§ 11. Mr. K. Robinsonasked the Minister of Health, in the light of the disclosure in his Department's Report on Maternal Deaths, 1955–57, that 41 per cent. of the 861 deaths expertly assessed were attributable to neglect and mismanagement and could have been avoided, what new steps he intends to take to protect the lives of women in childbirth.
§ Mr. Walker-SmithI do not think that these figures carry quite the implication the hon. Member suggests. The Report covers the second three years of a continuing investigation of the factors contributing to maternal deaths, and by promoting the study of those which are avoidable is itself an important contribution to the measures taken to bring about an improvement. I am glad to say that this second Report contains ample evidence that a considerable improvement has in fact been achieved.
§ Mr. RobinsonWhile the right hon. and learned Gentleman can be congratulated on conducting this investigation, is he aware that his Department's Report is extremely disturbing in some respects? Would he not agree that, since the Report also indicates that the risks attendant upon childbirth in the home are about four times as great as those attendant on childbirth in hospital, it provides the most powerful argument for his implementing at an early stage the Cranbrook Committee's recommendations about more carefully and rigidly controlled obstetric lists?
§ Mr. Walker-SmithThe particular recommendation of the Cranbrook Committee which the hon. Gentleman has singled out is one which, as he may know, is under consideration in consultation with the medical profession. Most of the other recommendations in the Cranbrook Report have already been commended to those providing the maternity services.
§ Dr. SummerskillThe Minister must not treat this so lightly. The Report specifically states that domiciliary midwifery and midwifery in hospital can be severely criticised. On domiciliary midwifery, it states that a number of women who died in childbirth had suffered from heart disease and nobody had examined their heart before the confinement. With regard to hospital midwifery, it is clear that people unfitted to do Caesarian sections in hospital have done them. I think that 140 women have died following a Caesarian section, which today should not be a complicated operation.
§ Mr. Walker-SmithIn so far as the Report draws attention to avoidable factors, it does a public service, and we shall seek to ensure that those factors are avoided in future. At the same time, while resolute to progress in that way, we should keep the context in view. Over the period of three years covered by the Report, over 2 million women were safely confined and, in this decade, we have succeeded in reducing the figures of maternal mortality from 0.87 per thousand in 1950 to 0.38 per thousand in 1959, a reduction of more than a half. These are figures which, I think, would arouse the envy and excite the emulation of most countries in the world.