Oral Answers to Questions

Daniel Kawczynski Excerpts

Tuesday 26th November 2013 Commons Chamber

[Jane Ellison]

Of course, it is possible, depending on clinical need, for clinicians to recommend treatment in England. The hon. Gentleman knows that there are ongoing discussions, some of which are quite difficult, but the intention is obviously to ensure that we get the best health care for everyone. I would urge the Welsh Government, in particular, to consider ways in which they can review how arrangements are made in Wales. There have been calls for a review of hospitals in Wales, not least the one today from the Royal College of Surgeons.

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

Hospitals such as the Royal Shrewsbury hospital, dealing with patients from both sides of the border, have historically incurred additional administration costs in dealing with the two separate authorities. What work is the Minister doing to find out what the costs are and whether she can help meet them in the future?

[Jane Ellison]

We are aware of those additional costs, and I know that my hon. Friend recently met my right hon. and noble Friend the Under-Secretary of State for Health. We are very conscious of those costs and of the difficult decisions. It is the subject of ongoing negotiation between the Welsh Government and NHS England.

Hospital Services (Shropshire)

Daniel Kawczynski Excerpts

Wednesday 9th February 2011 Westminster Hall

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

This important debate is on the reconfiguration of hospital services in Shropshire, and in almost six years as Member of Parliament for Shrewsbury, I have never received so many letters, e-mails and telephone calls from concerned constituents over a single issue. Many of those calls have been emotional, and even though the consultation process is still ongoing, I feel it is my duty to use the platform that I have in the House of Commons to highlight a few of the concerns to the Minister.

Part of the reconfiguration proposals would involve maternity and paediatric services moving from Shrewsbury to Telford. I want the Minister to imagine the geography of Shropshire and mid-Wales. The Royal Shrewsbury hospital covers not just the whole of Shropshire, but the whole of mid-Wales—a vast expanse just across the border. I am pleased that my hon. Friend the Member for Montgomeryshire (Glyn Davies) is present in the debate today.

Picture the wheel of a bicycle, and at the centre, the spokes coming into the middle. That is where Shrewsbury is in the area. Now imagine moving paediatric and maternity services right to the edge of the wheel. How would that wheel function? Telford is at the edge of the area, on the extreme eastern border close to Staffordshire. What is the sense in moving services so far away from the rest of central Shropshire and mid-Wales?

I am so passionate about this issue that I raised it during Prime Minister’s Question Time last week. The Prime Minister referred to the importance of public engagement and consultation, which he said was a fundamental aspect of any reconfiguration proposals. Therefore, I have asked the chief executive and the primary care trust for a public meeting to be held in Shrewsbury on 11 February at the football stadium in our town. I believe that hundreds and hundreds of people will attend. I intend to make a transcript of that meeting and of all questions put to the PCT and the chief executive, and I will be sending that transcript to the Minister.

[Glyn Davies (Montgomeryshire) (Con)]

My hon. Friend knows that I also have a huge interest in this issue as I represent Montgomeryshire over the border. Does he agree that the meetings that will be held in Montgomeryshire on 18, 23 and 24 February are of equal importance, and that it is crucial for the health board and PCTs to take notice of them? We also depend on the services in Shropshire.

[Daniel Kawczynski]

I agree with my hon. Friend. We are cognisant of the fact that his constituents, the citizens of mid-Wales, do not have facilities across the border and are dependent on the Royal Shrewsbury hospital. The people of Wales must be listened to equally, in the same way as the people of Shropshire.

I have slight concerns about the lack of sufficient engagement by the authorities with local people. I pay tribute to the chief executive and his colleagues. There have been public meetings, and the chief executive has met some of my constituents who have serious questions to ask on a one-to-one basis. Nevertheless, many letters and e-mails have not been answered in a timely way or to the degree that people wished for. Some people who have written in are retired senior consultants and experts in the field. I hope that all their questions will be answered.

