Care Quality Commission (Morecambe Bay Hospitals)

Lord Walney Excerpts

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. That regime was utterly flawed, and as far as we can tell, inspectors looking at hospitals and care homes had targets of inspections they had to complete in a way that was totally counter-productive to the concept of a rigorous, thorough, independent inspection where people speak out without fear or favour when they find problems.

I also thank my hon. Friend for the other point he makes: that the people who work at the University Hospitals of Morecambe Bay NHS Foundation Trust are working extremely hard and under great pressure. I think they are doing a very good job by and large, but there are clearly very severe problems with the trust that we need to get to the bottom of, and it is very important that we recognise that if we are going to create a safety culture in the NHS, we need to back the people on the front line. They did not go into the NHS to have to deal with these terrible breaches in health and safety; they went into the NHS because they care for people and they want to do the best for people at their most vulnerable.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

May I first thank the Secretary of State and the shadow Secretary of State for those words of apology to the Titcombe family and other families who have long been pressing for an inquiry and this kind of day of reckoning for the CQC? It is hard to imagine what it must be like to lose a child, but then to be faced with an almost impenetrable wall of bureaucracy, with one organisation and one group of people passing them over to another group, and with all of them ultimately washing their hands of accountability, is truly shocking. That has been laid bare in this report, and I commend its authors for bringing it to the attention of the public.

What the Secretary of State says about the staff in this trust is very important, because these are front-line people who have been failed by poor leadership and a poor inspection regime, which absolutely has to change.

The report says the particular issue here

“may constitute a broader and ongoing cover-up.”

Is the Secretary of State satisfied that that is not the case? If he is, how can he be? What can he do to look more widely than just at the CQC itself when looking into this allegation?

Health and Social Care

Lord Walney Excerpts

Monday 13th May 2013 Commons Chamber

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

It is a pleasure to follow the hon. Member for Stafford (Jeremy Lefroy), who made a thoughtful and considered speech on an issue of great importance nationally, as well as to his constituents.

It was a pleasure to be in the Chamber to hear such a powerful speech on plain packaging for cigarettes from my hon. Friend the Member for Barnsley Central (Dan Jarvis). Frankly, if Ministers are not convinced after hearing his arguments, they should probably not be in their place. I think that they are convinced and I hope to see them make progress.

I want to start on a note of consensus. I welcome the inclusion in the Gracious Speech of the Bill on mesothelioma compensation. This dreadful disease is a time bomb that, once detonated, often goes on to kill within months. With its shipbuilding heritage, more individuals in Barrow and Furness suffer from mesothelioma than in any other constituency in England. We owe a duty of care to all those who are suffering: they made an honest living and what is happening to them is not right. We should applaud all those who have pushed for further progress, including former Labour Ministers and the hon. Member for Chatham and Aylesford (Tracey Crouch), who I understand wanted to be here but is on her sick bed.

There are early concerns about the Government’s paucity of ambition. It is vital that the Government mandate a scheme that will build fittingly on the work of my predecessor, Lord Hutton, who expanded and speeded up compensation in the previous Parliament. However, many will see the thin programme last week as a missed opportunity to address increasing alarm about the Government’s poor stewardship of the NHS. It would be too optimistic to hope that Ministers have had an early change of heart on the costly and ill-conceived reforms they have just bulldozed through Parliament. In addition to the lamentable absence of plain packaging legislation, they could have introduced measures that sought to bridge the yawning gap between their rhetoric on listening to local people and the reality that is seeing the clear wishes of residents on NHS services ignored up and down the country.

In Barrow and Furness, we hope that health professionals in charge of provision across Morecambe bay will heed the passion and powerful arguments from local people on oncology, maternity, and accident and emergency provision. While residents understand that it can make sense to travel to get the best that 21st century health care can offer, like so many across the country they love their local hospital, they think it should have its fair share of the very best, and they think local provision, that is accessible to them and visiting loved ones, is a basic part of a quality service, not something to be dismissed as an unnecessary luxury.

I have some hope that the new management team at Morecambe Bay NHS Foundation Trust will listen to local concerns. An early test will be the publication of revised plans for Furness General hospital’s oncology unit this month. However, we see what is happening in other areas where the Government’s local engagement test is proving to mean little more than holding a meeting and nodding in an understanding manner, and ignoring everything people say and downgrading services anyway. When my constituents see the scale of the upheaval and cuts to front-line nursing staff involved in reducing the budget of Morecambe Bay Trust by £25 million within two years, they are, understandably, very wary of trusting Government promises that no efficiency savings will be allowed to affect the quality of patient care. I hope the Minister will tell me whether the Government will heed calls, including from the trust itself, for a rethink on the speed and scale of the cuts they are imposing.

Will the Government not take heed of the dismay felt about recent NHS reorganisations and enact measures to strengthen the power of local opinion in determining the future of our hospitals? We live in times of strained resources, but faith in the future of the NHS may continue to be eroded until we learn genuinely to trust local communities. When we come to look back at the history of the NHS over the current decade, I think we will see this as the time when we were bound overly tightly to the idea that the clinician always knows best. We will come to see the Government’s blind faith in the clinical stamp for taking services away as an early 21st century equivalent of the “Whitehall knows best” mentality that gripped reforming Governments after the second world war. Just like the “Whitehall knows best” ethos of the 1940s and 1950s, the clinician knows best mantra has the best of intentions but is insufficiently responsive to challenge from the patients who rely on the services that are being shaped by those at the centre.

Let me be clear. It is essential that health professionals make their case when decisions are made. Their expertise is immense and people should not deviate lightly from their plans. However, it is by no means certain that any one group, even one bursting with medical experience, will always call it right first time. Their views must be subject to scrutiny. Often the clinical push to concentrate a specialism at a single site takes less account of local geography and community links to health facilities than is demanded by local people, who ultimately pay the clinicians’ wages.

This is not an argument for sentimentality. The views of local people will sometimes be irreconcilably different in a single area, but if, for example, Barrow families suddenly face the prospect of a 100-mile round trip to visit a relative—because a unit at Furness General hospital has moved to Lancaster—their views on the move will be important. Many communities across England are fighting for their local health services. Some are threatened by cuts, but others are at risk from this clinically led decision-making model.

