§ 3. Michael Fabricant (Lichfield)If he will make a statement on the future of midwife-led maternity units. [43717]
§ The Parliamentary Under-Secretary of State for Health (Yvette Cooper)The NHS provides various types of care for women during pregnancy and childbirth, including care in midwife-led units for low-risk births. The Government expect that variety to continue to support choice for women, although it is for health authorities and trusts to decide the pattern of service provision in each area.
§ Michael FabricantBefore the last election, the Government said that they would undertake a review of the future of midwifery-led units. The Minister may know that I led a delegation of people from Lichfield and Burntwood, local charities and Conservative and Labour councillors to discuss the future of in-patient care in 689 Lichfield and Burntwood. The visit took place in November, when I also wrote a letter to the Department; the answer came in January, but there was nothing at all about what would happen to midwifery and maternity care in Lichfield, nor was there anything about the future of health care in Burntwood. Can the hon. Lady finally put people in Lichfield and Burntwood out of their misery and say what is the future for in-patient health care?
§ Yvette CooperThe hon. Gentleman will be aware that it is for the health authority and, in future, primary care trusts to propose local services and their configuration in his area. However, I can tell him that the Government support properly established midwife-led maternity units, which are extremely popular with women. The maternity and neonatal work force group is looking at all kinds of models of care in maternity services and the different work force requirements and procedures needed to support them.
§ Mr. Barry Gardiner (Brent, North)My hon. Friend will be aware that the Secretary of State visited the maternity unit at Northwick Park hospital last year and saw for himself the care provided by midwives there. There is an undertaking to modernise that maternity unit. What will be the role of midwife-led care in that modernisation, how much money will be made available and when we can expect an announcement?
§ Yvette CooperI know that hon. Members are keen to secure improvements to their local services. We have already announced £100 million of investment in maternity services this year and next to improve the physical infrastructure and facilities for women, their babies and professional staff. I will write to my hon. Friend about progress on the situation at Northwick Park. He is right to say that midwives are crucial in providing high quality maternity services, wherever they are delivered and whatever the care model and play a critical role.
§ Mr. Peter Lilley (Hitchin and Harpenden)Last month, I welcomed the decision of the Minister's predecessor to override the plan of local management to close the special care baby unit and maternity and women's units at Hemel Hempstead hospital. Can the Minister confirm that last week local management decided to reverse that plan and close the special care baby unit, but not to announce that until Parliament was in recess? Can she confirm that no fewer than two thirds of the nursing posts in that unit are vacant-I accept that that means that it must close-but that one third of the posts in the unit at Watford, with which it is to merge, are also vacant, so she must draft in extra nurses? She must set out a plan for the full restoration of services at Hemel Hempstead, and must appoint permanently two consultants to replace those who have gone, subject to an inquiry which reported unsatisfactorily this week.
§ Yvette CooperI understand that the relevant trust has made and announced a decision today to close temporarily the special care baby unit at Hemel Hempstead on safety grounds and that a further meeting is taking place this afternoon to discuss maternity services. We have always said that patient safety is paramount; trusts have a duty not to put women and babies at risk. A series of local 690 factors has been involved in the situation at Hemel and Watford, but there are no clinical reasons why a maternity unit of that size should not be viable.
The right hon. Gentleman is right to raise the issue of staffing; the local trust must address concerns about staffing, not just at Hemel, but at Watford. My noble Friend Lord Hunt of Kings Heath has already asked the NHS Modernisation Agency to work closely with the trust to try to improve the staffing situation. If the trust decides this afternoon to close the maternity unit temporarily, my noble Friend will ask the chair of the Bedfordshire and Hertfordshire strategic health authority to convene a taskforce to restore appropriate services at Hemel as rapidly as possible.
§ Ms Julia Drown (South Swindon)Midwife-led units have been very successful in reducing caesarean rates and increasing breastfeeding rates. Does my hon. Friend agree that a major part of every local maternity service, whether it is provided by an acute hospital or by a community hospital, should be midwife-led? Could we not obtain major public health benefits from reduced medicalisation of births-allowing interventions only when midwives and parents agree that they are appropriate?
§ Yvette CooperMy hon. Friend is right: many midwife-led units have proved extremely popular and successful. It is important for women to have a wide range of choices, and not to feel that a birth is being over-medicalised when that is not appropriate. Those choices should include the availability of a variety of pain-relieving drugs in maternity units throughout the country.