Maternity Services: Gloucestershire

Debate between Danny Chambers and Max Wilkinson

Wednesday 9th October 2024 Westminster Hall

[Max Wilkinson]

I would. The hon. Member makes a strong case, and I will come on to some of the evidence from the Royal College of Midwives later. It has done some important studies into the stress that midwives are put under in the system.

I will move on to Stroud—the hon. Member for Stroud (Dr Opher) is in his place. In Stroud, six post-natal beds were closed around the same time as the closure to new births at the Cheltenham Aveta centre. The reason given by the trust was that the temporary closure would consolidate staffing across the county and provide a safer level of care for births across the whole of Gloucestershire. I am certain the hon. Member will have more to say on this if he is called to speak later, and I am pleased to see him here.

In our county, the 6,000 families who rely on our maternity services each year view this as a significant downgrade in service, and it is a cause of worry for a large number of families. It is clear that these services can only reopen when staffing levels improve. At the moment, the trust says it is around 13% below the staffing level required to return to the previous level of service, with Cheltenham open and the beds reopened in Stroud. However, the nature of midwifery means that quite a lot of the midwives will be off on maternity leave themselves at any one time. Indeed, I will come on to talk about the stress that midwives are under and some of its causes, which have led to a larger proportion of midwives being off for a significant period of time each year than staff in the rest of the NHS.

Research into what is driving the recruitment and retention crisis exposes the scale of the challenge we face in Gloucestershire and across the rest of the country. We are told that recruiting to a trust under a section 31 safety notice is even more challenging than it is elsewhere. Midwives who are already under significant pressure are subjected to additional strains in the form of monitoring and bureaucracy, and that can have an impact on staff morale. Of course, monitoring and bureaucracy are important when we are trying to get trusts out of safety notices; however, we cannot look past the fact that that makes it more difficult to overcome those recruitment challenges.

If that were the only barrier, it would be somewhat simpler. The Royal College of Midwives conducted a randomised survey of weekly hours worked by midwives and maternity support workers. The findings were absolutely shocking. It found that the staff surveyed reported a collective total of nearly 120,000 unpaid hours that week. That is a stark illustration of the demands placed on frontline NHS staff, who go above and beyond in a system that appears to be falling apart at the seams.

It is no wonder that the Darzi review reports that there is a high rate of sickness absence among midwives at 21.5 days a year per midwife. The most common reasons cited for absence were anxiety, stress or depression, or other psychiatric illnesses. Midwives go into the profession because of a commitment to the health of women and babies and to giving care at a critical moment, and to be part of a joyful moment in so many families’ lives. The fact that they are collectively suffering such high levels of stress tells us just how badly wrong the system has gone.

[Dr Danny Chambers (Winchester) (LD)]

As the Liberal Democrat spokesperson on mental health, I believe we should acknowledge and pay tribute to NHS staff in general and specifically midwives because we know that one factor that causes stress is overwork. We are also aware that the NHS very much runs on good will—people working extra hours and unpaid hours. That has been the norm for many years, but it is not sustainable. We need to acknowledge the support they need from a mental health point of view.

[Max Wilkinson]

My hon. Friend makes a strong point. Employee assistance schemes have a strong role to play here. I understand that in the NHS there is quite good support in general. However, it is a massive struggle when people are working so many extra hours to ensure that they get the support they need. In the case of midwifery, it is a stressful job—a life-and-death matter in many circumstances.

There is a clear and obvious link between the extreme overwork identified in the RCN survey and the findings of the Care Quality Commission. Obviously, if staff are working so many extra hours, they will suffer. Gloucestershire Hospitals NHS Foundation Trust has identified staff turnover levels and low morale due to the workload as significant factors. The Darzi report also calls for a shift away from care in centralised hospital settings towards communities, and states that that is a likely route towards the recovery of our health services. That being the case, and with a Minister in the room, I say that there is a clear argument for restoring Cheltenham families’ access to a fully functioning birth unit in our town as soon as it is safe to do so.

I have three questions for the Minister, if she would be so kind as to answer them. First, what is the Government’s position on seeking to reinstate maternity services in places such as Cheltenham and Stroud, which have been recently downgraded? Secondly, what will the Government do to address the ongoing recruitment and retention crisis in midwifery? Thirdly, in cases such as Gloucestershire’s, where a section 31 notice is exacerbating recruitment and retention issues, what can the Government do to help local trusts improve their staffing position? I understand that there are examples of trusts around the country being supported to pay high wages and salaries to ensure that midwives can be properly recruited and to overcome shortages.