[James Duddridge]

The hon. Gentleman is making some valid points, several of which I am deeply sympathetic to, but on clinicians, is he referring to GPs or specialists? Does he think that the clinical commissioning groups of GPs who are more fixed in the community could have an impact on, for example, oncology and other specialisms in local hospitals?

[John Woodcock]

That is a good point, and it remains to be seen. We hope so, but the system has yet to be put to the test.

I am disappointed that no move towards genuine localism was outlined in the Gracious Speech. It is time for a people’s NHS Bill to end the toothless sham that too often passes for local consultation. When local people say no, the default should be that they have exercised a veto that ought to be heeded. That would require a step change in our NHS away from a model that, yes, might have helped deliver improvements in health outcomes of which the country should be proud, but which has done so—

[Norman Lamb]

Will the hon. Gentleman give way?

[John Woodcock]

I will give way, if the Minister is quick, because I do not have much time left.

[Norman Lamb]

I am interested in what the hon. Gentleman is saying, and I accept the point about the importance of accountability. [Interruption.] He has just realised that he has got an extra minute of time, so I have done him a favour. Does he accept, however, that the old NHS, which we reformed, had no local accountability at all and that we have introduced some accountability through the health and wellbeing boards, bringing together local authorities and the NHS?

[John Woodcock]

It is an interesting point. I am not claiming that the system operating now is fundamentally different from that of three years ago, but around the country people who were promised a say in local decisions have been devastated to find out that they have none. Unquestionably, what has been put in place is not adequate. It is a sop to localism that does not do what it says. It would be a step change to move away from the current model.

Following the current model has meant alienating many local people who understood the trade-offs, but nevertheless fervently desired to keep services local. Whatever happens, surely the current tension between national planning and local unrest is unsustainable in the long term. In opposition, the Conservative party told the public that it understood that and pledged to end local hospital service closures, but of course its promises turned out to be a cheap election con trick. Instead, Ministers have forced through an expensive, chaotic and divisive health reform package that ultimately has pushed NHS decision making still further from the people it serves. We need a change of direction. Local communities pay for the health service they receive, and they deserve to be treated with greater respect.

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[James Duddridge (Rochford and Southend East) (Con)]

It is a privilege to be called to speak in the debate, and it is good to follow the hon. Member for Bridgend (Mrs Moon). Some of her comments about rare kidney diseases resonated with me, as I have recently visited the very good renal centre in Southend. I have also looked into the issue of rare diseases. Individually, they might be rare, but collectively they are quite common as a group, and the funding for the relevant drugs and for more general treatment can be tricky.

I have a quite carefully drafted speech here, but I was blown away by my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard), who spoke without notes and whose speech was a fantastic tour de force. I am tempted, perhaps unwisely, to pick up on a number of issues that have been mentioned in the debate, some of which have been quite controversial. I did not listen to every single speech today; I missed half an hour. While I nipped out for a cup of tea, I heard colleagues on this side of the House speaking out against equal marriage—perhaps some Opposition Members did so as well—but I for one am glad that that legislation will be dealt with in this Session. The carry-over motion will ensure that we have ample time to debate it and to work through some of the issues. In 20 or 30 years, we will look back in confusion as to what the problem was. We are perhaps introducing the legislation faster than the public has an appetite for, but politicians sometimes need to lead rather than follow.

At lunchtime today, I had the privilege of having lunch with my mum and dad, who were in very good form. They said that they had been looking for me during the Queen’s Speech but had been unable to see me, and I told them that the debate was carrying on today. I asked them what they had thought of the speech, and they told me they thought it was very funny. I am not sure that either Her Majesty or the Prime Minister wanted to create that impression. I asked my mum why she found it funny, and she described how Black Rod had got stuck halfway down and been held up by the Speaker.

There has been a debate today about whether the Queen’s Speech was too narrow. The right hon. Member for Rother Valley (Mr Barron) criticised Conservative Members for talking more about what was not in the speech, but the general public do not think in terms of Bills and Acts; they think in themes, as my hon. Friend the Member for Blackpool North and Cleveleys said. One theme of today’s debate has been immigration seen through the prism of the NHS, although the general public probably also look at it through other prisms, including housing and Europe. Looking at the Queen’s Speech in a thematic way is perhaps slightly more useful.

I am tempted to make some comments on Europe. It is constructive that we should vote on the matter. If the coalition is to survive, it will need to be more comfortable about having open debates rather than simply private ones. We will need to have more open debates, rather than fewer, if the coalition is to be healthy all the way through to 2015. It is a strength of democracy to have open debate rather than narrowly commit ourselves to certain lines.

On immigration, the right hon. Member for Rother Valley talked about the use of extremist language. Actually, far from its use being negative in this context, the use of immoderate language can sometimes be essential if we are to have an open discussion. Otherwise, the debate gets overtaken by the Daily Mail and the Daily Express. We should have a full and frank debate on immigration, and on other issues.

When we consider health—the main focus of today’s debate—I think politicians are sometimes too scared to ask questions about a merger or a closure, for example, and to query whether those are the right things to do. We should be more open minded. The hon. Member for Barrow and Furness (John Woodcock) said that more local people should be involved in the process. I am sure he is right, but I am not sure that that is a totally new thing, as the Minister intervened to say in the latter part of his speech. I was certainly very close to the position the hon. Gentleman stated. I am not sure which of us should worry more about that, but it is a statement of fact about how I felt.

The commitment to spending 0.7% of gross national income on international aid was not in the Queen’s Speech. That is a totally arbitrary figure, but it is a promise that all the main political parties made and one that I fully support. To be frank, I cannot get het up about whether or not the commitment is built into a piece of legislation. If my family was starving in Ethiopia, or in the northern badlands as Bob Geldof would describe them, I would not care whether the money was coming because it had been mandated or because it had been promised. It makes little difference. I certainly congratulate the Government on actually spending that money, which is far and away the most important thing.

