Midwife and Maternity Services

Part of the debate – in the House of Commons at 10:13 pm on 17th January 2012.

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Photo of Anne Milton Anne Milton The Parliamentary Under-Secretary of State for Health 10:13 pm, 17th January 2012

I acknowledge that the hon. Gentleman has written to me about those issues, and I will come on to discuss the measures we want to put in place to ensure such past tragedies do not happen again. CQC reviews have corroborated that there are problems. It raises concerns about the safety and quality of maternity care in some areas. They are small but significant areas of concern, and they must be of note to all involved in this area of care, especially as sometimes they involve personal and family tragedies.

Media and public attention on maternity services has picked up pace over the last year. In particular, there is anxiety about safety, capacity and changes to services. In many respects, there is a “perfect storm” of circumstances, which makes things difficult. The issue is how well we react, and how well services evolve and the work force are equipped to react positively.

We have put extending maternity choice as a key priority in the NHS operating framework. To help communities achieve the desired outcomes in the most individually suitable ways, when services change, that change will be led by clinicians, midwives, and women—the very people who run and use those services.

To make sure the maternity infrastructure is being put to best use, I want there to be maternity provider networks across the country, bringing together all the different elements of maternity services, so there are no gaps or hidden corners where mothers might get substandard care. The incident that John Woodcock raised involves precisely such hidden corners and gaps, and such incidents often result in a personal tragedy. Hospitals, GP surgeries, charities and community groups can all be linked up to share information, expertise and services.

We also want more efficient use of skills in maternity wards themselves. Obstetricians and gynaecologists, maternity support workers and, of course, midwives can come together and use their complementary skills and expertise to get the best results for mothers, with appropriately trained support workers providing valuable assistance, for example with breastfeeding, leaving midwives to concentrate on the more specialist areas. This is not just a numbers game; it is about getting the skills, expertise and team mix exactly right. That will mean the talents of all 27,000 midwives can be put to the best, most efficient, use. That number shows that more midwives are working in the NHS now than ever before. The picture looks good for the future, too, because it is backed up by a record number of midwives entering training. Subject to the number of forecast births, that will be maintained.

In July, we published “Supporting Families in the Foundation Years”. That report does not have the catchiest of titles, but it is important because it sets out how everyone who commissions, delivers or leads on something can work to support parents and families. We cannot overstate the importance of the health and well-being of women before, during and after pregnancy; it is a critical factor in giving children a good start and in continuing that good health and well-being as they get older. The latest data show that more than 90% of women who gave birth in the third quarter of 2010-11 saw a maternity health professional within 12 and a half weeks. That is another dry statistic, but it is crucial. Early intervention and early contact with a maternity health professional is crucial to the well-being of not only the mother, but the child. Those meetings are about more than just basic maternity care. Work will have been done on, and discussions will have been had about, things such as diet, exercise, smoking and drinking. This is about improving the health of the baby, the mother and the whole family, and decreasing the kind of health inequalities that remain and are so persistent in our society. All those things affect the outcome for those women and their babies, and the lasting impact of those things cannot be underestimated.

To back all that work up, from April a maternity experience indicator will be introduced as part of the NHS outcomes framework. That will be an important part of identifying those gaps, as it will allow us to chart a woman’s experience of care throughout antenatal care, labour, delivery and post-natal care. It will also allow women and their partners to compare people’s experience of care and makes choices about what they want to do. It will be a valuable tool for midwives as well, as they will be able to see how they are doing in relation to peer organisations. If they are doing well, this will drive them on to maintain their level and if there are weaknesses, the experience indicator will show specific areas to improve. As I say, this is not about the numbers; it is about getting the team mix right. In one busy maternity unit that I visited, it was simply about moving women around the labour facilities effectively and efficiently.

The Department of Health funded the “Birthplace in England” study, which was published in November last year. It provided evidence about the expected outcomes for women and their babies at “low risk” of complications. It was the first study of its type in this country, and the findings will be a very important part in shaping maternity services, as well as other, linked parts of the NHS, such as ambulance services, so that every part of the system is working together. It is an extremely important body of evidence. In addition, we have asked the Centre for Workforce Intelligence to carry out an in-depth study of the nursing and maternity work force to determine whether we have the right skill mix and professional teams, and whether they are able to deliver what is needed. That will start this year and will inform the future commissioning of training places.

I hope that what I have said reassures my hon. Friend the Member for Crawley and other hon. Members in the Chamber that we are continuing to improve maternity services to women, whoever they are, wherever they live and whatever their circumstance; it is not good enough to give excellent care in one place and for services to be patchy elsewhere. We want consistently high-quality care and we will carry on with that process, making sure maternity services and midwives are fully prepared for the demands of the modern maternity landscape.

I know that my hon. Friend has had specific issues to deal with in his local area and that they have been ongoing for many years. I am also aware that the picture is complex in terms of the circumstances of the women who end up using the local services. I hope that I have reassured him, to some extent, that we have taken note of what is going on. There is no doubt that the birth of a baby is a very special moment and we want it to be a positive experience that shapes the future of not only the child and their mother, but the whole family.

Question put and agreed to.

House adjourned.