HC Deb 04 November 2003 vol 412 cc656-9
6. Dr. Doug Naysmith (Bristol, North-West)

What plans he has to increase choice in the provision of maternity services. [135974]

The Secretary of State for Health (Dr. John Reid)

My Department is conducting an extensive consultation on what patients want in terms of choice and involvement in, and flexibility of, their care and treatment. Maternity services are a key theme of this consultation.

Dr. Naysmith

I thank my right hon. Friend for that reply, and I hope that he has had a chance to look at the Health Committee's reports on maternity services, which were published earlier this year. One of our recommendations was that the ability should exist to be referred to midwifery services by a midwife, rather than through the GP services. I should be grateful if he would outline what the Department intends to do to encourage that.

Dr. Reid

It is true that choice becomes substantial choice only if capacity is increased and investment to increase that capacity is made. That is the difference between our policy and the theoretical and cruelly deceptive choice that is offered by others to benefit only a tiny minority of people. We have therefore increased capacity through investment, resources and training in order to give women a real choice over maternity services. For instance, I understand that in my hon. Friend's area in Bristol, a number of midwives have proposed a midwife-led unit as an alternative to traditional hospital-based maternity services, and the primary care trust is now actively considering that option. We aim for the NHS to provide maternity services that offer women a variety of options through which they can receive care during their pregnancy and where they give birth.

Dr. Richard Taylor (Wyre Forest)

What plans does the Secretary of State have to deal with the shortage of midwives, which risks curtailing choice for patients and specifically curtailing the midwife-led birth centres that he mentioned? I would be grateful to know that he attaches a great deal of importance to such midwife-led centres and I hope that, because of the shortage of midwives, he will protect them from attacks by the consultant-led obstetrics units.

Dr. Reid

On the hon. Gentleman's second point, it is crucial that we do not allow any vested interest to stand in the way of better-quality, quicker and better service and more choice for patients. When I say that, I mean any vested interests within the NHS or any vested interests from outside that want to undermine it. I can tell the hon. Gentleman that I will make sure that we protect and help to prosper the midwife-led opportunities.

On the first part of the question, we have an expectation that, from a baseline of the year 2000, more than 2,000 extra midwives will be working in the wards by 2006. As the hon. Gentleman may already know, in September last year, there were 870 more midwives working in the wards than when we took power in 1997. It is not easy. but we are putting in the investment to attract people back. It would be a disaster if we had cuts in investment on the scale envisaged by the so-called Opposition.

Mr. Ivan Henderson (Harwich)

May I tell my right hon. Friend that my constituents welcome the news that Harwich is going to get a new community hospital, which includes a new maternity unit? That will continue to give my constituents a choice about where to give birth in their local community. However, at the moment, the existing maternity unit is temporarily closed because of the shortage of midwives. To ensure that the new hospital and new maternity unit is a success, will my right hon. Friend do all that he can to ensure that we recruit, retain and encourage midwives back into the profession? We want the investment to make an improvement, which counters the suggestions of failure from Conservative Members—[Interruption.]

Mr. Simon Burns (West Chelmsford)

It's closed.

Dr. Reid

Despite the baying from Conservative Front Benchers, that is a helpful question because it is important to have an honest appraisal of where we are with the health service. It is light years better than the health service that we inherited from the crowd on the Opposition Benches, but we still have a long way to go—[Interruption.] I can do no better than quote Professor Mike Salmon, chairman of the Essex Rivers Health Care NHS trust. When the Government gave the go-ahead in 2001 to the project mentioned by my hon. Friend, he said: This is the best local health news since the creation of the NHS itself in 1948". It is certainly much better news than anything that appeared during the near 20-year reign of the crowd opposite. Nevertheless, we have a great deal more to do to attract more midwives. We are increasing the number of training places and there are now 470 more than in 1996–97—an increase of 28 per cent. We are also taking a range of further actions to help recruitment. All of that would be put in peril by the massive cuts in investment proposed by Conservative Members.

Mr. James Gray (North Wiltshire)

It is unfortunate that the Secretary of State allowed some party political banter to creep into what had until then been the helpful answer that he was determined to put women's interests first when deciding on maternity services. Will he bring his influence to bear on the Avon, Gloucestershire and Wiltshire strategic health authority, which is currently consulting on closing down maternity services in Trowbridge, Devizes and Malmesbury?

Dr. Reid

I do not understand the logic of the hon. Gentleman's question. My God, if in the context of the biggest annual increase in the NHS for the longest period in history, he is keen to point out to us where difficulties occur, what will he do when there is a 20 per cent. cut in that investment?

Mr. Gray

That is no answer. What a disgrace. Get back to Scotland.

Mr. Speaker

Order. The hon. Gentleman should not say too much about Scotland. He knows where I come from and it is not so long ago that he lived in my constituency.