Let me deal with the deregulation Bill—legislation announced in the Queen’s Speech to reduce the body of existing legislation. I feel that an awful lot more can be done. The Bill has not been published, but I think that the Government have been too modest in their ambitions when it comes to deregulation. The Better Regulation Task Force is producing some really strong ideas.

[John Woodcock]

I am fascinated by what the hon. Gentleman is saying. Perhaps he was about to mention this, but what does he want to deregulate?

[James Duddridge]

At the moment, we have piecemeal deregulation, whereby we look at specific issues and then deregulate. I was elected as chair of the Regulatory Reform Committee, which as a body deals with pieces of legislative reform that the Government think can be fast-tracked for regulation or deregulation in order to avoid burdensome regulation. That is very much a piecemeal process—we looked, for example, at veterinary legislation—but it would be much better to have a big thematic review of issues surrounding care homes, for example. Rather than look at health and safety, the medical issues or equipment separately, it would be better to have a thematic review, cutting across Departments in the same way this debate cuts across the division between the health service and social services, local councils and different funding streams. I think it is our responsibility to do that here in the House of Commons.

The deregulation Bill will be good and tidy up bits of the statute book, but I would like to see a lot more detail about how that is going to happen. A Joint Committee will be set up between the Lords and the Commons, and I would very much like to serve on it, but as much as possible we should open out the number of Bills that we are looking at. Setting aside the issue of whether we should be in or out of Europe, the increase in European legislation demands that we face up to a two-for-one deregulatory challenge, just to stay standing. We need to go further.

The economy is another key theme in the Queen’s Speech. Given our current economic position, if we had had a Conservative Government from the outset, I believe such a Government would have tested every single Bill by asking, “Will this Bill help the economy? If not, it is marginal, and we should push it to one side—certainly when it comes to parliamentary time and impact.” I think that the Budget is much more important. When we highlight the themes in the Queen’s Speech, we should not judge ourselves by the amount of paperwork we sign off. The Budget is, in many ways, more important. Corporation tax, the national insurance deal and so forth will get Britain booming. I have seen it in my local area, where, for example, Southend airport has boomed, generating over 500 jobs in the few years that it has been motoring in a serious way, as opposed to when it was a rather hobbyist airport. There is much still to be done, but we should not judge ourselves by the volume of legislation. In fact, through the deregulation Bill, we should be able to reduce that volume.

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[Sarah Champion (Rotherham) (Lab)]

I would like focus on two groups of people who are not adequately covered in the Care Bill: young carers and the disabled.

I recently had the pleasure of spending time with a remarkable group of Rotherham young carers who are supported by Barnardo’s. Because of funding limitations, Barnardo’s is able only to work with young people between the ages of eight and 18, and only 100 in a year. Sadly and shockingly, Barnardo’s estimates that 3,000 young people are carers in Rotherham alone. It has on its waiting list children as young as six who are counting down the days until their eighth birthday when they can get some support.

The young carers asked me to make colleagues aware of their plight. Hannah told me that the main thing she wanted was recognition for the work she did. She understands her mum, who suffers from severe depression, better than anyone. Hannah wants her experience to be fed into her mum’s assessments. As she said,

“they trust me to look after her but they don’t trust my opinions.”

When Hannah calls the medics to say that her mum is deteriorating, she should be taken seriously. Instead, young carers have to contact their Barnardo’s worker to lobby on their behalf, because they are not recognised by the authorities.

I welcomed many of the measures in the draft Care and Support Bill, but they are limited to adults caring for adults. The Care Bill represents a missed opportunity to improve the rights of all carers, including adults caring for children and young carers. The young carers I met know that, because of them, their parents do not have to stay in hospital, a mental institution or a care home. They know how much their help saves the Government. On their behalf, I urge the Minister to make sure that the Care Bill gives young carers a little support in exchange.

Consolidating provisions relating to adult carers in previous Bills will create neat, codified legislation, with

“clear legal entitlements to care and support”

for adults, while young people will be left with piecemeal, leftover legislation that practitioners will struggle to navigate. This is highly problematic. As I have said, workers often need to act as advocates for young carers and protect their rights. This area has long faced the challenge of a confusing legal framework, and the Bill has the potential to make matters worse. It appears to provide a clear picture of carers’ rights, while in effect excluding some of the most vulnerable carers.

I recognise that the bulk of the changes needed to protect young carers need to be made in the Children and Families Bill, but changes could also be made in the Care Bill. In order to prevent inappropriate caring, it is important that measures are put in place to ensure that adults’ needs are met and that young people with potential caring roles are identified as part of an adult’s assessment. Not only would that recognise the important role that young carers play, but it would allow their needs to be acknowledged formally, forcing existing services to be more accommodating. For example, all of the young carers I met faced challenges at school, with inflexibility on late homework, missing school and the need to call home during the day. If young carers are formally recognised as part of the assessment process, that could be fed through to the school and teachers could be notified of the young person’s needs, allowing them to be better supported.

On the Bill’s implications for those with disabilities, my office has seen a marked increase in the number of cases of disabled people struggling to make ends meet. The introduction of the employment and support allowance has been confused and poorly administered. I have dealt with numerous cases of vulnerable people being placed in unnecessarily stressful situations and left financially worse off by this Government’s reforms. Such cases already make up 10% of my overall case load. The abolition of incapacity benefit will soon be followed by the abolition of the disability living allowance and the introduction of personal independence payments, meaning that disabled people are being squeezed at an unsustainable level.

[John Woodcock]

My hon. Friend is making an important speech. Does she share the concern of my local disability association that the problems with the ESA benefit and how it has been reassessed have led to grave worries about the introduction of personal independence payments?

[Sarah Champion]

I thank my hon. Friend for yet another example of the extreme stress that people are being put under and the mismanagement of this entire process. The pressure of the burden being placed on them is intolerable.

I am extremely concerned that the Government’s Care Bill will put further pressure on that vulnerable group. The key issue for social care reform is eligibility. A third of social care users are working-age disabled people. The Bill will not improve the social care system for them, and 105,000 disabled will be shut out from receiving the social care that enables them to live their lives.

