Denise Tiran. Singing Dragon, 2018. 224 pages. £18.39 (pbk). ISBN: 978-1848193864
Review by Brydon Williams, Clinical Supervisor for Midwives, Wales.
MIDIRS Midwifery Digest 29:2 2019.
This book is a clear, comprehensive guide to setting up a business. It is packed with detail, yet proved to be interesting and thought-provoking on many levels. I read it in an afternoon but found it succinct and ‘meaty’.
In the opening chapter, Denise Tiran recognises that NHS resources are not infinite and that demand for services is growing exponentially. The author argues that the time is ripe for thinking of new ways and models of service provision and that there is a growing societal desire to pay for pregnancy-related services.
She questions whether the NHS is a paternalistic system that obviates any real need for individuals to take responsibility for their own health if treated for free.
Sadly for our public services, the author suggests that tokophobia may be more to do with fear of the maternity service and lack of care than the fear of labour itself. This may be, in part, the reason for an increase in demand for doula services in the UK.
Personally, I would have loved to have read more discussion on equality of service provision for all rather than for just those that can pay. Having said that, the author does cite very interesting examples of ‘social enterprise’ as one form of business model. Importantly, she questions the medical/positive results/NICE bias that has discouraged alternative therapies from being offered on the NHS.
The bulk of the book takes the reader through the practical and thorough process of setting up a business, from examination of our motivations and personal attributes, business models, finances, marketing, and professional issues to the importance of naming and branding a business. The emphasis throughout is on safety and professionalism and the relevance of the Nursing and Midwifery Council (NMC 2015) Code over and above consumerism.
As a midwife who is not particularly thinking of starting a business, but is increasingly being asked to recommend services in the area for pregnant women, the book was full of insight into what advice women may need when looking for a well-run and ethical private business.
Although I did not always agree with the viewpoints taken on private service provision, the author really opens up the possibilities before us, as midwives, to consider different ways of delivering care, either nationally and systematically or on a personal, financial basis.
I would definitely recommend this book (and already have) to anyone starting a maternity business. There don’t seem to be many stones left unturned and there is a pervading positive, supportive but realistic approach throughout the book to setting up a private practice or social enterprise.
Nursing and Midwifery Council (2015). The Code: professional standards of practice and behaviour for nurses and midwives. London: NMC.
© MIDIRS 2019.