health

Lord Beith Excerpts

Tuesday 18th September 2012 Commons Chamber

[Sir Alan Beith (Berwick-upon-Tweed) (LD)]

I am very glad to have this opportunity to raise the important issue of the lack of maternity services in Berwick, and I hope that it will prove helpful that the Minister replying to the debate is a specialist in obstetrics and gynaecology.

Berwick is 50 miles from the district general hospital—although there is one that is slightly nearer on the Scottish side of the border, the Borders general, which we also use quite extensively. That is a long way to travel for a birth, but on 6 August all deliveries at the Berwick midwife-led maternity unit were suspended. Along with that went all overnight recovery stays for people who had given birth in the Wansbeck or Borders general hospitals. There are now no facilities to support home births in the area, which is contrary to National Institute for Health and Clinical Excellence guidelines, and no evening antenatal clinics because the unit is open only during the day.

Two reasons for the suspension of the services were cited. One was that staff were not getting enough experience of deliveries. That has been a long-standing problem, and a review was taking place to address it—and the problem could have been addressed. Reference was later made to two incidents that were seen as a reason for taking more urgent action. However, the details of those incidents have not been disclosed, probably because proceedings relating to them may still be taking place.

The announcement caused great distress to the midwives concerned, who are much respected locally, and caused fury in the local community. Plans for Berwick’s new hospital are being drawn up, and many people believe that the trust might be trying to avoid providing maternity services there. The trust has often assured me that that is not the case, but there is increasing suspicion. Meanwhile, these services are absent, so mothers have to travel 50 miles to give birth. That is not the only issue.

One mother told me she had been driven the 50 miles to the Wansbeck hospital and examined there, but the hospital staff said, “No, you’ve come here too soon. Go home.” She was then driven 50 miles home. Within an hour or two of arriving back, she became convinced labour was about to start, so she was again driven by car 50 miles to the Wansbeck, where she was examined and the staff said, “No, we think you should go home. There’s no need for you to be here at present.” She dug her heels in, however, and said, “No, I’m not going. I’m staying here.” Within the time it would have taken for her to return home again—taking her total journey to 200 miles—the baby was born at the Wansbeck infirmary. That story serves to illustrate that the issue is about not births alone, but all the associated journeys that may be involved. That is one of the reasons why we generally try to provide maternity services reasonably locally.

The review that is taking place should look at how we can ensure that we have maternity services in Berwick that have the full confidence of the trust and the clinical staff. The majority of local mothers initially opt for births at Berwick, but by the time of delivery, the majority of them have accepted advice to have delivery at Wansbeck or the Borders. One has to ask why that is the case. Any mother reading the NICE guidelines, which are given to mothers, will say, “Oh, ambulance transfer might happen after labour has begun!” An ambulance transfer takes two hours; that is the specified NHS time for an ambulance transfer from Berwick to Wansbeck infirmary. It is clear that doctors often feel that they do not want to take any risk at all, so they recommend that delivery should take place at the distant hospital.

Some of the problems and other characteristics of a small unit that might have led to this situation arising can be addressed. The experience issue can be dealt with by staff rotation, so giving them time in a busier hospital to maintain their experience. Having consultants on call, and ensuring they can get to the local hospital more quickly than a transfer can take place, is another necessary feature. Such matters need to be examined much more carefully. Also, there is a role for telemedicine and the practice of having a consultant at the larger centre make an early assessment of whether problems are arising that need to be dealt with. The number of births at our maternity unit have at times been very low because the majority of mothers have been advised to go elsewhere. There was an entire year in which there were only 13 births, but the numbers have increased again, and at the time when the closure took place, 40 women were booked in to have their births at Berwick.

My overriding concern is for the safety of mothers and children, but it ought to be possible for most births to be safely carried out locally. In our debates on this topic, many Members have referred to problems in transfers to hospitals 10 or 15 miles away, but I am talking about a transfer of 50 miles for every birth to a Berwick mother. The majority of mothers in the Berwick area want to have their babies born in Berwick, and they should be able to do so and have confidence that the necessary skills and support are in place.

At last week’s Prime Minister’s questions, the Prime Minister set out that changes in clinical services should not be made without these four conditions being satisfied: support from GP commissioners, strengthened public and patient engagement, clarity on the clinical evidence base and support for patient choice. Those conditions are not satisfied in what is happening in my constituency, and they certainly would not be satisfied by a total withdrawal of maternity services, including delivery, at Berwick. I seek the Minister’s assurance that those conditions remain relevant and that the attention of the health care and primary care trusts involved in taking decisions about maternity services in my area will be drawn to their significance. I hope that the Minister and Department will assist the trusts in any way that they can to work up a good scheme to ensure that people in my constituency can have confidence in their future maternity services at Berwick.