My hon. Friend the Member for Easington (Grahame M. Morris) mentioned statistics from Scope that make depressing reading. Four in 10 disabled people who receive social care support say that it does not meet their basic needs, including eating, washing, dressing and just getting out of the house. A third of working-age disabled people say that cuts to their social care have prevented them from working or volunteering.

The Bill appears to focus on the elderly and does not address the care crisis facing disabled people. For those working-age disabled people who do not meet the eligibility threshold, the £72,000 cap on care costs will not apply. They will continue to need to meet the cost of their social care. If an individual’s care needs increase later in their working life to the point that they become eligible for social care, the cap will not take into account the contributions they have already made to meet their care needs.

I agree that the introduction of a national eligibility threshold is a step in the right direction. Alongside a new assessment system, I hope that it will end the postcode lottery in care provision. However, it is vital that the threshold is set at a level that ensures that working-age disabled people receive support to meet their basic needs.

The Government spend £14.5 billion a year, or 2% of public expenditure, on adult social care, which includes older people’s services. However, it was estimated by the Dilnot commission that social care services are under-resourced by £2 billion. Those services are being further squeezed by the pressure of an ageing population and a 33% reduction in local council budgets. Local authorities are therefore dramatically under-resourced for the demands that are placed on them. As a consequence, they have been raising the threshold at which disabled people become eligible for support. Recent surveys suggest that almost half of local authorities plan to reduce spending on care services for adults, which will hit those with learning difficulties and those with disabilities.

Unless there is sustainable funding for adult social care, the situation is likely to get worse. The upcoming spending review must be used to secure more long-term funding for social care services to underpin the Care Bill. The Government must not lose sight of disabled people and young people as the Bill progresses.

Mid Staffordshire NHS Foundation Trust

Lord Walney Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

Yes, I can confirm that. My hon. Friend is right, because part of the big change that we need is to see a big increase in provision of domiciliary care, and an increase in the standard of that care.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The Secretary of State talks about severance and follow-on employment. Does he think it is acceptable that when the former chief executive of Morecambe Bay hospitals trust had to step down in February last year, because of the problems there, he was kept on the books in secret and paid £250,000 from local trust budgets—which could otherwise have gone to local health care—and was transferred to the NHS Confederation where his responsibilities could include teaching future leaders and helping to redesign the system?

Sudden Adult Death Syndrome

Lord Walney Excerpts

Monday 25th March 2013 Westminster Hall

[Steve Rotheram]

I will highlight some of the statistical evidence relating to what the hon. Gentleman says, but if nothing else, if we can debunk the myth that we will do damage if we try to intervene and that the use of defibrillators will cause complications, that will be a start. The campaigners who have come here today do not believe that this is the end of a process; rather, it is the start of the momentum that they are building to ensure that this issue is more widely recognised.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I congratulate my hon. Friend on securing this very important debate. He will share my sadness at the death last week of Eleanor Murphy, who was the mayoress in Barrow last year and who, along with her husband, the mayor, was able to raise £40,000 to buy 20 new defibrillators to be placed around Barrow. Does he agree with me that a great tribute to her life and their effort would be to encourage more firms and shops to agree to have defibrillators on the outside of buildings, which was their big cause towards the end, so that if someone collapses in the street, people do not need to go inside a shop, which might be closed, to be able to save their life? The Co-op is a particular example.

[Steve Rotheram]

Absolutely. What campaigners, or indeed anyone who is sensible enough to understand that we are in times of austerity, will say is that it is not for the Government to do everything. The example given by my hon. Friend of £40,000 being raised and the example of the OK Foundation, which has put defibrillators in all Liverpool schools, and of other organisations that are doing sterling work, prove that this is a partnership. This is something that charities can help with, but it does demand action from the Government.

Accident and Emergency Departments

Lord Walney Excerpts

Thursday 7th February 2013 Commons Chamber

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

It is a pleasure to follow the hon. Member for Morecambe and Lunesdale (David Morris), who made what I must say was a quite extraordinary speech. I realise that I may be in danger of being a little ungracious, given that he was kind enough to thank me. I shall say a little about the University Hospitals of Morecambe Bay NHS Trust, which our constituencies share. However, I must first say to him—on behalf, I think, of several Members who are present—that to suggest that the impending closure of Lewisham A and E department is a scare story from the local Labour party does an incredible disservice to the many thousands of families who are deeply alarmed and worried about what is happening in the area.

[Margaret Hodge]

I congratulate my hon. Friend on managing to save his A and E department, but does he not agree that money should go to where patients are? In my area, north-east London, 132,000 patients currently attend the Queen’s hospital A and E department, and 100,000 attend King George’s hospital A and E. Closing an A and E department that serves more than 100,000 patients is unfair to patients and madness in terms of funding distribution.

[John Woodcock]

My right hon. Friend is right to speak of the crazy situation in which heavily used accident and emergency provision across the country is under threat. I intend to say a little more about the particular challenges faced by geographically isolated regions such as mine, but first let me say how grateful I am to the Backbench Business Committee for securing the debate, and congratulate my hon. Friend the Member for Ealing, Southall (Mr Sharma) on a very powerful opening speech.

I want to speak briefly about the accident and emergency department at Furness General hospital in my constituency, and, in doing so, stress the importance of ensuring that A and E provision remains accessible to the high-tech, highly skilled industries in which this nation must continue to lead the world. Barrow’s A and E department is not yet under immediate threat of closure, but there is grave concern about the impending review of services throughout the Morecambe Bay area, which has been driven at least partly by the trust’s need to make significant cuts in its operating budget in the years ahead.

A trust covering 300,000 people would often be served by just one A and E department, but in the Morecambe Bay area there are two. That is due to the particularly challenging geography of the area, and, in particular, the time that it takes to travel the 50 miles from my constituency to Lancaster with only a single road connecting Barrow to the M6.

