Maternity Services: Gloucestershire

Alex McIntyre Excerpts

Wednesday 9th October 2024 Westminster Hall

[Alex McIntyre (Gloucester) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Cheltenham (Max Wilkinson) on securing the debate and bringing attention to the challenges that our maternity services face in Gloucestershire. I must declare that as well as being an important subject for my constituents, this is a personal subject for me, and I am privileged to contribute my family’s experience to the debate today.

My little boy, who turns one later this month, was born in the county and spent his first night at Gloucestershire Royal hospital. While it is clear that there are challenges facing our maternity services and that improvements are required, I want to start by sharing the positives of our experience.

First, the support and care provided by the community midwifery team was second to none. Our midwife Lynsey was with us throughout our journey, and was even on call the day my wife went into labour, so she was there to deliver our little boy. Lynsey looked after us throughout my wife’s pregnancy, answering our questions and signposting us to courses that would enable us to become advocates for the birth we wanted. From the outset, our experience was positive, although I know that is not the case for all families, and it is essential that their voices are heard in this debate.

Being able to choose where you have your baby is important. Having conducted our own research, we decided that we wanted to give birth in a midwife-led unit. There are of course differing views on that, but that was our choice as we had read that midwife-led care can lead to fewer interventions. At the time in Gloucestershire, Stroud was the only reliable option, as Gloucester’s midwife-led suite was frequently closed due to a lack of available midwives. As part of our maternity care, we were invited to Stroud maternity unit to visit the birthing suite so that it was familiar on the big day. I understand that is very important, as stress produces hormones that can actually stop or slow down labour.

Once my wife was in labour, however, our plans were nearly changed at the last minute due to a lack of midwives at Stroud maternity unit—stress we could have rather done without. That highlighted to me the great reliance currently placed on midwives working overtime to cover shifts across Gloucestershire. However, with Lynsey on hand and with minimal intervention, the birth itself was relatively quick and our baby boy was born. It was truly the best moment of my life.

Unfortunately, my wife needed an operation after the birth, so we were transferred to Gloucestershire Royal hospital: wife and baby in an ambulance, me following behind on what was, following the best moment of my life, the scariest car journey of my life. The care we received that night was exceptional. Not only were my wife and baby looked after, the unbelievably compassionate team looked after me too. Something as simple as a cup of tea and a reassuring chat when I had been up for 48 hours and left on my own with a newborn baby was transformative.

Unfortunately, things were not so positive the following morning. All was well with mum and baby, and we were told we would be going home in the afternoon. I went home to grab a quick shower, get some shopping in and make sure the house was ready for our new arrival. I was gone for at most two hours. When I got back, my wife told me she had been visited by over 10 different people in those two hours: pharmacy assistants, nurses and midwives, each adding new information about her discharge. She had just had a baby and undergone surgery under general anaesthetic. There were instructions for her and our baby. None of them were written down. For her, it was overwhelming, and something as simple as written discharge notes would have made a huge difference.

After we got home, our baby unfortunately developed some issues with his breathing. That can be quite normal, I understand, as babies are used to breathing fluid and getting oxygen via the umbilical cord. But as first-time parents who had been awake for 60 hours, we were worried, and there was no one to turn to. We phoned Stroud maternity unit, where we had given birth, but their post-natal unit is closed due to a lack of midwives, as the hon. Member for Cheltenham rightly pointed out. They advised us to call 111, and they told us we had to call Gloucestershire Royal’s delivery unit. They told us we had to call Stroud maternity unit because that is where we had given birth. We went back to Stroud, then back to 111, and no out-of-hours GP service was available. The only solution was to go to A&E.

Taking a newborn baby to A&E on a Saturday night is an interesting experience. The staff in A&E were wonderfully friendly, but their procedures limited what they could do. Our baby could not be seen by the neonatal unit as we had been discharged from the hospital. He would have to go to the paediatric unit, which the staff warned us was rife with covid. All we wanted was someone medically qualified to listen to his chest and let us know he was alright. There must be so many parents in a similar position, learning the art of being a parent for the first time and needing that little bit of assurance that their baby gasping for air is going to be okay. We need to find a better way for those parents to access that care.

Overall, I have to say a huge thank you to the team who looked after us from the early days of pregnancy right up until our son was born. How lucky were we to have our community midwife there at the birth—the person we had grown to know and trust? But in a way, that points to another problem: Lynsey is just one of many midwives across the county being pulled from the community to fill gaps in midwifery services.

Across Gloucestershire, vacancies and turnover rates in midwifery services remain high. The increased workload is causing low morale, and the workforce is struggling with the level and pace of change required for the service. Community midwives such as Lynsey regularly find themselves on call when too few midwives are available at midwife-led units in hospitals. Right now, there are vacancies for 32 midwives in Gloucestershire, which is 13% of the workforce. When we take into account sickness and maternity leave, that figure rises to 63 full-time equivalent vacancies. It is no wonder that midwives such as Lynsey are being asked to fill the gaps.

As the hon. Member for Cheltenham pointed out, the Royal College of Midwives estimates that across the UK, midwives give more than 100,000 hours of unpaid time to the NHS every week to ensure the safe running of services. While no one could doubt the dedication and compassion of those incredible midwives, that cannot be right. We cannot continue to rely on the commitment of midwives to their vocation to fill those gaps. If midwives are working more than 100,000 hours of unpaid overtime a week, it is inevitable that services will be affected, and that the safety of mothers and their babies will be put at risk. Midwives are being driven from the profession because the work and the pressure of work is just too much. It is no wonder my wife left hospital with no written discharge notes—where was the time left to write them?

While our experience of Gloucestershire Royal was largely positive, others have not been so fortunate. Many will have seen the harrowing instalment of “Panorama” that aired on the BBC in January this year, which focused on maternity services in Gloucestershire. The programme included the tragic deaths of the mother and two babies at the hospital between 2019 and 2021. Feedback from staff suggests that chronic staffing issues and a poor culture where midwives felt unable to speak out about unsafe conditions played a large role in what were avoidable deaths.

We also need to ensure that in a diverse city such as Gloucester, all residents—including those for whom English is a second language—can access the care they need. The recent CQC inspections of services in Gloucestershire have been very concerning, and Gloucestershire Royal hospital was issued with a section 31 enforcement notice by the CQC earlier this year. I raised this with the chief executive of the trust in my meeting with him in my first few weeks as the new MP for Gloucester. I understand that the trust has already made progress on its improvement plan, and I will keep a close eye on that on behalf of all Gloucester residents.

Earlier this year, the CQC published the national review of maternity services in England. It reviewed 141 units across the NHS and highlighted widespread issues with staffing, buildings, equipment and safety management processes. There are many deeply troubling takeaways from this report, but what stuck with me was the CQC’s stark warning that across our maternity services, preventable harm is at risk of becoming normalised. The last Conservative Government pushed our maternity services—our midwives—to the point where preventable harm could become a routine consequence of understaffing in units and on wards up and down the country. We cannot accept this for the future of maternity services in Gloucestershire or the UK.

I urge the Government to ensure that maternity services are given due attention when considering the Secretary of State’s 10-year plan for our NHS. Staff shortages are not the only issue we need to address, but it is clear that they are fundamental to the challenges our maternity services face in Gloucestershire and across the country. The Government have committed to training thousands of new midwives. We must honour that commitment to ensure that giving birth in the UK is safe, that parents have choice, and that midwives feel supported and valued for the incredible work they do.