I am also concerned about the dates of the public consultation. In began on 9 December and will finish on 14 March. I find 9 December a rather strange time to start a public consultation. We all know how stressful Christmas is at the best of times, and we would have been gearing up to buy the Christmas tree and presents and get our homes ready for festivities. A lot of people in Shropshire will not have been thinking about the consultation as intently and with as much time and focus as they might have done, because they were distracted by the coming festivities. If we are to have a public consultation, it must be held at the right time of the year and there must be sufficient time for people to make their views heard.

[David Wright (Telford) (Lab)]

I am grateful to my hon. Friend—I use that phrase pointedly—for giving way. There will be a consultation in Telford next week, and I hope that people will come to it. It is important that people across Shropshire express their opinions. Does my hon. Friend accept that under the proposals, both hospitals have to give something in order to sustain health services in Shropshire? Acute surgery would move to Shrewsbury, and some elements of paediatric and maternity services would move to Telford. There will be a balance between the two hospitals. We do not want to see services move out of the county, and if we are to sustain services in Shropshire, I think this is the best plan we are going to get.

[Daniel Kawczynski]

I will reciprocate by referring to the hon. Gentleman as my hon. Friend. We are from different parties but we are colleagues. We get on well, and across the parties we have a passion for Shropshire. I will come later to the importance of retaining services in Shropshire. However, constituents do not pay attention to services that come to their area; they are focused on those that are leaving. That is why they are pressing me to highlight these issues in Parliament.

My other concern is that there is no plan B. This is a consultation process in which the chief executive and the board come forward with proposals. However, there are no shades of grey—it is take it or leave it. I speak purely as a layman, but if there is only one option, it is difficult for a large group of people, many of whom do not have medical experience, to scrutinise that proposal. Surely, if we are to genuinely engage with local people, differences and alternative options could be put forward so that the community as a whole could come together, debate them and make recommendations.

[Mark Pritchard (The Wrekin) (Con)]

Does my hon. Friend accept that in an ideal world, both hospital sites would have all-singing, all-dancing acute and clinical services? However, we do not live in an ideal world, but in a time of constrained public finances. Does he accept that the current consultation recognises the importance of having an accident and emergency ward at both Shrewsbury and Telford? That is a breakthrough from the original consultation process and shows that the hospital trust has listened to Shrewsbury and Telford on that important point.

[Daniel Kawczynski]

I concur with my hon. Friend and with the point that he makes in his usual eloquent way. I have been told by the chief executive, and others, that if we do not go for the proposals, we will potentially put our foundation trust status at risk. If we put that at risk, there is the possibility of losing services—and the management of those services—out of the county. Again, I speak without medical experience, but I do not understand how we could enter into a consultation process but be told that if we do not go for the proposals, services will be lost from Shropshire.

I cannot envisage a time when we have no maternity or paediatric services in the whole of Shropshire. That is unthinkable to me, so I do not understand the logic of the trust. It is saying, “Take it or leave it, but if you leave it, that’s it. We won’t get our foundation trust status and you’ll lose your services.” That position needs to be clarified because many people see it as a gun being pointed at their heads and are therefore frightened to challenge the proposals.

[Glyn Davies]

I am grateful to my hon. Friend for his tolerance in allowing me to make a second intervention. The point that he has just raised is key. Everyone, including, I am sure, my hon. Friend, recognises that there must be a reconfiguration of services. The points that have been made are crucial. However, that does not necessarily mean that the reconfiguration of services that is before us has to be the case. The argument is not about whether there should be a reconfiguration of services, but about how that should take place. In the interests of the people of Montgomeryshire, I think that services are best placed not where it is convenient for a balance in Shropshire, but where they are accessible to the people who will use them.

[Daniel Kawczynski]

I completely concur with my hon. Friend on that point.

