The House of Commons Select Committee 2nd Report on Maternity Services (1992) provides recommendations to the future structuring of Maternity Services. The explicit messages provided by this report indicate that services should be woman centred, placing the Midwife as the Central Care Provider. Politically this places midwives in a strong position to lead future maternity services. The current culture that maternity services are operating needs to be examined by Managers before the recommendations can become operational policy. Attention also needs to focus on those elements of practice and organization that currently meet the report's recommendations. This is essential to ensure that any re‐organization required builds upon the strengths within maternity services whilst addressing the weaknesses. At Leicester Royal Infirnlary the development of a Midwifery Managed Service has evolved over a period of 5 years. The developments at this Unit have provided foundations to take the Winterton Committee's recommendations forward in a positive structured process that will guarantee consumer controls whilst establishing midwives as leaders in maternity service provisio