The hon. Member for Morecambe and Lunesdale directed all his fire at the local Labour party, and in doing so highlighted—probably quite helpfully for the party—the excellent work that it is doing with its campaign on the streets. I was probably more disappointed than surprised that he made no mention of his hon. Friend the Member for Westmorland and Lonsdale (Tim Farron), who is campaigning hard to take A and E provision away from Lancaster and transfer it to Westmorland General hospital.

Let me make it crystal clear why no one should get the idea that Barrow’s A and E department could move. Not only would every single resident in the geographically isolated Furness peninsula suffer unacceptably long journey times if it were closed; its removal would be a significant blow to industry in the area, and would ultimately threaten our potential to become a national cradle for advanced manufacturing. The manufacturing companies on which our local economy depends—including shipbuilding, nuclear engineering and pharmaceutical companies—have enviable safety records, but they nevertheless carry a small but inherent risk of industrial injury. As responsible business men, local employers seek to mitigate and manage that risk, but part of their management includes access to a full accident and emergency service in the locality.

BAE employs 5,500 people in Barrow, representing the largest of the many sites in the nation’s critically important nuclear submarine supply chain. This is what the company’s submarine arm told me for today’s debate:

“BAE Systems Maritime Submarines is possibly one of the highest risk manufacturing sites in the UK with a broad spectrum of safety hazards. Although these hazards are effectively managed and the site has a strong safety record, the absence of locally provided A and E services would have serious implications for the business. The treatment administered within the first hour following incidents is critical. A number of minor incidents, particularly associated with foreign object ingress to eyes, are referred to Furness General Hospital per week. Therefore additional ambulances would be required to transfer injured personnel, significantly increasing the ambulance demand within the area. Decontamination of people would currently be provided by FGH Accident and Emergency following a major incident at the Barrow site. This may include the cleansing of chemicals or radioactive substances.”

If, God forbid, something like that were to happen, time would be of the essence. Here in Furness, as in several areas of the country, A and E closure could put at risk the lives of employees who perform a service to their country and would ultimately endanger key parts of the nation’s prized industrial base. It is vital that Ministers wake up to the full spectrum of risks posed by the approach they seem intent on imposing on our national health service.

University Hospitals of Morecambe Bay NHS Foundation Trust

Lord Walney Excerpts

Tuesday 5th February 2013 Westminster Hall

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I am pleased to have secured this debate. It is a pleasure to speak under your chairmanship, Mr Howarth.

I represent a community in shock, reeling from the suddenly announced intention to transfer Furness general hospital’s beloved special care baby unit and consultant maternity services out of the county, from 9 o’clock this morning, to Lancaster. Pleas to rethink that emergency transfer have so far been rebuffed, leaving expectant mums distraught at the prospect of a 50-mile trip in the back of ambulance if they suffer complications in labour. I will set out our concerns in detail and stress the areas in which we hope the Minister, who is of course an expert in the field, will agree to intervene, but first I will discuss the wider issues the area faces, which prompted my application for this debate.

There is the forthcoming review of hospital services, triggered by the need for significant budget reductions across the University Hospitals of Morecambe Bay NHS Foundation Trust. All of us here are acutely aware of the long-term threat that that might pose to key provision, such as the need to sustain a consultant-led maternity service and accident and emergency provision across more than one site in the area.

There is also the campaign against the removal of A and E, maternity and intensive care units at Royal Lancaster infirmary, on which the Downing street petition in the name of Matthew Hood already has thousands of signatures. I think that my constituency neighbour, the hon. Member for Westmorland and Lonsdale (Tim Farron) wants to do exactly that—move Lancaster’s A and E department to the Westmorland general hospital. Let me simply say that any attempt to question Barrow’s need for an A and E department would be met with horror not only by every single resident of the Furness area, but by the prized and highly regulated industries on which the nation depends.

The broader question facing the Morecambe Bay trust is how best to locate services when the population is far more spread out than in most areas of Britain, and when centres of population are often connected by a single road that winds through Cumbria’s unique landscape. In other areas, a trust for hundreds of thousands of residents might naturally be based around one A and E department and one maternity unit, but that would put an unacceptable strain on residents of Morecambe bay. People in pockets of severe deprivation in Barrow and families who, for whatever reason, just do not travel would be forced to go to another county and be completely cut off from their families. In an emergency, it would result in journey times of more than an hour on routes that are prone to become blocked by breakdowns.

I want to ask the Minister four questions about the four tests in the Government’s forthcoming consultation. His first test is the evidence base. Will he ensure that the options and risks are properly weighed, so that the risks inherent in long-distance ambulance travel are set alongside what might otherwise be the optimal configuration of services? The second test is whether there is the support of GP commissioners. The past 24 hours have shown the damaging shambles that can occur when a trust attempts to press on against the will of local commissioners. The Government back the new system, so will the Minister ensure that local GPs have the teeth to insist on the services that communities need? The third test is choice for patients. Will the Minister ensure that problems of isolation and lack of access to services are an integral part of the assessment when it arrives on the Secretary of State’s desk? It is hard to imagine the test of choice being passed if, for example, an isolated peninsula’s only consultant-led maternity unit were downgraded. The fourth test is strengthened public engagement. The trust needs to do much better than the mess of the past few days, which has left women desperately worried and confused. I shall say more on that in a moment, but the underlying point is that engaging means listening and acting. Of course, health professionals have a duty to present the options and a proper assessment of safety in each case, but if the public weigh that up and say that they want to keep the services they need close to home, the Government should listen to them.

Another major issue is the need for Ministers to ensure that our local hospitals and the wider national health service adequately learn the lessons of the significant and prolonged failings in hospital management at the Morecambe Bay trust. There have been tragedies about which people are still demanding answers and which apparently did not trigger sufficient improvements, despite laying bare shortcomings in areas such as maternity provision several years ago.

[Mr Jamie Reed (Copeland) (Lab)]

As usual, my hon. Friend is making an excellent case on behalf of his constituents. Many people in the south of my constituency use Furness general hospital, as well. Does he share the fear that some of them have expressed to me that the rapid removal of the special care baby unit heralds a stealth reconfiguration of services there?