I shall briefly relate a couple of specific cases. I have been inundated with hundreds of letters on this issue. My own daughter was born at the Royal Shrewsbury hospital, and it was the proudest day of my life when my daughter was born within the community that I represent. She is not just a Salopian; she is a Shrewsbury girl and she will have that with her for the rest of her life. For us in Shrewsbury, being a Salopian is important, but being a Shrewsbury girl? Now that is something special. I feel so passionately about that.

One constituent’s family is directly affected by the proposals, as her three-year-old son needs 24-hour open access to the children’s ward at the Royal Shrewsbury hospital because he suffers from severe haemophilia. He needs treatment to be administered every other day and any additional treatment on demand if he should cut himself. I was told that it was vital for my constituent’s son to be admitted immediately to the children’s ward via A and E and not to be sent down the motorway to the Princess Royal hospital. How can that mother of a son with haemophilia empower herself to make her views known if the overview and scrutiny committee is not minded to refer this issue to the Minister?

The issue has also been raised with me by the father of a child who was previously a cancer patient treated at the Royal Shrewsbury hospital. He talks about the appeal in 2003 for a designated children’s cancer unit at the Shrewsbury hospital. It raised £500,000 and the unit was completed in 2005. My constituent told me that

“many people across Shropshire and Mid Wales donated or gave up many hours to fundraise, only to now find that the purpose built unit will…stand unused as Children’s services are being moved to Telford with no provision for this desperately needed unit which provides an essential service to families facing unimaginable turmoil whose children are being treated for cancer.”

I have been told of the severe disruption and anguish that will result from the need for seriously ill patients to travel from Shrewsbury if it is left with no consultant-led surgery, which may result in a catastrophic delay in emergency treatment.

I also want to mention Joshua, a young boy in my constituency who has chronic lung disease. His mother, Hayley Corfield, wrote to me about him. He has had bronchial problems since birth and is now 14 and constantly in and out of hospital. I have been given the most extraordinary list, which I will send to the Minister, of the medications that this poor young boy is on. He lives in Shrewsbury. His mother tells me that there have been many near misses in the last few years in terms of saving his life—resuscitating him. She is desperately worried about the impact on her son and the chances of his survival if, suffering from this chronic disease, he has to travel for an extra 20 minutes to Telford. I am therefore raising these issues with the Minister today.

The Minister kindly wrote to me. In his letter, he notes that I am planning to call a public meeting and encourages me

“to ensure views from that meeting are fed back to the local NHS via the consultation mechanism, so local concerns are fully taken into account.”

The next part is the bit that I am excited and happy about and grateful to him for—I know that he is one of the best Ministers we have. He says:

“The Department will be watching the outcomes from the consultation exercise with interest.”

I know that he cannot get involved at this stage, but I am extremely grateful that he has said that he will be watching with interest the outcome of that consultation process.

I have today written to all the general practitioners who practise in Shrewsbury and Atcham. Again, the Prime Minister stated at Prime Minister’s questions, and it was reconfirmed to me by my right hon. Friend the Secretary of State for Health, that the views of local general practitioners would have to be taken into account before any reconfiguration process could occur. I wanted an independent assessment of their views, rather than it being handed to me by the PCT or anyone else. I have therefore written today to all the general practitioners in my constituency and I urge my hon. Friends to do likewise if they so wish. I will compile the results of the views of local general practitioners in Shrewsbury and will share their views anonymously. I will not refer to specific people, but I will share their views with the Minister.

I am extremely grateful for the 15 minutes that I have had and for the constructive way in which we have debated this issue. It is extremely emotive. I do not want to get into a Shrewsbury-Telford pillow fight. We have had enough of that over the years. I want to work constructively with my colleagues and with the trust to come up with the best possible solution for our beautiful county.

Maternity Services

Daniel Kawczynski Excerpts

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 ---

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

I congratulate the hon. Member for Birmingham, Edgbaston (Ms Stuart) on securing the debate. Maternity services are an extremely emotive issue. When my daughter, Alexis, was born at the Royal Shrewsbury hospital, it was the most emotional day of my life. As a non-smoker, I smoked two packets of cigarettes that day.

