NHS Maternity Services

Debate between Richard Foord and Karin Smyth

Thursday 22nd October 2026 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I thank the hon. and gallant Member for North Devon (Ian Roome) for raising this very important matter. He calls attention not just to his own constituency but, as we have heard from others, to a broader issue that we face, particularly in our rural and coastal communities. I want to stress that the Government are clear that all women have the right to receive the same high-quality, safe and compassionate care, wherever they have their babies. We need to ensure, and mums need to know, that services are there for them when they need them, including at the time they go into labour.

I thank the hon. Member for North East Fife (Wendy Chamberlain) for sharing the experiences of her constituents Kristie and Tammy today, and I agree that we need to bear such experiences in mind. That is why my right hon. Friend the Secretary of State has chosen to prioritise maternity, and why the work of the national maternity and neonatal taskforce is so important. In particular, the new modern service framework will define the standards needed to deliver care across the country, whether in large inner-city areas or small rural places.

I know the hon. Member for North Devon understands that the North Devon maternity unit was closed for a good reason: the trust could not provide a service that it knew was unsafe. It is really important that we all bear that in mind as we discuss this issue. We must support good, sound clinical assessment, particularly in this area. However, it is unacceptable that, as we have heard from the hon. Member for Honiton and Sidmouth (Richard Foord), expectant mothers are travelling all the way to Exeter or Bristol, and the current situation is not sustainable. I have given birth very healthily three times, and I am grateful for the care that I had. I had to travel only a short distance down the road and, frankly, that was enough, so I empathise deeply with women who have to endure long journeys.

I will not rehearse the recent history that led us to this point, because I know the House is well acquainted with that. As the hon. Member for North Devon knows, the responsible Minister is the noble Baroness Merron, but I will do everything I can to take this opportunity to update him and the House on where we are, and follow up in writing on any specific questions, if necessary.

The trust has set the following three tests before the unit can reopen: first, there must be 24/7 consultant and registrar cover in place through an on-call rota; secondly, three quarters of those staff must be employed full time; and thirdly, new staff must have gone through employment checks, onboarding and induction. Today I can update the House that the outlook on safe staffing was more positive last week, but unfortunately some recruitment has fallen through since then. The trust is still seeking the additional clinical staff that they must have to provide a safe service. As hon. Member for North Devon knows, the issue is not that the roles are not funded. They are generously funded, and the trust has even gone so far as to offer salary top-ups, but the roles remain unfilled. The question is how we attract the best talent to our rural and coastal communities, and show them that Barnstaple and other similar places are among the best in the country to build a life.

I want to thank partners that are working with the trust on recruitment, including the Royal College of Obstetricians and Gynaecologists. The trust is also exploring hiring international candidates, but ultimately we want the unit to have enough staff to provide a safe service that is sustainable—another point that has been well made today—even if a doctor is unwell or otherwise on leave. Every week, the chief medical officer at the trust conducts an assessment to see whether the unit is ready to reopen its doors. Every two weeks, the trust updates key stakeholders on the status of the unit. Once safe staffing is secure, there will be a short period of time to stand up rotas and put services in place. I have had assurances that, during that period, the trust will get in touch with every mother and give them the chance to change their birth plans to Barnstaple, should they want to do so.

[Richard Foord]

I accept that this is a point about recruitment, but it is also a point about retention. A constituent of mine who visited the maternity ward at Exeter hospital heard that the staff temporarily redeployed there from Barnstaple are having to pay the full car parking charge of £20 per day while they are doing the additional service of travelling to Exeter. Does the Minister think that retention also needs to be looked at?

[Karin Smyth]

Yes, of course, and that is what the trust does. I would gently urge all hon. Members to work very closely with the entire trust on these issues to solve these problems. It is absolutely right that the trust is working with MPs. It is reviewing its decision on a weekly basis, and it is important that it communicates openly and transparently with all its partners when those decisions happen. I am always very clear that Members of Parliament speak on behalf of their constituents and can be helpful in communicating those messages, because we want to make this work.

In the meantime, the trust continues to offer a range of maternity services, and it has taken steps to help the women covered by its duty of care. There is a dedicated helpline for women to discuss their birth plans, a maternity triage line for urgent help, special appointments to talk about travel costs and accommodation, free taxis for women who do not have their own transport and are advised by the triage line to go to hospital, and mental health support. These are good and sensible steps, but it is still unacceptable for women to have to travel for two hours while they are in labour.

