My Lords, the Government are aware of concerns over the closure of some maternity units. We commissioned a multi-disciplinary working party to consider this and make recommendations on safe and appropriate service provision.
My Lords, I thank the Minister for his thoughtful reply. In so doing, I should declare an interest as patron of the National Childbirth Trust. I am very pleased that the noble Lord understands the anxiety in this respect, but is he aware that some reports of the situation have not been published? One in particular, produced by the Royal Colleges, construes that 80 units may close. These are consultant-led units. Can the Minister please give an assurance that a thorough appraisal of the situation will be made before any units are closed? Further, where there is the remotest possibility of this happening, can he assure us that consultant-led units will be transformed into midwife-led units?
My Lords, we should be very cautious about accepting the figure of 80 at its face value. I can certainly assure the noble Baroness that the criteria being developed as a result of the work of the three Royal Colleges will be used by the NHS to help towards assessing the future provision of services. I can well understand the popularity of midwife-led units; indeed, as far as concerns low-risk births, there is no evidence to show that such units are unsafe.
My Lords, it may be that as many as 80 smaller units are involved if press reports regarding the report of the Royal Colleges are to be believed. Is it not quite unacceptable that many of these units face closure due to lack of medical specialists when many young "obs" and "gynae" registrars in training cannot get consultant jobs because such posts have not been created? Is it not high time that the Department of Health got to grips with the problem?
My Lords, as far as concerns obstetric and gynaecological consultants, I can tell the noble Lord that Ministers met with the president of the Royal College only last week. He put forward some very interesting suggestions as to how we should move forward in tackling the issue. We shall consider his suggestions most carefully in addition to the other matters that we have taken forward for consideration in relation to the problem of "obs" and "gynae" posts.
Again, I urge caution on the noble Lord as regards the figure of 80 units. The report that we received from the Royal Colleges does not make any recommendation in relation to the closure of units. However, the colleges have provided very helpful criteria under which the NHS can make proper decisions about the future configuration of maternity services.
My Lords, I would be happy to do so. Breast-Feeding Awareness Week has been run for a number of years. I believe that it has proved to be successful. We certainly continue our support for it. I believe that the campaign launched this week will be highly effective in encouraging those who wish to do so to breast-feed and will perhaps also combat negative perceptions of breast-feeding which may be held particularly by the male partners of mothers.
My Lords, as my wife gave birth to two children at home I very much agree with what the noble Baroness says. The latest figures I have show that throughout the 1980s home deliveries accounted for 1 per cent of the total number of births. That proportion has slowly risen. In 1994-95, 1.8 per cent of total births were home births. I very much accept that the NHS should do its best to meet the legitimate wishes of women who wish to have a home birth.
My Lords, I must declare an interest as my wife expects to be using the maternity service in the next week and a half. Is the Minister aware that maternity services in London are under severe strain through lack of staff? This is apparent to those who are about to use the service.
My Lords, the Government are committed to developing policies and practices to encourage more nurses and midwives to enter the NHS. The campaigns that we have run have been successful. We have attracted more nurses and more midwives. We have increased the number of training places available. I believe that those measures, along with the other work in developing maternity services, will ensure that the noble Lord and others receive the best possible service.