I pay tribute to the hospital’s staff, whom I found extraordinarily professional, hard-working and dedicated. However, there has been a lack of funding for maternity services in Shropshire hospitals over the past 13 years. The hon. Lady talked about broken promises, and I want to highlight my concerns about the huge inequality in funding for maternity services around the United Kingdom. I sometimes go to Birmingham and I see the hospitals there, and there are huge differences between the quality of the buildings, equipment and resources in Birmingham and the quality of those in Shrewsbury and rural shire counties.

The Royal Shrewsbury hospital covers not only Shrewsbury and the whole of Shropshire, but the whole of mid-Wales, and I hope that my hon. Friend the Member for Montgomeryshire (Glyn Davies) will have the chance to explain the benefits of the maternity services for his constituents. The population of Shropshire and mid-Wales is not that much smaller than the population of Birmingham. Yes, the populations of those areas, even when combined, are smaller than that of Birmingham, but not by much. However, we have only two hospitals to cover our whole area. I am not sure how many hospitals there are in Birmingham. The hon. Lady said that there was a hospital for women’s services in Birmingham. My goodness, I wish we could have a hospital dedicated to women’s services covering my county and the whole of mid-Wales. I will find out how many hospitals there are in Birmingham, but I want to stress that my county lacks facilities.

As a result of the debate, I am also going to research the outcomes in Shropshire and mid-Wales versus those in Birmingham and to look at the resources that both receive. From all the league tables I have seen, many of the outcomes in maternity services are better in Shropshire than they are in Birmingham. Why is Shropshire so far ahead of Birmingham in the league table when it gets a fraction of the resources? The hon. Lady seemed to imply that greater resources needed to be provided, but I would say that we need to learn from Shropshire how it manages to provide such excellent maternity services when it receives such limited funding compared with Birmingham. When I have done that research, I will send it to the Minister.

During the 13 years of the previous Labour Administration—I briefed the Minister on this last night—there was a chronic lack of funding. I am not embarrassed to say that I think the previous Government deliberately targeted inner-city Labour areas with investment and deliberately stripped it from rural counties, which are predominantly Tory. That was done in a political way to put investment into Labour heartlands, and although the hon. Lady won her seat because she is an assiduous and hard-working MP, many other Labour MPs were re-elected because of that direct channelling of resources into Labour inner-city areas at the expense of rural shire counties.

As a result of that chronic lack of funding for Shropshire, a consultation is under way on proposals for a mass reconfiguration of maternity services. That will see in-patient children’s services and consultant maternity services move from Shrewsbury to Telford. My constituents expressed extreme concern about that at a public meeting on Sunday, as they have over the past few weeks. In the six years that I have been an MP, I have never received as many e-mails, telephone calls and letters from concerned parents, clinicians and GPs as I have over these reconfiguration proposals—there is a lot of concern.

I should stress that I expect any proposals put forward by local hospitals and primary care trusts robustly to meet the stringent tests set out by the Secretary of State for Health in relation to support from GP commissioners, public and patient engagement, clinical evidence and patient choice. If those stringent criteria are not met, I very much hope and expect my local council’s overview and scrutiny committee to refer the proposals to the Secretary of State, in anticipation of their being reviewed by an independent reconfiguration panel.

Today, I will write personally to all the GPs in Shropshire to find out their views about the reconfiguration proposals for maternity services, rather than being told by the PCT or the chief executive that GPs are in favour of them. If they are against the plans, I will share that information with the Minister, and I hope she will support me in challenging them.

Yesterday, I had a meeting with the deputy general secretary of the Royal College of Midwives, Louise Silverton, who has promised to help me get the Royal College of Midwives involved. I will also write to the Royal College of Obstetricians and Gynaecologists to find out its views. I have spoken to the Minister, who has kindly agreed to meet me and a delegation of concerned constituents so that we can raise these issues with her.

