Maternity Services

Debate between Baroness Stuart of Edgbaston and Daniel Kawczynski

Tuesday 1st February 2011 Westminster Hall

[Ms Stuart]

That leads me to my next point. We have clearly not come up with systems in the NHS that allow us to learn properly from mistakes when things go wrong. I fully accept that we have the NHS Litigation Authority, and that the NHS insures itself. We try to deal with negligence effectively and efficiently. However, there is still a mentality of institutions, when something goes wrong, closing in on themselves. I wonder whether we should look at the way the aviation industry deals with accidents. Fault is not allocated; the facts are looked at, and the real outcome is what to do as a result of the problem. Rather than understanding the errors that have gone further and further, we should consider what is to be done as a result.

Going through newspaper cuttings, I found one over Christmas about Good Hope hospital. There was a very unfortunate incident when a lady who had miscarried was left for four hours in sight of other patients. She complained to the hospital, which simply apologised and said it hoped to do better. Hoping to do better simply has not done us any good, if that experience is anything to go by.

It is not clear to me who has responsibility for this matter. In the current structure we have PCTs and strategic health authorities, where at least theoretically we could allocate responsibility. In the new NHS, who will do that? I will return to that point.

We need national maternity data sets that are much more standardised and allow us to make us comparisons across the country. That is not a question of money. Given that we are told that the NHS is one area that is ring-fenced, there is much we can do within existing provision.

I now come to the promise that the right hon. Member for Witney made during the election campaign. We all know what happens during elections; not keeping election promises is not particularly new. However, let us look at what he said in January 2010. Maternity and childbirth is an immensely emotive subject. It is not an illness; it is one of the most joyful events in life. In the majority of cases, a healthy baby is born and we try to keep the medics out of the process as much as possible. When politicians go into election campaigns and talk about maternity services—particularly when they do so in The Sun—it is a pretty toxic mix. The right hon. Member for Witney went to a maternity unit and said:

“Having a baby might be the most natural thing in the world.”

Fine, I agree with him. He continued:

“Every parent wants…to give birth in a relaxed local setting, where they get the personal attention they need. So, why isn’t that happening? It’s because after a decade of constant reorganisation, Labour are giving us bigger and bigger baby factories where mums can feel neglected and midwives are stretched to breaking point.”

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

Will the hon. Lady give way?

[Ms Stuart]

I assume that the hon. Gentleman comes in on the bigger and better baby factories.

[Daniel Kawczynski]

The hon. Lady surely understands that after 13 years, the previous Administration had still not managed to achieve some of its long-term goals and aspirations. She almost indicates that the promises made by the Prime Minister should have been met seven or eight months into a new Administration. Given the state of the public finances, she must acknowledge that it will not be as easy to deliver on those promises as quickly as she—or I—would like.

[Ms Stuart]

I am sure the Minister will be grateful for that helpful intervention. However, have we not been told that the NHS is ring-fenced? That is how I understand it. Therefore, the financial argument really does not hold.

I would like to analyse what the Prime Minister said a little more. He went on:

“It doesn’t have to be like this…First, we’re going to create new maternity networks…Second, we are going to make our midwives’ lives a lot easier. They are crucial to making a mum’s experience of birth as good as it can possibly be, but today they are overworked and demoralised. So we will increase the number of midwives by 3,000. This is the maternity care parents want: more local and more personal. And under a Conservative Government, it is what they’ll get.”

--- Later in debate ---

[Ms Gisela Stuart]

An important thing we have learned in the past 15 to 20 years is that when it comes to extremely complex and difficult clinical cases, a hospital must perform a particular function a minimum number of times if it is to be at its clinical best. Some of the hon. Gentleman’s constituents will end up in Birmingham. He questions why Birmingham has received investment, but it is because we provide national centres of excellence. Some of the mothers from his area will come to the women’s hospital because their case is so complex that only the women’s hospital can deal with it. There can be only two or three centres in the country able to provide that clinical excellence. There is always that tension between the local and the centralised.

The hon. Gentleman is unhappy about the reconfiguration, but does he have an objective assessment of how good, clinically, his area’s maternity services are? He may feel good about them, but does he have a professional assessment of whether they could be better?

[Daniel Kawczynski]

That is a very good question. The chief executive of the trust and the PCT and many others believe that there must be a reconfiguration and specialisation at both hospitals. The argument is that without it, we shall lose services, which will go out of the county. We shall not get our NHS trust foundation status and services will be moved out even further away. That is the gun being pointed at my head—not to rock the boat too much on this issue, because there is the possibility of services moving away. I understand that. I feel that the maternity services at the Royal Shrewsbury hospital are good. When my daughter was born there I found the services tremendous. Speaking emotionally, obviously I want them to stay in Shrewsbury. I understand that we must have the reconfiguration debate and that the professionals and clinicians must make the decision, and that is why I shall write to local GPs and consultants to gauge their views. I shall keep the Minister informed.

I congratulate the hon. Member for Birmingham, Edgbaston on raising an important issue, and look forward to hearing what the Minister has to say.