[John Woodcock]

My hon. Friend is absolutely right that that is indeed the great fear. It is up to the trust, and ultimately to Ministers and the Government, to demonstrate that that is not the case, but there are still questions to be answered.

The need for lessons to be learned has been shown by such problems as the basic lack of grip in key areas in recent years—for example, the failure of new computer systems designed to remind patients about repeat appointments, which has clearly put lives at risk. A police investigation into a number of deaths is ongoing. There is also a lack of openness at the trust.

I pay tribute to the hard work of the staff in the maternity unit and across Furness general hospital. They are dedicated people, who come to work wanting to help others and to save lives. There have been real improvements of late, and we should recognise the immense strain placed on staff by the ongoing spotlight on the hospital and the longer-term uncertainty over their future. None the less, families are still grieving because of past mistakes made in a poorly managed system. The Minister was good enough to write to me in response to a letter from my constituent James Titcombe, and again recently on the need for a genuinely independent inquiry into the lessons for the wider NHS of management failings at Furness general hospital.

[Eric Ollerenshaw (Lancaster and Fleetwood) (Con)]

I congratulate the hon. Gentleman on securing this debate and, as I know from having worked with him, on his concern for his constituents. Does he not think that we constantly go round the roundabout in relation to the Morecambe Bay trust? To the centre, Morecambe bay sounds as though it is a natural unit, but in fact it is a barrier. I suggest that we need to look at the fundamental geography, which might mean challenging the boundaries of the Morecambe Bay trust, if we are ever to get some balance between the demands of Furness, Kendal and Lancaster.

[John Woodcock]

The hon. Gentleman makes an interesting point, for which I am grateful. I am sure that Ministers will want to consider that, but I think it must not come at the expense of local MPs’ taking our eye off the ball in the forthcoming consultation.

The Minister was good enough to write to me about James Titcombe and other grieving families. In the first letter, he said that he would keep the issue under review. I hope that, when he has time to look at the matter further, the Minister will agree that the trust’s commitment to an independently chaired but internally managed inquiry, although it is a welcome step forward, will not be sufficient to give confidence and ensure that lessons are learned, not only in this individual hospital, but in the entire NHS. Most of all, I hope that he will join me today in sending a message, loud and clear, that the need to be accountable for past mistakes must never be used by the trust as an excuse to remove services that our community clearly needs.

The final part of my speech relates to the crisis caused by the trust’s shock decision to transfer, apparently temporarily, the special care baby unit and consultant maternity services out of Furness general to Royal Lancaster infirmary due to increased sickness absence levels at the trust.

Let me deal first with the shambolic process that has left expectant women unsure about where they can give birth—even now, as we speak, two hours after the transfer was due to take place—because of genuine fears about a lack of ambulance cover. The decision was taken unilaterally by the trust, with no consultation or warning given to the public, the obstetric consultants who work at Furness general, or the GPs responsible for commissioning the services. The option of transferring staff from the Royal Lancaster infirmary was not put to the board. Although there can be no doubt that staffing levels are low at Furness general, there was no detailed risk assessment of the dangers of transferring mums in labour by ambulance. Most alarmingly, no attempt was made to engage the North West ambulance service—this was confirmed to me by the service last night—until last Wednesday evening, leaving that organisation unable to find the extra unit that it estimates will be necessary to cope with the increased demand on an already stretched operation. This is an appalling and potentially dangerous shambles that has greatly increased the anxiety of pregnant women in my constituency, on top of the worry they already felt at the news, during what is naturally one of the most worrying times in their life anyway.

Will the Minister intervene personally to impose order on the chaos? Will he confirm that the regional health authority’s gold command is meeting today to escalate the situation? Will he meet me to ensure that we have the best chance of getting the services we need back as soon as possible? Let me be clear: families in my constituency and beyond will be devastated if we lose consultant-led maternity services permanently. The Minister is a practising obstetrician and will know better than I that the removal of the clinician-led special care baby unit will result in women who expect complicated deliveries or who experience complications during birth facing a transfer to Lancaster, involving a journey time of about one hour along a road that, less than a fortnight ago, became almost impassable due to heavy snow—in fact, journeys between Barrow and Lancaster were taking up to 10 hours. Trying to transfer a mother who needs consultant care in such conditions is hard to imagine.

It has been suggested that air ambulances could be used to speed up transfer times in the event of Furness general hospital’s maternity unit being downgraded, but serious questions need to be answered about the practicality of that proposal. The Great North air ambulance service is a fantastic organisation that helps to save many lives each year, but it has just three helicopters to cover not only Cumbria, but the whole of north-east England and North Yorkshire. We cannot simply assume that the answer lies in the air.

I am immensely proud to be backing the “Thousand Voices” campaign in my constituency, which comprises mums who got together to make themselves heard when they saw the crisis coming. I know that I cannot use props, Mr Howarth, so I will not, but I urge all hon. Members to go to www.YouTube.com/saveFGHmaternity to hear the stories being shared. People are going out and using camera phones to get video clips from mums and dads, wherever they can find them. Let me read just one such story on the site, which reflects the views of hundreds. Mum of three, Christina Pickering, said:

“Due to extreme circumstances in my third pregnancy, I was sent to the Royal Preston hospital to deliver my daughter and that’s got to be one of the most terrifying experiences of my life, being in an unknown hospital, on my own, to deliver my baby. I don’t want this to happen to any mums—it doesn’t have to. Downgrading our maternity services at Furness general would not only be detrimental to mums and babies, but to the whole community. We’ve got to stop this happening.”

Let me end with the Minister’s own words from before he was promoted, which I wholeheartedly endorse. In a Westminster Hall debate in September 2010, he said that,

“generally speaking, if we consider the example of”

other hospitals,

“we see that the push has been to have a low-risk, midwifery-led unit alongside a higher-risk unit. We in obstetrics know that a greater number of women—rising to about 30%—are giving birth by Caesarean section, and that number is going up year on year. Many births that we initially think uncomplicated end up being much more complicated.”—[Official Report, 14 September 2010; Vol. 515, c. 230WH.]

