Skip to main content

Health: Obstetrics and Gynaecology

Volume 783: debated on Monday 17 July 2017


Asked by

To ask Her Majesty’s Government what action they are taking to address the issues raised by the Royal College of Obstetricians and Gynaecologists programme Each Baby Counts.

My Lords, the Government and NHS England are supporting NHS maternity and neonatal services to address the Each Baby Counts recommendations on clinical care, human factors and reviewing cases with poor outcomes. Key initiatives include the Saving Babies’ Lives care bundle, an £8 million maternity safety training fund, which includes multidisciplinary training on team working and communication, a maternal and neonatal health safety collaborative programme, and a national standardised perinatal mortality review tool.

I thank the noble Lord. This report by the royal college, which I believe is the first of its kind, creates a national measurement and a national picture, and shows that over 500 babies who died or suffered brain injuries during birth could have had different health outcomes if they had received different care—the human cost of a maternity service which is thousands of midwives short, underresourced and under increasing pressure and demand. How are the Government addressing the chronic shortage of midwives in the NHS, when new figures out last week, I believe, showed that more midwives are leaving the service and fewer midwives are joining it? Will he meet me and representatives of the royal college to discuss how training can match the implementation of the recommendations in the report and how best those recommendations can be continued in the work of midwives?

The noble Baroness is quite right to highlight the appalling tragedies involved. As she said, over 500 families could have had different outcomes if the care they had received had been different. That is worth dwelling on because every one of these incidents is a human tragedy. She highlights midwives. There are over 2,000 more midwives in the National Health Service and 6,500 in training. There has been a big increase in the number of births in recent years, so the number has had to rise. Of course, I would be delighted to meet her to discuss the training and to make sure that it is the very best available so as to avoid and, as the Secretary of State has said, to reduce the number of maternity incidences in future years.

My Lords, does the Minister agree that it is good practice to involve parents in the reviews of what went wrong during their baby’s birth? Why were only 28% of parents involved in the reviews of what went wrong? Surely it is totally unacceptable that 25% of parents were not even told that a review was taking place.

I agree that parents should be involved in such reviews—as those who are ultimately most affected by these tragedies, they absolutely should be involved. It is fair to reflect that issues around maternity deaths, brain injuries and so on have been going on for a very long time, and in certain trusts there have been acute instances of tragedy. That is why, as I said, the Secretary of State is determined to halve the number of deaths and incidents. We have had a number of reports, not only the one we are discussing today but also that of my noble friend Lady Cumberlege, Better Births, in an attempt to improve the way that services are delivered.

My Lords, I want to follow on from the question about reviews. The royal college that looked at the way in which the local reviews were undertaken found wide inconsistencies between different hospitals. Not only did a majority of reviews not involve parents at all, but my understanding is that, in its initial report, it found that only 9% of the reviews involved external experts. I know that the Government are very reluctant to intervene, but surely it would be possible to issue very straight guidance to the NHS to say how reviews should be undertaken and that in all circumstances both parents and external reviewers should be involved. Will the Minister give that some consideration?

I shall certainly give that consideration. There may be specific reasons why, in particular instances, that might not be possible or even desirable, but I shall certainly look into it. Take one of the instances: the tragedies at Morecambe Bay. It was found that there was a lack of objectivity in investigations and that that—along with other problems such as a lack of good data—led to the kinds of tragedies we saw, not happening once but over and over again. I completely take the noble Lord’s point, and I will look into it.

Is the Minister aware of the excellent work of the charity Best Beginnings, of which I am a patron, which provides perinatal support to families? The charity has, for instance, created videos to support families with very premature children, helping them to bond with their children. With the Royal College of Gynaecologists and Obstetricians, it has developed the Baby Buddy app, which gives parents exactly the information they need during and after pregnancy, so that they can have the safest pregnancy possible.

I thank the noble Lord for his question. I was not aware of that and will certainly look at it. I know that foetal monitoring is one of the key recommendations of the Saving Babies’ Lives care bundle that I mentioned, making sure that movement of the baby in the womb is continuing and monitoring the heart rate. That is critical to avoiding some of these tragedies.