NHS chief executive David Nicholson has denied that the nation's midwifery service is in crisis but admitted that the country needs more midwives.
When challenged over the state of the service by a committee of MPs, the head of the NHS said government planning was not "quite as it should have been" and that, after examining revised figures on the country's birth rate, it was concluded that 4,500 extra midwives were needed to cope with the situation.
Mr Nicholson said the NHS tariff for midwifery services had increased significantly above inflation in order to provide hospitals with the cash they need to hire and retain more midwives.
But when pressed about what more could be done to increase their numbers he admitted: "I don't think we have concluded how we can do it. We are working through that at the moment."
He told the Commons Public Accounts Committee that in 1997 there were just over 608,000 births in England but this had risen to 671,000 by 2009, while the number of full-time midwives had increased from around 18,000 to just over 20,000 in the same time period.