Trusts in our rural and coastal communities do face systemic pressures, because they have fewer births and because it can be hard for the local NHS to recruit. Last year I visited North Devon district hospital, as part of my remit in overlooking the new hospitals programme, to see how it is using the £30 million the Government have made available to support the rebuild of the 50-year-old staff accommodation block and invest in MRI scanners. We are committed to those services in Barnstaple, and it is important for all hon. Members’ constituents to be clear about that.

Our 10-year health plan, produced last year, clearly set out the issues for rural and coastal communities, which the right hon. and learned Member for Torridge and Tavistock (Sir Geoffrey Cox) noted. We particularly highlighted those communities in the 10-year health plan because we recognise that they have specific needs and do not benefit from a one-size-fits-all approach. However, the broader systemic issues they face, particularly in staffing, must be addressed in our upcoming workforce plan, and I do agree that retention is a key part of that.

Ministers have made it clear to the NHS that we must do everything possible to help reopen North Devon maternity services. NHS England, the ICB and the regional team in the south-west are working with the trust to resolve these issues as soon as possible. As I have said, my right hon. Friend the Secretary of State has rightly made maternity a national priority for this Government. She is chairing the national maternity and neonatal taskforce to drive forward reforms, and to deliver systemic and sustained improvement across maternity and neonatal care, including in relation to the failings exposed in the south-west of England in recent months.

The Barnstaple maternity unit will reopen. I cannot give the hon. Member for North Devon a guarantee from this Dispatch Box of the date when that will happen, because it will depend on securing safe staffing. That is the problem that everybody needs to focus on, and this Government are focused on doing that with the local system. We will do everything we can to help the hon. and gallant Gentleman get those services back on track on behalf of his constituents.

Question put and agreed to.

NHS Funding: South-west

Debate between Richard Foord and Karin Smyth

Wednesday 11th June 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Torbay (Steve Darling) for securing the debate. We could have had more time, as this is an important issue for us all across the whole south-west. I thank colleagues for taking part.

The hon. Gentleman is right that the system has real challenges receiving deficit funding in our part of the NHS recovery support programme. He will rightly be following that closely. In the autumn Budget, which I think virtually everyone in this room disagreed with, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with a more than £22.5 billion increase in day-to-day health spending and over £3 billion more in the capital budget over this year and the last. Today, the Chancellor has announced the conclusion of the spending review, with £29 billion more day-to-day funding in real terms than in 2023-24. There is a £2.3 billion real-terms increase in capital spending over the spending review period—something I hope everyone welcomes.

The SR puts the NHS on a sustainable footing by cutting waiting lists so that by the end of this Parliament 92% of patients will start consultant-led treatment for non-urgent health conditions at 18 weeks, delivering on the Prime Minister’s plan for change commitment and prioritising people’s health. To respond to the hon. Member for Bath (Wera Hobhouse), we do encourage use of the independent sector for capacity, and that is a decision for ICBs to make sure they achieve those standards. The settlement also supports the shift from analogue to digital, with a total investment of up to £10 billion in NHS technology and transformation between ’26-27 and ’28-29, and an almost 50% increase from ’25-26. I agree with the right hon. Member for Salisbury (John Glen) that technology offers huge opportunities in geographies like ours.

Thanks to the Chancellor, we are taking the necessary steps towards fixing the foundations of our NHS and making it fit for the future. Since coming into office, the Government have published our urgent and emergency care plan, which will support the NHS across England to improve the timeliness and delivery of care to patients requiring urgent and emergency care over the next year, including for next winter. We are delivering on our plan for change through the accelerated roll-out of the NHS app. We will create an NHS fit for the future and continue to invest in the latest technology, shifting healthcare from analogue to digital.

Our investment and reform in general practice, to fix the front door to the NHS and bring back the family doctor, includes an additional investment of £889 million. We have published our elective reform plan, which will cut waiting times from 18 months to 18 weeks. We have exceeded our pledge to deliver an additional 2 million appointments, tests and operations—we have delivered over 3 million more. Waiting lists have fallen for the sixth month in a row and have now been cut by over 219,000 since we came to office. The Government have committed to a10-year health plan that will lead the NHS to meet the challenges set out in the plan for change to build the NHS for the future, and it will be coming very soon.

