The Minister for Secondary Care (Karin Smyth)
I thank the hon. and gallant Member for North Devon (Ian Roome) for raising this very important matter. He calls attention not just to his own constituency but, as we have heard from others, to a broader issue that we face, particularly in our rural and coastal communities. I want to stress that the Government are clear that all women have the right to receive the same high-quality, safe and compassionate care, wherever they have their babies. We need to ensure, and mums need to know, that services are there for them when they need them, including at the time they go into labour.
I thank the hon. Member for North East Fife (Wendy Chamberlain) for sharing the experiences of her constituents Kristie and Tammy today, and I agree that we need to bear such experiences in mind. That is why my right hon. Friend the Secretary of State has chosen to prioritise maternity, and why the work of the national maternity and neonatal taskforce is so important. In particular, the new modern service framework will define the standards needed to deliver care across the country, whether in large inner-city areas or small rural places.
I know the hon. Member for North Devon understands that the North Devon maternity unit was closed for a good reason: the trust could not provide a service that it knew was unsafe. It is really important that we all bear that in mind as we discuss this issue. We must support good, sound clinical assessment, particularly in this area. However, it is unacceptable that, as we have heard from the hon. Member for Honiton and Sidmouth (Richard Foord), expectant mothers are travelling all the way to Exeter or Bristol, and the current situation is not sustainable. I have given birth very healthily three times, and I am grateful for the care that I had. I had to travel only a short distance down the road and, frankly, that was enough, so I empathise deeply with women who have to endure long journeys.
I will not rehearse the recent history that led us to this point, because I know the House is well acquainted with that. As the hon. Member for North Devon knows, the responsible Minister is the noble Baroness Merron, but I will do everything I can to take this opportunity to update him and the House on where we are, and follow up in writing on any specific questions, if necessary.
The trust has set the following three tests before the unit can reopen: first, there must be 24/7 consultant and registrar cover in place through an on-call rota; secondly, three quarters of those staff must be employed full time; and thirdly, new staff must have gone through employment checks, onboarding and induction. Today I can update the House that the outlook on safe staffing was more positive last week, but unfortunately some recruitment has fallen through since then. The trust is still seeking the additional clinical staff that they must have to provide a safe service. As hon. Member for North Devon knows, the issue is not that the roles are not funded. They are generously funded, and the trust has even gone so far as to offer salary top-ups, but the roles remain unfilled. The question is how we attract the best talent to our rural and coastal communities, and show them that Barnstaple and other similar places are among the best in the country to build a life.
I want to thank partners that are working with the trust on recruitment, including the Royal College of Obstetricians and Gynaecologists. The trust is also exploring hiring international candidates, but ultimately we want the unit to have enough staff to provide a safe service that is sustainable—another point that has been well made today—even if a doctor is unwell or otherwise on leave. Every week, the chief medical officer at the trust conducts an assessment to see whether the unit is ready to reopen its doors. Every two weeks, the trust updates key stakeholders on the status of the unit. Once safe staffing is secure, there will be a short period of time to stand up rotas and put services in place. I have had assurances that, during that period, the trust will get in touch with every mother and give them the chance to change their birth plans to Barnstaple, should they want to do so.
Richard Foord
I accept that this is a point about recruitment, but it is also a point about retention. A constituent of mine who visited the maternity ward at Exeter hospital heard that the staff temporarily redeployed there from Barnstaple are having to pay the full car parking charge of £20 per day while they are doing the additional service of travelling to Exeter. Does the Minister think that retention also needs to be looked at?
Karin Smyth
Yes, of course, and that is what the trust does. I would gently urge all hon. Members to work very closely with the entire trust on these issues to solve these problems. It is absolutely right that the trust is working with MPs. It is reviewing its decision on a weekly basis, and it is important that it communicates openly and transparently with all its partners when those decisions happen. I am always very clear that Members of Parliament speak on behalf of their constituents and can be helpful in communicating those messages, because we want to make this work.
In the meantime, the trust continues to offer a range of maternity services, and it has taken steps to help the women covered by its duty of care. There is a dedicated helpline for women to discuss their birth plans, a maternity triage line for urgent help, special appointments to talk about travel costs and accommodation, free taxis for women who do not have their own transport and are advised by the triage line to go to hospital, and mental health support. These are good and sensible steps, but it is still unacceptable for women to have to travel for two hours while they are in labour.
Trusts in our rural and coastal communities do face systemic pressures, because they have fewer births and because it can be hard for the local NHS to recruit. Last year I visited North Devon district hospital, as part of my remit in overlooking the new hospitals programme, to see how it is using the £30 million the Government have made available to support the rebuild of the 50-year-old staff accommodation block and invest in MRI scanners. We are committed to those services in Barnstaple, and it is important for all hon. Members’ constituents to be clear about that.
Our 10-year health plan, produced last year, clearly set out the issues for rural and coastal communities, which the right hon. and learned Member for Torridge and Tavistock (Sir Geoffrey Cox) noted. We particularly highlighted those communities in the 10-year health plan because we recognise that they have specific needs and do not benefit from a one-size-fits-all approach. However, the broader systemic issues they face, particularly in staffing, must be addressed in our upcoming workforce plan, and I do agree that retention is a key part of that.
Ministers have made it clear to the NHS that we must do everything possible to help reopen North Devon maternity services. NHS England, the ICB and the regional team in the south-west are working with the trust to resolve these issues as soon as possible. As I have said, my right hon. Friend the Secretary of State has rightly made maternity a national priority for this Government. She is chairing the national maternity and neonatal taskforce to drive forward reforms, and to deliver systemic and sustained improvement across maternity and neonatal care, including in relation to the failings exposed in the south-west of England in recent months.
The Barnstaple maternity unit will reopen. I cannot give the hon. Member for North Devon a guarantee from this Dispatch Box of the date when that will happen, because it will depend on securing safe staffing. That is the problem that everybody needs to focus on, and this Government are focused on doing that with the local system. We will do everything we can to help the hon. and gallant Gentleman get those services back on track on behalf of his constituents.
Question put and agreed to.