HC Deb 24 March 1949 vol 463 cc548-52
39. Mr. Peter Freeman

asked the Minister of Health how many babies were born in Newport in 1948; in how many cases was analgesia required and provided; what complaints were received concerning this service by mothers or otherwise; and in how many cases was this service refused or not provided when required for any reason.

Mr. Bevan

Provisional figures of births registered in Newport in 1948 are 2,330 live births and 59 still births. Analgesia was given in 1,229 confinements in public hospitals or attended by municipal midwives, and it was probably also given in some confinements in private nursing homes or by midwives in private practice. Some other cases would have anaesthesia. No cases are known in which analgesia was withheld except on medical grounds. No complaints were received by the Council concerning the service.

Mr. Peter Thorneycroft

Would the right hon. Gentleman agree that these figures are certainly much better than those for the surrounding area of Monmouthshire, including Ebbw Vale and my own constituency, where three women out of four are unable to obtain this relief?

Mr. Bevan

If the hon. Member is correct in saying that these figures are better than those for some of the surrounding areas, it is the case that the figures for all the areas around are better than they were when the party opposite had charge.

40. Mr. Peter Freeman

asked the Minister of Health how many nurses there are in Newport available for maternity cases how many of them have been trained to use analgesia equipment; and whether there were any cases occurring in 1948 where trained nurses were not available for this. service.

Mr. Bevan

Forty-seven midwives are available, 22 of whom have been trained to use analgesia apparatus. There were no cases in 1948 where trained midwives were not available for this service. All 13 midwives employed in the municipal domiciliary midwifery service are trained to give analgesia.

Mr. Freeman

Can my right hon. Friend say how many of these nurses are provided with cars and the necessary allowance of petrol by the corporation?

Mr. Bevan

If my hon. Friend will put that question on the Order Paper I will try to give him the information.

41. Mr. Peter Freeman

asked the Minister of Health what arrangements have been made for providing and conveying analgesia equipment by the Newport Borough Council; and whether it is provided whenever necessary without difficulty.

Mr. Bevan

The council have provided four sets of gas and air apparatus, and transport is supplied through the ambulance service to convey the midwife and the apparatus to the patient's home. I am informed that no difficulty has been experienced in this matter.

Mr. Freeman

Do not the answers to these Questions indicate that if the hon. and gallant Member for Pudsey and Otley (Colonel Stoddart-Scott) wishes to see the most efficient service in analgesia for mothers who require this service in childbirth, he will find it in Newport?

Colonel Stoddart-Scott

Does the Minister think that to convey this apparatus in an ambulance is the most economical way of doing it? Would it not provide a much more efficient service if the midwives had their own motor cars and were given an allowance? Is the right hon. Gentleman aware that I have a letter here, which has arrived today, from the chief midwife at Newport saying that those midwives who have a car only receive a reduced allowance, and that anyone getting a car in future or changing a car will not receive an allowance?

Mr. Bevan

The inference contained in the question of the hon. and gallant Member for Pudsey and Otley a week ago was that transport was not available at Newport. The facts now show that he is as incorrect as usual. [HON. MEMBERS: "Rude."] In answer to the other part of his supplementary question, telephones are installed in the municipal midwives' houses, and the midwife has only to telephone the ambulance depot for a vehicle complete with equipment to be sent immemiately to her house to collect her and take her to the case. A sitting case car is used for this purpose if one is available. Otherwise an ambulance is sent. These transport facilities are provided day and night. The transport arrangements described apply only to the municipal midwifery service; they do not apply to midwives in private practice.

Mr. P. Thorneycroft

How does the midwife get home; and does the Minister's answer mean that he has rejected the advice of his own working party on the midwifery service, which recommended every midwife both in town and country should be provided with a motorcar and the means to run it?

Mr. Bevan

It is perfectly true that it is desirable that these transport facilities should be available everywhere and they are being built up, and very much more rapidly in the last six months than in the six years before.

66. Mrs. Ayrton Gould

asked the Minister of Health how many local authorities are providing analgesia treatment in childbirth; and to what extent he is impressing upon those who are not doing so their obligation to implement the proposals relating to analgesia approved by him under Part III of the National Health Service Act.

Mr. Bevan

Analgesia is being used in the domiciliary midwifery service of 134 of the 145 county and county borough councils. Individual action is being taken with the councils of the counties and county boroughs in which it is not yet being provided.

Mrs. Jean Mann

In view of the report published in the "British Medical Journal" a fortnight ago of the British medical commission which, after exhaustive inquiry, found that the mothers much prefer anaesthetics to analgesics and obstetricians to midwives, can my right hon. Friend explain this agitation for something so much inferior?

Mr. Bevan

I should not like to make any observations about the medical aspect of my hon. Friend's supplementary question, because that is entirely a matter for technical advice. With regard to the explanation for the propaganda about analgesia, I do not wish to repeat the adjectives I used a few weeks ago.

76. Lady Tweedsmuir

asked the Minister of Health if he will give the proportion of women receiving analgesia in childbirth in their own homes to the total births for the years 1947 and 1948 in England and Wales.

Mr. Bevan

I regret that this information is not available but I am circulating in the OFFICIAL REPORT information about the administration of gas and air analgesia by domiciliary midwives since 1938 which is the earliest date from which statistics are available.

Lady Tweedsmuir

Is it impossible to give the recent figures—the figures for 1947–48?

Mr. Bevan

When the hon. Lady sees the figures, I think she will find that she has all the information that she needs.

Mrs. Leah Manning

Is not my right hon. Friend able to give us the number of women who did not have analgesia, because that is what we are really interested in, and it is a simple arithmetical proposition?

Mr. Bevan

It is not a simple arithmetical proposition. Some confinements take place privately and others take place in institutions where it is normal to give analgesia if it is medically required. These statistics are not as simple as might appear. I think my hon. Friend might look at the answer in the OFFICIAL REPORT. I think that she will find that progress is very satisfactory indeed and that it far exceeds what has been said in some quarters.

Mr. P. Thorneycroft

Will the right hon. Gentleman consult with some body like the Central Midwives Board who know about these matters, and will he not then find that only one woman in seven gets analgesia when attended by a midwife in her own home?

Mr. Bevan

The answer is that the number of those who receive it has been doubled in the first six months of the National Health Service.

Following is the information:

Year Number of domiciliary confinements of which midwives were in charge Number of domiciliary confinements where gas and air analgesia were administered by midwives Percentage of col.(3) to (2)
1. 2. 3. 4.
1938 289,035 1,175 0.4
1939 285,024 1,029 0.4
1940 284,227 1,545 0.5
1941 268,905 1,783 0.7
1942 274,148 1,743 0.6
1943 269,579 5,207 1.2
1944 281,769 5,102 1.8
1945 245,237 7,262 3.0
1946 298,019 20,507 6.9
1947 327,245 43,683 13.3
1948 Information not yet available

In addition to the domiciliary confinements where a midwife is in charge there are a large number of domiciliary confinements where a doctor is in charge. These confinements numbered 95,545 in 1946 and 96,937 in 1947. Although figures are not available, it is known that analgesia or anaesthesia is given in a high proportion of these doctors' cases.