The closure of maternity units is always a temptation when the NHS runs into staffing problems, largely of its own making ( Up to 20 maternity units in England may have to shut, NHS leader warns, 19 October ).

In my area the quality of care has already been called into question at the largest local unit, and directing mothers to chance their luck there seems to be an undeserved reward. Likewise a nearby large trust has had the quality of its neonatal care called into question. Closing small units is unlikely to provide the quality gain that is sought.

The problem for the NHS is that there is a freedom of ability to employ consultant staff. If you have the money, get on and advertise. This means that the supposedly better, larger units will be able to hoover up all the people they want. The smaller units don’t get a chance.

The reason people want to work at big centres is because for the same pay they don’t have to work so hard, or have the same level of responsibility.…