I do not want to speak for too long, because I hope that my hon. Friend the Member for Montgomeryshire will get a chance to speak. I would not wish a reconfiguration of maternity services on my worst enemy. It is turning my hair grey and I am extremely upset about it. I am cognisant of the views of my constituents and I want to stress that they are very concerned at the prospect of Shrewsbury losing maternity services. People expect maternity services to be ever closer to them, not further away. Our services cover the largest landlocked county in the United Kingdom, with a vast rural expanse, as well as the whole population of mid-Wales, and we hope and expect that maternity services will stay in Shrewsbury and not be moved to the extreme east of the county, to Telford.

[Andrew George]

I do not want to intrude on concerns about reconfiguration in Shropshire. However, on the basis of yesterday’s debate, the Government’s intentions and the principle of “No decision about me, without me”—as well as the intention, at least, under the proposed Government health reforms, that many decisions will in future be made by communities working through their health and well-being boards with the GP commissioning consortia, and with the political support of the Government—presumably the community and GPs in Shropshire have a greater say in the present culture than they might have in the past. I should have thought that my hon. Friend might be reassured by that and would not necessarily need to get Ministers involved in the dispute.

[Daniel Kawczynski]

Yes, I concur with a lot of what my hon. Friend has said. However, I listen to members of the public, because I am directly accountable to them as their Member of Parliament, and often my voting and other decisions are affected by them. There is a bond of accountability between each one of us and our constituents. Unfortunately, chief executives and managers of trusts and PCTs do not necessarily have that bond of accountability. They are here one minute and gone the next. That is the problem. Many of my constituents are trying to engage in the consultation process and put questions directly to the PCT and chief executive, but they are not getting answers. I should like the Minister to be aware of that. If the Government are putting forward public and patient engagement as a stringent criterion of whether a reconfiguration of service should go ahead, it is important that the Secretary of State should have confidence that that aspect of the process has been fully and robustly carried out. My understanding is that the only method of referral is by the council’s local overview and scrutiny committee, but if the council is not minded to do it, what can local people who still have concerns do?

I have been approached about extraordinarily emotive cases, involving women who have major issues to do with maternity and paediatric services. They are very emotional about the prospect of those services being moved away from their community. I want them to be heard.

[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.

[Jim Dobbin (in the Chair)]

I call the shadow Minister.

--- Later in debate ---

[Emily Thornberry]

I respectfully agree with my hon. Friend. In a moment, I shall be speaking about another part of the work force, health visitors. They suffer exactly the same problem. The majority of the work force is over 55. It is important to retain such valuable and experienced people—they are mostly women—but we cannot increase their number if we continue to lose existing staff at the current rate.

According to the Library, the number of births in the UK was projected to fall in 2009-10, in 2010-11 and in 2011-12. If the Prime Minister’s pledge was based on the latest birth projections, perhaps he expects to cut the number of midwives. That is clearly nonsense. We need to consider what is needed and ensure that it is fulfilled.

My hon. Friend the Member for Birmingham, Edgbaston made a devastating analysis of the difficulties that will be caused by the changes the Government propose. How can we make forward projections and how are we to manage the national health service if we give NHS commissioning to doctors? They will simply consider the needs of the local area and not our national needs.

In passing, may I briefly touch on the important issue of Sure Start? During the election, the Prime Minister claimed that Labour was scaremongering when we said that there would be difficulties in relation to Sure Start. He said:

“Yes, we back Sure Start. It’s a disgrace that Gordon Brown has been trying to frighten people about this.”

The Under-Secretary of State for Work and Pensions, the hon. Member for Basingstoke (Maria Miller), then the shadow Minister for the family, said:

“It’s unforgiveable that Labour has used the tactics of creating fear and anxiety amongst families and Sure Start staff”.

