Maternity Services, Edinburgh

Part of the debate – in the House of Commons at 9:47 pm on 24th November 1994.

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Photo of Mr Allan Stewart Mr Allan Stewart , East Renfrewshire 9:47 pm, 24th November 1994

I congratulate the hon. Member for Edinburgh, Leith (Mr. Chisholm) on his success in the ballot and on initiating this debate on an issue which we all accept is of great interest and concern to the people of Edinburgh and to his constituents in particular. He has put his case in his customary well-researched and forthright way.

The hon. Gentleman referred to the timing of the debate and, as he rightly pointed out, it was only 10 days ago, after he had applied for the debate, that my noble and learned Friend the Minister of State announced ministerial endorsement for Lothian Health's acute services strategy. At that time, proposals for the future of maternity services in Lothian were still to be finalised.

The hon. Gentleman has rightly pointed out that the board has taken a decision in the past two days on how it wishes maternity services to be provided from now until the 21st century. I hope that the hon. Gentleman will understand that my noble and learned Friend the Minister of State will need to take time to consider the proposals carefully. Therefore, I am not in a position tonight to confirm the Government's endorsement or otherwise of the proposals. However, I assure the hon. Gentleman that what he has said tonight will be read carefully by my noble and learned Friend and all the points that he has reasonably made to the House will be taken fully into account.

I am sure that the hon. Gentleman agrees that we have made great strides in developing maternity care in Scotland. I agree with his point about meeting in principle the wishes of mothers, who have been saying loud and clear that they want services that are accessible, flexible and treat them with dignity. That shift in attitudes had led to positive changes in maternity care throughout Scotland, and we are actively encouraging those developments.

This debate is specific to Edinburgh, which has long been at the forefront of innovations in maternity care. It had the first professor of midwifery in the world in 1726—Professor Joseph Gibson. The hon. Gentleman will be aware of the pioneering work later of Professor James Simpson.

To respond to the hon. Gentleman's question about the number of births in the city, there are currently 7,000 a year, and mothers have access to a full range of antenatal and post-natal services. Most women experience shared care between GPs, obstetricians and midwives. Both the Simpson Memorial maternity hospital and the Eastern general hospital offer home births, domino deliveries, midwife care and shared midwife and obstetrician care. Lothian Health is committed to building on that range of choices.

I know that the hon. Gentleman joins me in paying tribute to the major contribution that the Simpson and the Eastern general have provided to mothers over the years. Tribute should be paid also to the excellent delivery services formerly provided by the Elsie Inglis maternity hospital and the Western general hospital.

There have been major changes in the pattern of maternity care in Edinburgh over the years and growing recognition of the need for proper community-based maternity care. Lothian Health would freely admit that there is considerably further to go in developing community-based services and ensuring that delivery services are fully sensitive to the needs of mothers. It is addressing those issues in its review of maternity services.

The immediate spur to action for Lothian Health has been the need to reconfigure maternity services in the light of its acute services strategy. In future, adult acute in-patient hospital services will be provided from three modern hospitals in Lothian. For Edinburgh, that means a new state-of-the-art royal infirmary, which will be built in Little France in south-east Edinburgh, and a substantial redevelopment and upgrading of the Western general. That is excellent news for Edinburgh, which for too long has had to make do with aging and increasingly outdated hospital buildings.

The proposals were, of course, strongly supported in Lothian Health's public consultation, and they promise substantial improvements in acute in-patient care. The hon. Gentleman raised the specific issue of further consultation. That matter is for Lothian, which will no doubt carefully read the hon. Gentleman's remarks.

To deliver that 21st century pattern of hospital services, it is necessary to close outdated and old buildings. More specifically, when Lothian consulted the public on its acute strategy, it proposed three maternity units in Lothian, with one each at the new royal infirmary and at the Western general hospital—the third being at St John's hospital in Livingston. That proposal was, of course, widely welcomed.

Subsequently, the board accepted that it should take account of concerns expressed that the highest standards of care might not be possible unless deliveries were kept to just two sites in Lothian. The health board was mindful of the need to consider both the importance of local accessibility, to which the hon. Gentleman rightly referred, and the requirement to secure a pattern of service that offers the greatest possible scope for successful outcomes. The board therefore commissioned its maternity services liaison committee to conduct a full appraisal comparing the two-site and three-site options. As the hon. Gentleman told the House, the committee's report came down in favour of two sites—one at St John's and one in Edinburgh—and the board undertook to consider that report at its meeting on 22 November. Ministers were happy to announce their approval of the acute services strategy last week on the understanding that the maternity issue could remain unresolved for a little longer, but Ministers would need to approve the board's final proposals.

As the hon. Member knows, the board has now decided to accept its maternity services liaison committee's recommendations. It is committed to the principles that primary care should be the main focus of maternity services; community-based midwifery teams are needed to ensure greater continuity of care; and consultant-led obstetric outreach facilities should be further developed to provide local community care for more complex pregnancies. The board also intends further to develop neonatal services, enhance the range of anaesthetic services and look into furthqr developing maternal intensive care services for those with the greatest need for medical care.