Health: Now it's standing room only at the antenatal clinic: Maggie Brown attended the prestigious King's College Hospital during her pregnancy, but it fell far short of her expectations

THIS article is written from a sense of outrage that has festered over the nine months it takes to have a baby.

During that time I attended the antenatal clinic at what should be one of Britain's leading maternity units, at King's College Hospital in Camberwell, London.

This is a great hospital. Its fame and move towards trust status, obtained in April, resulted in a television series, Channel 4's Operation Hospital, shown earlier this year. I had my first baby there 10 years ago; but returning this year for my fourth, I could hardly believe my eyes. Conditions at the antenatal clinic have deteriorated disastrously: lengthy queues, hurried consultations, despair among the waiting women and harassed looks on the faces of the midwives. Virginia Bottomley, the Secretary of State for Health, ought to go and see for herself.

King's College Hospital has some of the most dedicated and experienced midwives and doctors it is possible to find. In three previous pregnancies they have assisted me with the utmost professionalism.

However, two years ago the maternity unit at the nearby Dulwich Hospital closed. As a result, I was told privately, the number of pregnant women attending King's increased by at least half. Staff and local GPs believe the switch has been disastrous.

The basement waiting room at the hospital, never an attractive place with its low ceiling and absence of basic amenities, has remained unaltered in size, despite the increase in patients. There are still only three lavatories available for women who have to provide urine samples. The scales on which patients are weighed remain in full view of the overcrowded room.

This is what I found on a typical morning last month. By 10.15, all 40 or so seats were taken, with five pregnant women having to stand, another six waiting outside the lavatories to provide their urine samples, and the receptionist facing a lengthy queue. The light bulb in the lavatory was broken so women had to provide samples in the darkness. Patients unable to get into the waiting room were standing outside. Everyone had settled down for a long wait.

This was typical of my visits during the past nine months. I have seen women waiting up to three hours for consultation, sometimes with small children wailing on their knees. On that particular morning I asked the nurse for a chair. She called out: 'Anyone who isn't pregnant, stand up.' A man accompanying his wife vacated a seat, which I took, forcing him to stand.

How can the management of King's College Hospital let down both its patients and professional staff so hopelessly? The midwives say they are allowed to allocate each woman only 10 minutes of their time. One midwife was so appalled at the overcrowding and queues on my last visit that she called out the names of three patients and took them upstairs to the maternity wards to try to reduce the delays.

This part of London, as a glance around the waiting room indicates, has more than its share of young, single, deprived mothers. Yet no one appears to have time for proper counselling, or pastoral care. Not one midwife had the time to ask me what sort of labour or pain control I wanted. This is completely different to the sense of bustle - but real care - that used to characterise this unit.

The overcrowding extends to other prestigious areas at King's. For example, the Birthright scanning unit, which screens pregnant women for genetic defects, kept me waiting until 6pm one December evening; I was not seen and had to return the next day.

Many of the women who attend antenatal care will be feeling either exhausted or ill. Once they have been seen, they emerge on to a busy road with little useful public transport to hand. And how can a major hospital continue without any available parking for the public?

The many volunteers who raise money for King's, often for glamorous and hi-tech projects, ought to look more deeply at what the hospital needs. The maternity unit seems to be going the way of the hospital's casualty department, which was renowned for its awful conditions.

I can honestly say that the worst experiences of this pregnancy have been inflicted by King's College Hospital's maternity services. Its managers urgently need to improve conditions and to facilitate, rather than hinder, the work of their fantastic staff. Even if they now plan to solve the problem of overcrowding, the question remains: how have they allowed it to continue for so long?

Maggie Brown gave birth at King's College Hospital to a boy, John Charles, on 11 May.

Improvements will start in August, promises King's

PLANS to rebuild and expand the antenatal clinic at King's College Hospital are to go ahead in August this year. Mr Donald Gibb, consultant obstetrician and director of women's services at the hospital, said that the clinic had been a 'black spot' for years, but proposals to improve conditions had been put on hold repeatedly because money for the project had not been made available.

'We have fantastically good doctors and midwives working in fantastically poor fabric,' he said.

Mr Gibb said that although the clinic was seeing more women, overcrowding was not directly connected to the closure of nearby Dulwich Hospital.

Waiting times at the antenatal clinic had shortened considerably over the past two years, Janette Brierley, director of midwifery services, said. But things 'were by no means perfect'. The new building would include more cubicles, which would further reduce waiting periods, she said.

Ms Brierley said that although an appointment with a doctor normally lasted 10 minutes, women usually spent 15-20 minutes with a midwife. There were plans to increase the number of midwives working at the clinic, she said.

(Photograph omitted)

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