The Minister summed it up perfectly. Families in Furness want the security of knowing that they can have their babies in Barrow with specialist help on hand. They pay for their health services with their taxes and they are speaking with one voice. They need the Government to listen.

[Mr George Howarth (in the Chair)]

I call David Morris, but for two minutes only, as the Minister needs time to respond to the debate.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a great pleasure to serve under your chairmanship, Mr Howarth. It is not the first time, but nevertheless it is a pleasure.

I pay tribute to the hon. Member for Barrow and Furness (John Woodcock) for his advocacy on behalf of his constituents and all those in Cumbria who are looked after by the local trust and to my hon. Friend the Member for Morecambe and Lunesdale (David Morris), whose constituency I recently had the pleasure of visiting, for his advocacy on the behalf of his constituents. I have indeed received a copy of the letter sent to him by the chief executive of the NHS trust, which says:

“Whilst it would be wrong of me to second guess the future, I personally find it hard to imagine Lancaster not having emergency services.”

I hope that that is reassuring to him and his constituents.

On the main issues raised in the debate, I have already paid tribute to the strong advocacy on behalf of his constituents by the hon. Member for Barrow and Furness. He was very kind to brand me an expert in obstetrics. I would not go quite that far, but he is right to say that I have considerable understanding of the issues involved and of the importance of ensuring that we provide safe and comfortable environments in which women can give birth. He is also right to read out the case that I advocated in a debate here in Westminster Hall some time ago, and it is important that we recognise that uncomplicated deliveries can become more complicated. We know that for women in some parts of the country, particularly those in more deprived areas, there are often higher risk rates of prematurity. These are all issues that need to be taken fully into account whenever services for the safe delivery of babies, and for the safe care of women during pregnancy, delivery and the period afterwards, are examined.

The hon. Gentleman is also right to highlight that there are geographical considerations in Cumbria, as in many rural areas, including the fact that there is only one main road and the problems that presents in respect of allowing the local trust to transfer patients effectively and safely from one site to another. It potentially creates difficulties at certain times of day if the road is busy, as he is aware. However, it also requires the availability of ambulances, and he was right to point that out.

When decisions are made about changing services, whatever the reason may be for changing them, they cannot be taken in isolation. In this case––I will discuss this further later––I believe that the decision was made in good faith, although I share some of the concerns that the hon. Gentleman raised, given that we know that there have been a lot of problems at the trust with maternity services as well as the safety concerns he outlined. Those decisions cannot be taken in isolation. They need to be taken in collaboration and after discussion with local commissioners and indeed with the ambulance service, if they are to be made correctly and for the benefit of patients.

The hon. Gentleman was also right to outline the four tests for reconfiguration. In particular, he was right that reconfiguration must be clinically led, based upon evidence and always in the best interests of patients. Reconfiguration should never happen for cost reasons alone, and he was absolutely right to highlight that. Reconfiguration also needs to have the support of local GP commissioners. However, from what he has said today it appears that there are local concerns about the proposed changes, and that there has not been an integrated, joined-up approach in relation to this decision.

We have also discussed the concerns over the need to integrate ambulance transfers into any local decisions because of the travelling distance from Barrow to Lancaster. That is one of the issues that should have been take into account when these decisions about reconfiguration were being made, and I am very concerned to hear the hon. Gentleman say that he does not believe that they were taken into account and that local commissioners also have concerns about this matter.

I am very happy to meet the hon. Gentleman again in the very near future to discuss this; that would be very desirable. It is vital to ensure, as the hon. Member for Copeland (Mr Reed) said, that we do not see service reconfiguration by stealth or via the back door. We should have an integrated, joined-up approach to local decision making, particularly in view of what can only be described as the deficiencies of the past at the trust and the very sad cases that the hon. Member for Barrow and Furness and I have corresponded about, as well as the police investigations that are going on. He is aware that it would be inappropriate for me to comment directly on those.

There is a need to ensure that in the future decisions are made in a holistic way and in the best interests of patient safety. Such decisions are not just for the trust to make alone but must be made in conjunction with the local commissioners and the ambulance service, if we want to ensure patient safety. The hon. Gentleman and I can discuss that further when we meet.

The hon. Gentleman raised another important issue: the ongoing investigations at the trust. He was right to do so. As we know, tomorrow the Mid Staffordshire report will be published, which makes these sorts of issues all the more poignant and important. The NHS has sometimes had a history of covering up bad things that have happened to patients, and that is completely unacceptable. The result of that is bad care for patients, and cultural problems in trusts and hospitals. Those sorts of things cannot go on. When there are investigations, they need to be carried out transparently and openly, so that people feel the issues have been fully aired. It is also vital that those investigations have a degree of independence, as he suggested.

[John Woodcock]

I thank the Minister for giving way, and for the excellent and considered way that he is responding to my points. He referred to the Mid Staffordshire situation. Does he accept that that started as an internal inquiry, which was found to be insufficient to get to the bottom of the issues and required a greater degree of independence to be established? We are worried that the same thing may be apparent in Furness.

[Dr Poulter]

Absolutely. There will be a full response to the Mid Staffordshire inquiry tomorrow, so I will not pre-empt it or go into detailed discussion of that issue. However, it is absolutely right that we must encourage staff who have concerns about patient care to raise those concerns and air them in an open way. Moreover, when we know that there have been long-standing failings at a trust about the quality of care provided to patients and concerns raised about those failings—although Morecambe Bay NHS Foundation Trust, for example, has made some good progress in recent months, there are some long-standing issues there—it is important that, when an investigation is carried out, it is carried out in a transparent, open and independent way; there must be a great degree of independence involved.

If a trust sees fit to launch an investigation and a review of what has happened, it is important that the investigation and review pass the test of transparency. There may well be a role for local MPs and other interested parties in that process, and when the hon. Member for Barrow and Furness and I meet, that is an issue that I will be very keen to discuss further, to ensure that we can discuss with the local trust ways in which we can ensure that there is that transparency and independence in the process. That is very important to ensure that those patients, and their families who have had problems in the past—in some cases, there have been deaths at the trust—feel that the investigation addresses their allegations.

