Maternity Services

Al Pinkerton Excerpts

Tuesday 25th February 2025 Westminster Hall

[Jess Brown-Fuller]

I agree wholeheartedly that we need to change the way that we do litigation, because NHS trusts often argue that they want to learn and grow from poor experiences, but the litigation system means that they rarely have the opportunity to do so, because everybody is so afraid to speak out. We need to change that culture within maternity services and the NHS as a whole.

As a country, we are training more midwives than ever before, yet retention remains a problem and the pandemic exacerbated an already difficult situation, with highly trained midwives with families or caring responsibilities leaving the profession too soon.

[Dr Al Pinkerton (Surrey Heath) (LD)]

I congratulate my hon. Friend on bringing this debate here today. Frimley Park hospital in my constituency received an outstanding report from the Care Quality Commission in 2023, but it none the less identified that inadequate staffing remains one of the highest risks on the maternity register. That has daily implications; many midwives reported, for example, that daily checks were often incomplete, handovers were interrupted and not standardised, and mandatory training was often not completed.

Does my hon. Friend agree that to ensure high-quality maternity care, from admission to discharge, requires not only stringent oversight by trust boards, but far greater care for staff in the setting of the hospital, providing safe spaces where conversations can be had, handovers can take place, and nurses can rest? In that way, we will both retain and also hopefully recruit more of our vital nursing staff.

[Jess Brown-Fuller]

My hon. Friend is absolutely right; the key to providing strong maternity services that benefit both the staff and the patients is making sure that there is a full workforce so that they can do not just the “need to haves”, but the “nice to haves” in a maternity department, which can make such a difference to patients’ experiences when they are going through that service.

The retention issue that we have directly impacts training. Newly qualified and inexperienced midwives need experienced mentors, but if seasoned professionals leave, the next generation lacks the support necessary to transition into leadership roles. Midwives and other maternity staff must train together at every level to be fully equipped for every situation, and ensure that concerns can be escalated effectively. That is why the Ockenden report and the Royal College of Midwives seek a commitment to including midwives in the long-term workforce plan.

In 2017, bursaries for student nurses and midwives were ended, with the Royal College of Midwives warning that that decision threatened the future of our maternity services in England. It has led to one third of midwifery students having debts exceeding £40,000, with 80% of them knowing someone who has dropped out of their course due to financial hardship. Many also take on additional jobs to afford their studies, which detracts from their vital training. To mitigate those pressures on trainee midwives, I encourage the Government to explore alternative routes to support midwifery and nursing students, which have been laid out by the Royal College of Midwives, through new funding options or a scheme where student debt is forgiven after a defined period of service in the NHS.

A similar funding issue affects apprenticeship schemes in midwifery. Despite receiving overwhelmingly positive feedback from trusts across the country regarding the apprenticeship route, many trusts cannot afford to offer those positions due to a lack of backfill funds, so trusts often hand back their apprenticeship levy, as the scheme is undeliverable. I hope the Minister will work with her colleagues in the Department for Education to address this fundamental flaw in the delivery of level 6 and level 7 apprenticeships, which have proven to deliver the midwives of the future.

In preparing for today’s debate, I was invited to my local maternity unit at St Richard’s hospital in Chichester, where as I mentioned I had both of my children. University Hospitals Sussex had its maternity services inspected by the CQC in September 2021, which found all hospitals across the trust to be inadequate or requiring improvement. Although there has not been a formal inspection since, the trust assures me that all actions from the CQC have been completed, with the majority of the Ockenden immediate and essential actions implemented. However, to fully implement all the IEAs will require funding, which currently the trust does not have.

St Richard’s hospital confidently tells me that it is now fully staffed for the first time in a long time, and the director of maternity services is keen to look at how she can further improve patient experience and communication. I know Members across the House are keen to work with their NHS trusts constructively to ensure the best outcomes possible for their constituents. I was reassured by the senior leadership team, those working in the department, and the new parents on the ward, who I had the pleasure of congratulating. Introducing tiny babies to the world was probably the best moment of my recess—it was very bizarre for those parents when the MP walked in and said, “Can I say hello?” I am pleased that the trust is taking seriously its responsibility to provide a much improved service.

It would be a missed opportunity if I, as the chair of the all-party parliamentary group for infant feeding, did not mention how we could do much more as a society to support mothers to breastfeed, if they choose to. The UK’s breastfeeding rates are among the lowest in the world. Only 1% of mothers exclusively breastfeed at six months, despite the World Health Organisation recommending exclusive breastfeeding for this period and continuation, alongside nutritious foods, for up to two years. Some 44% of mothers surveyed wished that they had breastfed for longer and would have done so if they had received better and more tailored support. New mothers need time, expertise and evidence-based information to make informed decisions on their feeding choices, and maternity services play a key role in establishing a feeding plan that works for mother and baby before they go home. But, across the country, community midwifery and health visiting services have been vaporised, so support is patchy and often delivered by volunteers or midwives in their spare time. I hope that the Government will support improved community services such as milk support groups, to give all women, regardless of their feeding choices, somewhere to turn when they need support.

I will take this opportunity, perhaps selfishly, to get on record the name of one of the coolest kids I ever met. Benedict Henry Goodfellow was an absolute dude—[Interruption.] I am not going to cry—and I am proud to call his mum, Steph, one of my close friends and the strongest woman I know. This debate is so important to me because Bendy needed 24-hour care since birth after a case of extreme birth trauma left him with devastating neurological damage. Bendy was loved by everyone who came into contact with him until he died, aged 10. The experience left Steph traumatised and profoundly changed. Bendy was born nearly 30 years ago and yet Steph and Ben’s story is just as relevant today. It should not be.

