HL Deb 19 January 1987 vol 483 cc706-9

2.42 p.m.

Baroness Cox

My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government what steps they may consider taking to alleviate the shortage of midwives willing to practise in the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)

My Lords, although there is a shortage of midwives in some localities, nationally the total number of qualified midwives employed in the NHS in England continues to increase and at September 1985 there were 18,260 wholetime equivalents; an increase of 14 per cent. since 1981. In recent years, there has been an encouraging increase in the proportion of new midwives who notify their intention to practise immediately following qualifications.

Baroness Cox

My Lords, I thank my noble friend the Minister for that partially encouraging reply. Will she agree that a commencing salary of only £6,700 and a possible maximum basic salary of only £10,800 is inadequate incentive to retain midwives in a profession whose responsibility it is to advise and care for all new parents and to supervise a significant proportion of deliveries of our country's babies?

Baroness Trumpington

My Lords, my noble friend will be aware that the remuneration of staff midwives and of midwifery sisters is determined in the light of the recommendations of the independent review body on the pay of nurses, midwives and health visitors. Each year, economic, financial and other information such as recruitment and retention levels are given to the review body by staff organisations, NHS management and the health departments. It is for the review body to make judgments. As the review body is even now engaged on reviewing the pay of nurses, midwives and health visitors, your Lordships will not expect me to influence its recommendations by expressing an opinion on current pay levels.

Lord Ennals

My Lords, will the noble Baroness have consultations with the Royal College of Midwives, which informs me that as of today it is more than 15 per cent. short on establishment and that the position is getting worse each year? Is she aware that for tutors in midwives' training schemes there is a shortage on establishment of 16.5 per cent., and that, again, the position is getting worse each year? Can she explain why her figures are so totally different from those of the midwives who presumably know better?

Baroness Trumpington

My Lords, I shall confine my reply to the question of midwifery tutors. The reported shortfalls of midwifery tutors in some parts of the country may still be partly due to a requirement introduced in 1981 that midwives must undertake an advanced diploma course in midwifery before being eligible to take the tutor training course. However, the Nursing and Midwifery Staffs Negotiating Council has reached an agreement on a more flexible grading structure for senior tutors and this may make a teaching career more attractive.

Lord Molloy

My Lords, does the noble Baroness agree that it is to be hoped that the review body will take into consideration the fact that midwives have to do extra studying, take extra examinations and pass them to become midwives but that there is no reflection of that endeavour in their pay? Does she agree that that is wrong, and also that the review body could be helped if it were to contact the Royal College of Midwives and the Confederation of Health Service Employees who are the real experts on this question?

Baroness Trumpington

My Lords, there are a number of groups within nursing and midwifery—and I am sure that the noble Lord, Lord Molloy, will agree on this point—which argue that their particular skills or responsibilities deserve extra financial or grading recognition. The jobs of midwives, health visitors, intensive care unit nurses, special care baby unit nurses, theatre staff, and so on, are difficult and demanding, as are all nursing jobs. The right way is not to look at any one group in isolation but to consider them all in the grading review. It will be for the review body to make recommendations on appropriate salary levels.

Baroness Lane-Fox

My Lords, in an attempt to redress what the Royal College of Midwives sees as an alarming shortage of midwives, will the Government agree to enable the setting up of direct entry midwifery training schemes and give that initiative the funds it needs to prime the pump?

Baroness Trumpington

My Lords, the advanced diploma in midwifery can be regarded as a means of enhancing a midwife's career prospects in clinical and managerial as well as tutorial fields. We consider that the responsibility for funding these courses should for the time being remain with health authorities.

Lord Morris

My Lords, may I ask my noble friend whether it is true that the birth rate throughout the country is falling rather than rising and that the need for more midwives will likewise fall rather than rise?

Baroness Trumpington

My Lords, I think that if my noble friend was having a baby, he would need a midwife.

Lord Cledwyn of Penrhos

My Lords, is it not the case that the shortage of midwives is increasing and that the average shortage is at present more than 15 per cent? What is the position in the rural areas of Britain compared with the urban areas? The noble Baroness will be well aware of the enormously important contribution made by the midwife in rural areas, especially where there is a great deal of travelling to do. Can she give an indication of what the comparison is?

Baroness Trumpington

My Lords, as I said in my original Answer, there are reported difficulties in recruiting midwives in some localities but there is no evidence that there is a national problem. The result of a sample survey of English health authorities for the review body for nursing staff, midwives and health visitors showed that at March 1985 only about 3 per cent. of whole-time equivalent funded posts for midwives remained vacant for more than three months, compared with the average of 2.5 per cent. for nursing and midwifery staff.

Lord Cledwyn of Penrhos

My Lords, the noble Baroness has given a great deal of additional information but she has not answered my question. What is the comparison between the rural areas and the urban areas? It is very important that she should make plain to the House that there is no greater shortage in the rural areas.

Baroness Trumpington

My Lords, I cannot specify the rural areas. As I originally said, we realise that there is a shortage in some places but I have not been given the information as to which places.

The Earl of Halsbury

My Lords, will the noble Baroness acquaint the review body with this point? On passing upon my lawful occasions along Notting Hill Gate last week, I saw an advertisement in these terms: Wanted—shorthand typists, salary £9,000 a year".

Baroness Trumpington

My Lords, I hope that perhaps the review body will read Hansard.

Lord Rugby

My Lords, is entry to midwifery confined to one sex only? If it is open to both sexes, I wonder whether the terminological word should not be "midperson" rather than midwife?

Baroness Trumpington

My Lords, if my memory serves me right, I think that I have met one male midwife.

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