Obviously, this debate is not just about maternity services at the Morecambe Bay NHS Foundation Trust; there have been other issues around the trust, and any investigation will need to take account of all those issues. I understand that that is what will happen.

Oral Answers to Questions

Lord Walney Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Burns]

My hon. Friend has raised that issue in different forms on many occasions, and feels strongly about it. The decision to reconfigure services in his constituency was made locally, and the Hampshire overview and scrutiny committee decided not to write to my right hon. Friend the Secretary of State asking him to refer it to the Independent Reconfiguration Panel, because it presumably believes that it is the right way forward to continue to provide first-class quality care for patients.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

Does the Secretary of State agree that commissioners in Cumbria must bear their share of responsibility for the deep-seated problems in the Morecambe Bay health trust, which have taken far too long to address. Will he join me in urging those commissioners to protect services such as Barrow’s maternity unit in their forthcoming review?

[Mr Lansley]

As we have seen in a number of instances over the years in the NHS, all those responsible should always be aware that, although the responsibility for quality may be, in the first instance, for the board of a trust, it is also the responsibility of those who commission the services. As the hon. Gentleman will be aware, one of the key considerations for the future in the development of services is for the NHS to respond to the commissioning intentions of local commissioners. Clearly, the matter that he raised will be determined locally as regards what commissioners require in terms of services from Morecambe Bay trust.

National Health Service

Lord Walney Excerpts

Monday 16th July 2012 Commons Chamber

[Clive Efford]

rose—

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

rose—

--- Later in debate ---

[Clive Efford]

rose—

[John Woodcock]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Hon. Gentlemen, the Minister has given way quite a bit, and I am sure that if he wishes to give way he will let you know. You do not need to keep standing and hovering for so long.

NHS Annual Report and Care Objectives

Lord Walney Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

My hon. Friend makes a very important point, and I was happy to announce earlier this year that in response to the report by Professor Sir John Bell and his colleagues we will now put resources behind the establishment of genetic testing centres throughout the NHS, which will enable us to undertake what is known as stratified medicine. This means that, by identifying when medicines have particular benefits for patients with certain genetic characteristics or phenotypes, we will be able to target such treatments, as we will be much more certain of their effectiveness and be able to reduce, as my hon. Friend rightly says, the many cases in which medicines are prescribed but turn out not to be effective in a particular patient’s circumstances.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

If the Secretary of State really believes that people will accept Ministers standing back from the consequences of their decisions, will he hear from families in my constituency, who are going to be devastated if, after all the turmoil—of which he is well aware—and after the forthcoming review, they are forced to travel for an hour and for 50 miles to receive consultant-led maternity services?

[Mr Lansley]

I do not construe what we are doing as Ministers stepping back from the consequences of our decisions. The Secretary of State will continue to be responsible for the comprehensive health service, and I fully expect, in the same way as I am making a statement today on the first annual report, that I and my successors will make statements in years to come on annual reports and be held to account for the performance of the service.

The point is that delivering the best possible care is not achieved by Ministers interfering on a day-to-day basis in how the NHS goes about its task. We have been very clear, through today’s mandate, about what we are looking for the NHS to achieve: consistently improving outcomes. We are not trying to tell the NHS to do so.

Any particular service change, such as the one the hon. Gentleman describes, has to meet four tests: being of clear clinical benefit; responding to the needs and wishes of local service commissioners; responding to strong patient and public engagement; and maintaining and protecting patient choice. If there are any questions and objections, stating that such a service change does not achieve those aims, his local authority has the right under legislation to refer the matter to the Secretary of State for its reconsideration, so I am not taking the Secretary of State out of the process completely.

The safe and sustainable review was set up independently by his right hon. Friend the Member for Leigh, and it has been conducted completely independently, but, in the same way as I have just described, if local authorities have grounds for objections, they have also a mechanism, if they wish to use it, for referral.

Midwife and Maternity Services

Lord Walney Excerpts

Tuesday 17th January 2012 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

Let me begin by not only congratulating my hon. Friend the Member for Crawley (Henry Smith) on securing the debate, but thanking him for raising the high-profile issue of midwife and maternity services. Those services, and the midwives who work in them, are extremely important to women, and the provision of high-quality maternity care is non-negotiable for a Government and a health service. I want to outline some of the measures that we are taking to improve the quality of that care, but let me first pay my own tribute to the midwives throughout the country who do such a fantastic job.

I hope that you will allow me a brief personal comment, Mr Speaker. My four children were delivered in four different hospitals, but in each of those instances the midwife had a profound impact on the experience, and a profound impact on the start that we made with a new little family member. I know that it will have been the same for many other families. The importance of midwives and maternity services cannot be overestimated.

We want to ensure that all pregnant women and new mothers receive the best care that it is possible to give. As my hon. Friend has said, and as other Members will know only too well, maternity services face increasing challenges, and they will have to evolve to meet those challenges. Over the last few years the birth rate has been rising, and the number of complex pregnancies is rising as well. There are also more high-risk births. Women are having babies when they are older, heart disease and obesity are increasing, and more mothers born outside the United Kingdom are giving birth here.

Impressive improvements have been made in many services. The Care Quality Commission’s 2010 survey of women’s experiences of maternity services found that 92% of the women surveyed rated their care during pregnancy as excellent, very good or good, 94% rated their care during labour and birth as excellent, very good or good, and 89% rated their care after birth as excellent, very good or good. I hate statistics as they can seem meaningless and dry. It is important to congratulate the midwives who achieved those satisfaction figures, but we should never forget that if 94% of women rated their care during birth as good or better, then 6% thought they did not get care that was good enough. That might not seem like a large proportion, but for the women concerned it is all that matters.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I have written to the Minister about the high-profile problems at the Furness General maternity unit, triggered by personal tragedies. What reassurances can she give on the future of that unit? More generally, what can she do to ensure that trusts with poor performing services in need of investment get the resources they need to deliver the first-class care people in my constituency and the whole country rightly expect?

[Anne Milton]

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 the hon. Member for Barrow and Furness (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 make 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.