I am immensely grateful to Donna Ockenden for putting me in touch with families from across the country—including from Leeds, Nottingham, Shrewsbury and Sussex—ahead of this debate to hear their personal experiences of failures in maternity care.

Hospice and Palliative Care

Al Pinkerton Excerpts

Monday 13th January 2025 Commons Chamber

[Gregory Stafford]

Well, the simple fact is that what the hon. Members and his Front-Bench team are doing is ensuring that the NHS is worse off, because raising the money will have a greater impact on the rest of the service. [Interruption.] The Minister for Care is shouting at me from the Front Bench, and I am sure that, in his response to the debate, he can outline whether he and his team knew about the national insurance contribution rises and whether they planned for them.

The other part of this is the workforce, who have been touched on briefly. There is a real shortage of qualified healthcare professionals. Vacancy rates for hospice nurses have risen to nearly 19%, and the corollary is that staff morale is low. Again, the Government need to make sure that the long-term workforce plan that they and the NHS are rolling out includes how we will ensure that hospice staff are part of the long-term funding. Hospice UK has warned, seriously, that without urgent action, some, indeed many, hospices may be forced to close their doors in the next 12 months.

I have some requests of the Government. First, as the hon. Member for Birmingham Erdington (Paulette Hamilton) said, we need them to commit to a long-term sustainable funding model for hospices. That is not to say that hospices should be brought into the central NHS—I personally believe that the innovation of the hospice sector is down to its independence from the NHS—but they need multi-year funding to understand where they stand.

Secondly, as has been mentioned, we need to scrap the postcode lottery that comes from the integrated care boards. Some kind of ringfenced funding, particularly for children’s hospice grants, would prevent a lot of the delays and inequities in the service. As I said, we need to make sure that hospice staff are integrated into the NHS long-term workforce plan and are paid in parity with similar NHS roles.

[Dr Al Pinkerton (Surrey Heath) (LD)]

Will the hon. Gentleman join me in paying tribute to the Phyllis Tuckwell hospice, which does great work in his constituency and mine? I have been speaking to the hospice over the last few days, and it requires £25,000 a day to maintain its services. The hospice has told me that it desperately needs multi-year funding settlements to offer a guarantee of future financial security, as well as a clearly articulated workforce plan to ensure continuity of high-quality staff.

[Gregory Stafford]

I think I mentioned Phyllis Tuckwell at the beginning of my speech, so I entirely agree with the hon. Gentleman. It does fantastic work in Farnham and across Surrey and Hampshire. I am sure like all hospices around the country, it relies on donations but requires secure funding from the Government.

I welcome the £100 million of capital investment. We need to remember that hospices and palliative care are not a “nice to have.” They are absolutely essential charitable services, and they must be fully integrated into the funding and planning frameworks of the Department of Health and the NHS. They provide compassionate, life-changing care to thousands of adults and children every year. However, this vital work is being undermined by short-sighted Government policies.

If the Government are serious about improving end of life care and reducing hospital pressures, they must deliver fair funding, address workforce challenges and ensure that no family are left without the care they need, regardless of where they live. This is not just about numbers—the Minister might listen to this. It is about dignity, it is about compassion and it is about humanity at the most vulnerable time in people’s lives.

Access to Primary Healthcare

Al Pinkerton Excerpts

Wednesday 16th October 2024 Commons Chamber

[Dr Al Pinkerton (Surrey Heath) (LD)]

For my constituents in Surrey Heath, access to primary care—whether GPs, dentists, pharmacies or optometrists—has increasingly become a postcode lottery. Vast dentistry deserts—maybe not of Saharan scale—have opened up across Surrey Heath, with residents simply unable to find an NHS dentist with an open list for them or their families. When a list does open up, it almost immediately closes again due to the overwhelming demand. Today, families are being forced to seek private provision for their dental care—if they are able to stretch their finances that far—or they simply forgo dental care altogether. During the recent election, I even met a constituent who had resorted to an amateur tooth extraction because of the lack of affordable dental treatment locally.

The postcode lottery extends to GP services too, although the issue of access takes on a slightly different form. Surrey Heath has some excellent and much-loved GP practices that are working hard to put the experiences of users first, but others have booking systems, triage mechanisms and approaches to communication that leave patients feeling anxious and frustrated.

I pay particular tribute to the surgery in Lightwater, a village in my constituency. Residents regale me routinely with stories about the fast, efficient and friendly telephone service it provides, the availability of on-the-day appointments and the generally high quality of the service. It is little wonder that residents from miles beyond Lightwater are so desperate to move their registration to that particular well-run surgery.

Some other surgeries, however, are not so highly praised. They are criticised for their impersonal online booking systems and inappropriately long waiting times for appointments, sometimes requiring patients to wait a month or so to see a GP. This is not just poor practice; it has real-life implications for the health outcomes of patients and for the economy, as residents take longer to be seen, longer to be treated, longer to recover, and longer to get back to work than if they had been seen earlier. Online booking systems risk creating a digital barrier to entry for our most vulnerable residents. It cannot be right that those requiring healthcare might be dissuaded from seeking it because of the complexity of approaching their GP, or because they do not have, cannot afford or cannot operate the technologies required to book an appointment.

Our local pharmacies, too, are under huge strain, and I commend the incredible local independent pharmacies who look after communities across Surrey Heath so well. I am incredibly pleased that we are having this debate today, not only to talk about the challenges of primary healthcare but to highlight some of the great practice that we can see within our communities. We need to support our local pharmacies, which deliver so much care and support, and we need, as the Liberal Democrat manifesto proposed, to enshrine the commitment that patients can see a GP within seven days—a commitment underpinned by an associated commitment to train and recruit thousands of GPs every year.