Midwives in the NHS

Nigel Evans Excerpts

Monday 17th January 2022 Commons Chamber

[Siobhan Baillie]

I thank my hon. Friend for all the campaigning that he has done—as has my hon. Friend the Member for Rutland and Melton (Alicia Kearns), who is not in the Chamber this evening—and he is absolutely right. Birthing partners not only provide that immediate bond and that precious time with the baby; they provide support for the mother and support for the team, and have the important ability to spot what is going on. A mother who is taking quite a lot of gas and air might need someone else to have a couple of conversations when she cannot do so herself.

We are making changes in schools so that we do not see restrictions and closures again, and I think that if we are ever faced with the need to introduce further covid restrictions, we cannot do that in maternity services. The restrictions have had a knock-on impact on midwives as well: seven out of 10 RCM members have experienced abuse about visiting restrictions. That abuse may well have come from very worried and well-meaning people, but there is no doubt that it has contributed to their wish to leave their jobs.

The campaign group Pregnant Then Screwed did a great deal of work on this, and 98% of respondents to its survey said that the possibility of further covid restrictions on maternity services was causing them anxiety. There is enough for pregnant women to be worried about without their having to worry about that. Mothers reported rushing their hospital care during the pandemic, and seeking early discharge so that they could get home to be with their partners. As was mentioned earlier by my right hon. Friend the Member for South West Surrey, women-centred care is the ethos of midwifery. and continuity of carer is the national recommendation. It is the right approach, but at no stage have the current staffing levels and the impact of covid been taken into account to assess the viability of a new system. The vaccine mandate continues to cause concern, and the potential loss of more staff is adding to the pressure-cooker effect.

We in Stroud are hugely proud of the facilities that we have. In the past, Stroud constituents have come together and fought to save the maternity unit, and that fight was so strong that I do not think anyone would dare to try to close it down again. We have also recently instigated an important campaign to deal with mental health and birth trauma. Between 25% and 40% of women view their experience of giving birth as traumatic—I am probably in there somewhere—and one in four have experienced sexual abuse. Such issues often have a huge impact on fears for pregnancies and future births. The campaign and the dedicated mental health team that Gloucestershire is setting up will change perceptions and conversations surrounding birth from the off. Our minor injuries unit across the road from the maternity unit has received a welcome £2 million for refurbishment purposes. I was at the hospital recently for my scan, and it is really buzzing. Although I have raised some serious matters, I do not want expectant mums to be worried about the care that they will receive at Stroud or anywhere else, as professional maternity teams will look after all of them.

One midwife told me that midwives do not speak out because they are always trying to put the women in their charge at ease, but unfortunately it has reached the point at which they feel that they must do so, which is why they have sent me here today. That said, although a Minister will respond tonight, the issues raised are clearly not just for the Government to address. NHS trusts, their human resources teams, managers, and all of us as patients in society need to think about how we behave, how we use the NHS, and how we can improve it. Making the NHS a political football, claiming that more and more money is the only way to fix issues, or putting the NHS on a pedestal so that there can be no criticism or open scrutiny, will not help a single midwife in this great country. I believe that the men and women of our maternity services deserve better. They literally hold new life in their hands, along with all the hopes, dreams and responsibilities that come with that job.

I leave the final words to a midwife who told me:

“I love my job. I love supporting women and the team. But I too feel that maybe this is as far as I can go. I have never suffered with mental health concerns prior to this last year. Anxiety has crept into my normally happy life due to work issues.”

I think that that is quite a stark way in which to end the debate, and I genuinely think that we can do better. I look forward to hearing from the Minister, who I know cares deeply about this issue, and I am grateful for the time that I have been allowed tonight.

[Mr Deputy Speaker (Mr Nigel Evans)]

The hon. Member for Stroud (Siobhan Baillie) and the Minister have agreed that Taiwo Owatemi may make a short contribution. I ask her please to allow the Minister some time to sum up.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I thank my hon. Friend the Member for Stroud (Siobhan Baillie) for securing this debate and wish her well with her “vested interest” and her pregnancy. I am sure that her experience with her midwife, Jan Partridge, will be positive.

I want to thank all midwives and maternity teams up and down the country. For the past 18 months to two years, they have gone above and beyond their duty. I have visited maternity units, spoken to midwives and heard how difficult it has been, particularly with covid. Being on a maternity ward, particularly a labour ward, is a busy enough experience anyway, but if there are women there with covid, the added infection control measures bring extra pressures. With staff isolating and being off sick, it has been an incredibly busy time, and I have heard at first hand many of the experiences that my hon. Friend raises.

I say to midwives that I fully recognise the pressure that they are under. Sometimes there are not enough staff on the wards, and they are dealing with more complex cases. I hate to use the term “geriatric women”, but we are seeing women becoming pregnant much later in life, with the risks and complications that that brings. We are also seeing babies being born much earlier. The expertise and skills that a midwife brings to those situations mean that we all see the incredible work that they do.

There are three areas that I think we need to address. The first is staff numbers, an issue that the hon. Members for York Central (Rachael Maskell) and for Coventry North West (Taiwo Owatemi) and my hon. Friend the Member for Stroud all raised. I reassure hon. Members that we are trying to get on top of staffing levels. Health Education England undertook a survey based on the Birthrate Plus midwifery workforce planning tool to assess the numbers of current midwives in post, current funded posts and recommended funded posts to try to bridge the gaps between the three. Following that, NHS England invested £95 million to support the recruitment of 1,200 more midwives and 100 more obstetricians and to support multidisciplinary teamwork. There is also £450,000 for a new workforce planning tool at a local level, so that maternity units can calculate their own staffing level requirements.

We are trying to increase the number of midwives in practice. Returners are being encouraged to join Health Education England’s Return to Practice programme, where a payment of £5,000 is given to employers to support returners. Funding is given to the students to pay for their fees and their Nursing and Midwifery Council tests of competence, and they get a stipend while they are learning.

My hon. Friend is right about new students. We have increased student training places to 3,650. We are also recruiting from overseas. Early this year, we are advertising and interviewing for between 300 and 500 overseas midwives to join the NHS in the next 12 months. We are also recruiting extra maternity support workers to support the work of midwives.

We are also trying to improve the environment and to bring in a positive working culture. Some £52 million has been brought in to accelerate the digital maternity programme, so that the burdensome paperwork and paper records that midwives are having to work with will hopefully come to an end. Improving that documentation will improve the outcomes for mums and babies, too.

There is so little time to express how much we are doing. We are trying to bring in a positive working culture; it is not right that midwives are having to go without toilet breaks or are unable to drink during shifts. That is completely unacceptable, and it creates a vicious circle: because working conditions are so tough at the moment, we are losing experienced midwives, which makes trying to recruit and retain more staff even more difficult.

The debate we have had this evening is just the start, and I want to work with Members across the House to ensure that we support midwives as much as we can. We are serious about increasing staffing numbers and improving the working environment for midwives, because that is how we improve the safety of maternity care.

[Mr Deputy Speaker (Mr Nigel Evans)]

The Speaker and his team send their congratulations to the hon. Member for Stroud (Siobhan Baillie).

Question put and agreed to.