I know that hon. Members across the House share the concerns of the hon. Member for Torbay about the crumbling NHS estate after years of neglect. I wish to assure Members that my right hon. Friend the Chancellor has given us the funding to begin reversing the trend of decline in the south-west and nationwide, with health capital spending rising to £13.6 billion this year.

In the south-west region, allocations have been made totalling £448 million in operational capital, empowering systems to allocate funding to local priorities; over £238 million from our constitutional standards recovery fund to support NHS performance across secondary and emergency care; and £83 million from the £750 million estates safety fund to deliver vital safety improvements, enhance patient and staff environments and support NHS productivity. This includes £7.3 million for Torbay hospital in the constituency of the hon. Member for Torbay; £10 million from our primary care utilisation fund for improvements in the primary care estate; and almost £5 million to help to reduce inappropriate out-of-area placements for mental health patients in the south-west.

ICB allocations have been talked about a lot today. For the south-west, they have been confirmed as totalling £11.5 billion out of a total of £116.7 billion allocated for England. The regional allocation per capita for the south-west is above the national average. We heard from my hon. Friends the Members for South Dorset (Lloyd Hatton) and for Bournemouth East (Tom Hayes) that the signs are being seen in their constituencies.

[Richard Foord]

Will the Minister give way?

[Karin Smyth]

I am going to just complete these points, so that I can try to address as many points as possible.

In the constituency of the hon. Member for Torbay, the local ICB, NHS Devon, receives £2.5 billion of the £11.5 billion for the south-west. The allocation per capita for Devon is higher still, and above the south-west regional average. Likewise, NHS Cornwall and the Isles of Scilly ICB received just over £1.2 billion of that £11.5 billion total. The allocation per capita for Cornwall and the Isles of Scilly is above the south-west regional average and national average.

To respond to the hon. Member for St Ives (Andrew George), I understand from NHS England that the ICB has had the debt written off, so that might be something he wants to follow up. My hon. Friend the Member for Truro and Falmouth (Jayne Kirkham) and others talked about funding allocations—we could talk about this for a very long time. They are difficult things to get right, and are controversial, but the funding formulation does account for older people and for rural populations.

The latest financial performance position publicly available is for quarter three of last year. It showed an overall deficit position of £51.7 million against the year-to-date plans, of which Dorset ICS had the largest variance of £27.7 million. Final end-of-year positions are still being finalised and will be made publicly available in due course. For ’25-26, NHS systems overall have received £2.2 billion of deficit support funding in their allocations. All systems in the south-west have now agreed a balanced plan for ’25-26. The position on deficit support for ’26-27 will follow the spending review settlement for individual organisations agreed as part of the planning guidance process.

NHS England will continue to support all organisations to deliver financially sustainable healthcare through a range of improvement measures, some of which we have heard about today. Devon integrated care board, and three trusts within the ICB, are currently part of the recovery support programme, which provides intensive support to challenged organisations. Where organisations are struggling significantly, the Department of Health and Social Care provides cash support to support the continuity of patient services—obviously, that is critically important. So that colleagues are aware, I am personally meeting with finance colleagues from NHS England and the Department of Health every week to support that work. We are clear as a Government that we need to be certain that every pound of taxpayers’ money is used to best effect, and that best practice is followed in this region and across the entire NHS.

The hon. Member for Torbay asked about coronary services, and that is a local decision. NHS Devon and Torbay Foundation Trust have proposed undertaking a test-and-learn process for out-of-hours primary percutaneous coronary intervention. That service will be provided in Torbay and Exeter, which would involve a temporary change to provide out-of-hours services at Exeter only. Members will be aware that the ICB was due to make a decision on the pilot at its board meeting in May. However, following significant local feedback, the ICB has decided to reflect on those issues raised, and I am sure the hon. Member for Torbay will be following up on that. The ICB will be providing an update at its board meeting in July.

In conclusion, the Government are taking the necessary steps to fix the NHS, and the Chancellor’s spending review settlement puts the NHS further on the road to recovery. I assure Members that we will write back to them on any other individual points raised.