Yes, I recognise that fact. When we receive responses to our new survey of antenatal care, we shall consider the extent to which we can provide out-patient care as close to home as possible, while at the same time enabling women to have access to the latest facilities in the services that are most appropriate to them. There may need to be more of a division between facilities. I shall refer later to isolated units.
Much of the improvement in baby mortality is well known. What is less well known is the sharp drop in the death rate of women in childbirth that has accompanied all these improvements. Forty years ago, when I was born, the number of births a year was roughly the same as it is now, but some 700 women died in or soon after childbirth. Even 10 years ago it was 74, a rate of 12 per 100,000 live births. Now it is seven per 100,000 live births, but, at 45 cases in the most recent year for which we have figures, it is still too many. Nevertheless, it shows a continued improvement.
We have given a lot of thought to this subject and we have done a lot of work on it. I attribute much of this welcome change and the drop in the death rate of babies and mothers to our efforts in maternity care. It has involved far more women giving birth in hospital. Most now follow the recommendation that births should take place in modern hospitals that provide a full range of services, including anaesthetics and a paediatrician on call. I recognise that, where they still exist, people say that they like small, isolated maternity units, but we are still advised to move away from delivering women in such units.
Such advice was included in a recent publication of the National Birthday Trust Fund. I believe that it is wise to continue to take that advice. Fewer women and fewer babies are dying. The results have convinced me. I am also convinced that it should be possible—that in fact it is essential—to provide modern maternity care in a way that is both professional and friendly. I say that firmly.
I referred to sick babies. When a child is ill, the presence in hospital of the mother or another close relative may be an essential element in the child's recovery. I agree firmly with the National Association for the Welfare of Children in Hospital on these matters. I hope to be able to issue new draft guidelines for consultation within the next four weeks which will update those issued in 1972. The hon. Member for Peckham (Ms. Harman) knows that that fulfils a promise that I made in Committee on the Health and Medicines Bill.
The last topic that I want to cover is still concerned with women and their babies. It is breast feeding. This week, we made an announcement that is of considerable significance. Since 1980, the proportion of women breast feeding has stood at around two thirds, but the most recent survey in 1985 showed that, while 85 per cent. of educated and social classes 1 and 2 women breast-feed their babies, only 45 per cent. of social class 5 do, which is rather the reverse of what I should have expected. In January, we published the latest report on infant feeding from the Committee on Medical Aspects of Food Policy, entitled "Present Day Practice in Infant Feeding: Third Report." It affirms:
Breast feeding from a woman who is in good health and nutritional status provides a complete food which is unique to the species. There is no better nutrition for healthy infants both at term and during the early months of life.
The significance of that for us today is that there is plenty of medical evidence that natural feeding is better for both the baby and the mother. It returns her to normal far more quickly. It also helps to cement a very special bond between her and her baby, to their mutual advantage. I have to confess that it is also very nice, so we want to promote it.
I have therefore agreed to support a new initiative to promote breast feeding around the country by the National Childbirth Trust's breast feeding promotion group, the La Leche League and the Association of Breastfeeding Mothers. We will grant aid these bodies for a sustained campaign among health professionals and mothers. We expect to spend at least £100,000 over the next two years. In addition, the infant and diatetic foods association of the Food and Drink Federation, whose members make infant formulae, have agreed this week to provide an additional £30,000 this year, and possibly next year as well, to help with the printing and dissemination of suitable breast-feeding literature, posters and so on. I think that that is a remarkable gesture, and I congratulate and thank the association.
But the manufacturers have done more. They have agreed to phase out by the end of this year all free samples and subsidised supplies of baby milk to hospitals, thus closing an important loophole. The bottle and teat manufacturers have agreed to consult on ending their advertising to the general public along the same lines as the baby milk manufacturers. I accept with gratitude the good wishes of the hon. Member for Stoke-on-Trent, North (Ms. Walley), who is smiling. All these changes bring us into line with the World Health Organisation's requirements on marketing breast milk substitutes, promulgated in 1981 and strengthened in 1986. We shall be revising the relevant NHS circular. We intend to issue the new version in the autumn when the manufacturers issue a revised complementary marketing code—I hope in time for a major seminar on 18 October—which will launch the new breast-feeding promotion initiative.