lost or otherwise end up not being used for subsequent examinations.

What then should I use?  I was told that we were just having to use obstetric cream until the next delivery of KY.  Obstetric cream is antiseptic, which is probably a bit over the top for a normal examination in labour.  It is normally used by doctors to lubricate instruments like forceps.

I’m as much against waste of material resources in the NHS as anyone, primarily for ecological reasons.  But, you truly know the NHS is in trouble when a maternity unit runs out of KY jelly.  A real false economy.  So, what I want to know is what happens when the midwives have used the limited supply of obstetric cream? With what will  doctors lubricate forceps?

I expect this is just a little local irrationality, but with increasing budget pressures every NHS trust will be indulging in their own variants, which will test the goodwill of staff and patients alike.  I just want to do my job, with the right tools and without having to give to much thought to the irrational decisions of procurement.

And when we run out of obstetric cream?