HC Deb 11 May 1982 vol 23 cc584-6
7. Mr. Newens

asked the Secretary of State for Social Services what guidance he has issued to district health authorities on the organisation of midwifery services.

19. Mr. Lofthouse

asked the Secretary of State for Social Services whether he has received any representations about the reorganisation of the midwifery service.

Mr. Kenneth Clarke

In July 1980 we issued a circular requiring district health authorities to arrange their services into units of management, giving several examples, including the districts' maternity services. I am now awaiting regions' decisions on the pattern of services at district level.

Mr. Newens

As hospital confinements ensure the highest possible standards of safety for both mother and child, will the Minister ensure that in any reorganisation adequate places will be available for all women to have their babies in hospital? Will he also take steps to ensure that induced births—which have deterred many mothers-to-be from going to hospital—are reduced to the minimum?

Mr. Clarke

Such management decisions will have to be made by the new management structures which the districts will set up. The aim of modern maternity practice is for children to be born in hospital whenever possible. It should also be an aim to pay proper regard to the wishes of mothers about the way in which they wish their children to be born.

Mr. Lofthouse

Does the Minister agree that, in the organisation of midwifery services, the most important factor is the quality of service for the patient? Does he accept that that is more likely to be achieved by reorganisation based on midwifery divisions than on small geographical areas? Will the hon. and learned Gentleman give an assurance that the reorganisation of the NHS will not have a detrimental effect on the midwifery service?

Mr. Clarke

I agree with those general propositions. The advice of the Royal College of Midwifery has been to have midwifery units, and the Government cited midwifery units as an example of the kind of structure that should be set up. I understand that in Pontefract a separate maternity unit has been established. I am sure that district health authorities, which in the end must decide on these matters, will bear in mind all the advice that they are receiving on this subject.

Mrs. Dunwoody

But there is clear evidence that there is no proper pattern. Some areas are moving away from functional organisation, others are using geographical boundaries, and as a result there is utter chaos in the midwifery services. Will the Minister take great care to find out what is happening, because it is important that midwifery should be properly organised for the benefit of mothers and children?

Mr. Clarke

We are seeking to increase local responsibility for the Health Service. Therefore, we have left some discretion to districts to set up a management structure to fit their particular needs. Thus, variety is produced, not chaos. There is plenty of advice that midwifery units are desirable, and we backed up that advice in the circular that was issued.

Mr. Christopher Price

Is the Minister aware that most right hon. and hon. Members were probably born not in hospital, but at home? Having listened to the Royal College, will he also listen to ARM, the Association of Radical Midwives, and make certain that those women who want to have their babies at home have the ability to do so?

Mr. Clarke

I am sure that it is the desire of all professionals involved that perinatal mortality should be reduced to the absolute minimum and that every possible care should be available to the mother and child during childbirth. I agree with whatever groups put forward the proposition that one must have regard also to the wishes of mothers. Those two aspects should be equated in reaching decisions about future practice in the maternity services.