[Mr Roger Gale in the Chair]

The Minister of State, Department for Education, the hon. Member for Brent Central (Sarah Teather), has said:

“Sure Start is at the heart of our vision for early intervention”

If that is true, why did the charities 4Children and the Daycare Trust find out that 250 centres, which serve 60,000 families, are certain either to close or be earmarked for closure? There are 3,578 children’s centres in England, 3,100 of which have been told that their budgets will be cut this year. About 2,000 services will be cutting their services as a result. The findings are based on responses from almost 1,000 Sure Start managers to a questionnaire sent out by 4Children and the Daycare Trust.

It is hugely important for a new mother to be able to find a friend, get guidance and go to a children’s centre. Nevertheless, centres offering such services are being cut. The other friend that mothers need is the health visitor. Again, when the Prime Minister was in opposition, he made a big thing about increasing the number of health visitors:

“The substantial increase in the number of health visitors will mean that families get more support—from properly trained professionals. Health visitors will be able to spend time with families, have the opportunity to spot parenting issues, and build the trusted relationships needed to help with them. For instance, if they feel a mother is not bonding with her baby, and recognise the cause as post-natal depression, they might gently recommend that she visit her GP, or steer her towards a local counsellor.”

He was absolutely right; no one can disagree with that. However, when I met London health visitors from the Community Practitioners and Health Visitors Association earlier this year, they told me that there was a huge problem in recruiting new health visitors. They were losing a lot of older, experienced staff through early retirement. Nearly a third of health visitors in London are over 55 and they have dangerous work loads. In some cases, there are more than 1,000 children per five health visitors. That is four times higher than Lord Laming—the writer of the Baby P and the Victoria Climbié reports—recommended. His recommendation is for health visitors to have a quarter of their current work load.

In an area such as London, which is very demanding, current work loads are dangerous. We need more health visitors. The Government recognise that a health visitor should have no more than 250 children under five and no more than 100 in highly vulnerable areas, as was recommended by Lord Laming and the Community Practitioners and Health Visitors Association. Will the Government consider that recommendation when they look again at how many health visitors are needed?

When I asked the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), whether the Government would take responsibility for recruiting and training the extra 4,200 health visitors promised, the answer I received was odd. She said that she will learn from the decisions on the case loads and they will be “locally determined”. In the same answer, she says that the Department is shortly to publish plans to

“conduct a demographic and geographical analysis to establish location and population need and match with trainees and training places; and ensure positive correlation between work force growth and population need.”—[Official Report, 27 January 2011; Vol. 522, c. 460W.]

On the one hand, the Government say they will look nationally and decide what the need is, and on the other they say that it will be left to localities to decide. We really cannot have it both ways. What we have is a lack of health visitors.

[Daniel Kawczynski]

The hon. Lady talks about the need for more health visitors and staff and maternity services. If there were a Labour Government, the NHS would not be ring-fenced and there would be cuts in the NHS budget. Only our party has promised to ring-fence the NHS budget. How can she promise additional services when there would have been cuts in the NHS budget under Labour?

[Emily Thornberry]

Although the Government have said that, in principle, there is a ring fence to the NHS budget, a closer analysis will show that that is not true. The real position is that there is double-counting of over £2 billion—

Termination of Pregnancy (Information Provided)

Daniel Kawczynski Excerpts

Tuesday 2nd November 2010 Commons Chamber

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

I am very pleased that my hon. Friend has raised the issue of the rights of women in this context, but what about the fathers? I hope she agrees with me that the law needs to be examined to ensure that the rights of the potential father are taken into consideration.

[Nadine Dorries]

I thank my hon. Friend for his contribution, but I am afraid that I must stick to the point of the debate, because otherwise we shall run out of time.

