Maternity Services: Gloucestershire

Jim Shannon Excerpts

Wednesday 9th October 2024 Westminster Hall

[Max Wilkinson (Cheltenham) (LD)]

I beg to move,

That this House has considered maternity services in Gloucestershire.

It is a pleasure to serve under your chairmanship, Sir Christopher. The hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown) sends his apologies; he was due to be here but he is counting the votes somewhere else at the moment in an important internal election. He wanted me to start by saying that he gives his full support to the comments that I and others will make in support of maternity services in Gloucestershire, so I hope Hansard reflects that.

It is not controversial to say that NHS services across the country are struggling. One of the services that impacts all of us at least once in our lives is maternity care. This service is at the heart of women’s healthcare; it must be treated with the utmost seriousness. Pregnancy and childbirth is a special moment for families. It is a memory I cherish—obviously I was not pregnant myself. It is something to be cherished by all. But for pregnant women it can also be an extremely stressful experience. If there are failures in the system, the consequences can be dire.

Some of those consequences were laid bare in the recent “Panorama” documentary on maternity services in Gloucestershire. In that documentary we heard too many harrowing stories. Brave whistleblowers from within the system and brave mothers told their stories—one brave father told a story too. Those stories were told in the most heartbreaking terms, and will stick with me for as long as I live. Gloucestershire Hospitals NHS foundation trust apologised for those failings. It has invested in increased staffing, worked to reduce staff turnover and has made changes to leadership in maternity care. But so much more needs to be done.

The service at Gloucestershire Royal hospital was rated inadequate in 2022 and again in 2023. The findings of a further inspection earlier this year are still awaited, but a section 31 safety enforcement notice was served in May. Cheltenham’s midwife-led Aveta birth unit serves a large chunk of our county. It was closed for births in autumn 2022, some time before six of our county’s seven Members of Parliament were elected. The closure was due to a shortage of midwives. The reorganisation by the hospital’s trust was carried out to ensure that one-to-one care across Gloucestershire’s wider maternity services could be achieved. It is an entirely understandable response; nobody would want to put mothers and babies at risk.

We were told, however, that the measures were temporary. Two years down the line they are still in place, and that is not an acceptable situation for people in our county. The NHS hospital trust suggests that the Cheltenham Aveta centre will not re-open for births before April 2025. Even then, nothing seems certain. The trust states that it is committed to reopening the centre when it is safe to do so. However, the byzantine way in which the NHS sometimes works means that it is difficult to work out who will be the ultimate decision maker. Sometimes decisions on resources are made by the integrated care board rather than hospital trust staff, and that collaborative process makes it difficult to work out who must be held to account for statements that have been made in the past.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman on securing this debate. Everyone in this room will be very aware that the difficulties in Gloucestershire are unfortunately replicated in every part of the United Kingdom—certainly in my part of it. We have some of the best staff in the world in our maternity wards, and we rightly recognise the good work that they do, but they are being hampered in doing their job and caring by understaffing, budgetary restraints and an inability to get support from senior staff. I believe this needs a root-and-branch change across all the United Kingdom. Would the hon. Gentleman agree with that?

[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.