Does not the way in which abortions are carried out in this country today almost amount to abuse? We need to take lessons from our European neighbours. In Germany, women are offered counselling and a cooling-off period. That gives them a chance to breathe and think. It gives them support. They are informed about the procedure, and of the possible consequences. They are provided with alternative routes other than the surgical removal of a life. They are given information about adoption—and yes, I know that people throw up their hands in horror when that is mentioned, but it is not our pregnancy, and it is not our baby.

We have no right to institutionalise and frame a decision-making process that is void of choice for the women who seek information. It is a woman’s right to choose, and women should have the right to be given every shred of information that we have and every alternative option. If a woman wants to continue with her pregnancy and deliver her baby for adoption, she should have the right to choose to do so. If she does not, at least she can emerge from the abortion process feeling that she made an informed decision. She can emerge feeling that she went in empowered and not helpless, strong and not vulnerable, and believing that she did the best thing because she knew exactly what she was doing and had full knowledge of every available option. She will be able to draw strength from that in future.

Women are entitled to an option. They are entitled to give informed consent, which should be explicitly supported by pro-choice and pro-life campaigners. When it comes to a decision of such magnitude, it is vital for women to receive information that is absolutely accurate and is given calmly, without coercion or a principled bias and, in particular, without political ideology. Last month ComRes, the pollsters, revealed after an extensive survey that 89% of people agreed with that. They think that women should be entitled to have more information when requesting an abortion. Given that overwhelmingly high figure, it is time that this House paid some attention. I hope the Minister agrees that it is time that we took a little more care of women undergoing such a procedure. It is time that we introduced a statutory process of informed consent and a cooling-off period. The European evidence shows that that could provide us with a considerable reduction in the number of abortions, and everyone would surely welcome that.

I shall finish by mentioning a book which is to be launched this month. It is published by the charity Forsaken, which is neither pro-life nor pro-choice: it is pro-women. For two years, the charity has put together the stories of women suffering from post-abortion syndrome. Reading the book is so heart-wrenching that we just want to reach out and take their pain away, but we cannot. There is no going back. We cannot make it better; abortion is a procedure to end life—it is final.

The women interviewed for this book feel that talking about abortion is taboo. That forces them into silence, leaving them unable to express their suffering. Abortion really is a taboo subject. We will never see an abortion filmed on television; we will never see that screened. It is still the taboo subject that we do not talk about.

One woman in the book describes how even when she told the anaesthetist that she was changing her mind and was having doubts, he pushed her to go ahead. He did so because, if she changed her mind, he would not have been paid. There is the same process as for the counselling. If the woman does not go ahead with the abortion, the clinics are not paid for the counselling, and therefore they need to know that she is going ahead before she is given the counselling—and we can imagine the process that ensues.

I will conclude by reading a paragraph from the book, giving a young girl’s account:

“An uncle dropped me off at the clinic with a letter to give to them. I don’t know what that letter was. At this point, I was holding onto the thought that they were only checking me. The staff at the clinic were very nice there, seemingly courteous and kind. It was not my usual surgery, I did not realise it was an abortion clinic until I was shown into a counsellor’s room. When I went to the counsellor’s room, I was asked: ‘Why don’t you want to keep this pregnancy?’

‘I want it but my family don’t want it,’ I replied, and promptly burst into tears. ‘They won’t support me and I can’t look after it myself.’

Nothing more was said that I remember...I was given a bed—there must have been 20 of us crowded into that ward. I was the first in line. As I waited, I scanned the corridors for some means of escape, but I was already wearing my hospital gown and no underwear. It wasn’t long before a man brought a wheelchair to take me to the operating theatre. For a brief moment I wondered if I had the strength to run away, but instead I sat obediently into the chair.”

That is a story of loneliness, suffering, emptiness and loss that many thousands of women live with day after day. It is they who become the 30%.

It is time for the UK to catch up with the rest of Europe and introduce informed consent in an attempt to ensure that stories like this become a rare exception. It is time for this country to start looking after our young girls and women at the most vulnerable time in their lives and treat them with some respect.