🤰 Maternity Services

Westminster Hall

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Maternity services in England are under scrutiny due to widespread safety concerns, with 65% of maternity units deemed unsafe by the Care Quality Commission. Despite the dedication of staff, staffing shortages and high levels of burnout contribute to a system struggling to meet the needs of mothers and babies, with one in five stillbirths potentially preventable. The debate highlighted the urgent need for systemic reforms, including better support for midwives, improved infrastructure, and addressing health inequalities, particularly for black and Asian mothers. The government has pledged to update the maternity safety plan and invest in workforce and safety initiatives, but the challenge remains to ensure these commitments translate into safer, fairer care for all families.

Summary

  • The debate focused on the critical state of maternity services in England, highlighting the need for urgent improvements to ensure safety and quality of care for mothers and babies.

  • It was noted that a baby is born in England every 56 seconds, with most deliveries occurring in NHS settings. However, a Care Quality Commission (CQC) inspection found that 65% of maternity units are not safe for childbirth.

  • The Ockenden report, which investigated Shrewsbury and Telford Hospital NHS Trust, identified fundamental flaws in maternity care across England and suggested immediate and essential actions for reform.

  • MPs discussed the challenges faced by maternity staff, including midwives, who are overworked and under-resourced, leading to burnout and high turnover. In 2023, midwives worked over 100,000 hours of unpaid overtime weekly.

  • The need for litigation reform was raised to encourage a culture of open learning from mistakes rather than fear of legal repercussions, which could improve patient safety.

  • Retention of midwives was highlighted as a significant issue, exacerbated by the pandemic, leading to a loss of experienced professionals and affecting training for new midwives.

  • The debate also touched on the financial struggles of student midwives, with many facing debts over £40,000 and dropping out due to financial hardship. Suggestions were made for government support through funding or debt forgiveness schemes.

  • Several MPs shared personal and constituent stories of maternity care failures, emphasizing the emotional and physical toll on families, and the urgent need for systemic changes.

  • Inequalities in maternal and neonatal outcomes were discussed, with black women being nearly three times as likely to die in childbirth as white women, and higher neonatal mortality rates in deprived areas.

  • The importance of mental health support for new mothers was raised, alongside the need to increase breastfeeding rates and support for new parents.

  • The government’s commitment to improving maternity services was acknowledged, with ongoing initiatives and plans to enhance safety, tackle workforce challenges, and address inequalities.

  • The debate concluded with a call for NHS trusts to engage more directly with bereaved families to learn from tragic events and improve future care.

Divisiveness

The parliamentary session on maternity services displays very little disagreement among the participants. The debate is characterized by a collaborative and supportive atmosphere, with Members of Parliament from various parties expressing a unified concern and desire for improvement in maternity care. Here are some key points and examples that support this assessment:

  1. Consensus on Issues: There is a unanimous agreement across the House on the critical state of maternity services. Multiple MPs from different parties highlight the same issues, such as inadequate staffing, outdated infrastructure, and disparities in care outcomes, without any significant contention or opposition.

  2. Support for Recommendations: The MPs all support the recommendations outlined in various reports, particularly the Ockenden report. For instance, Jess Brown-Fuller (Chichester) (LD) and other MPs reference the need for implementing the report’s actions, and there is no dispute on this matter. Jeremy Hunt (Godalming and Ash) (Con) and Jess Brown-Fuller agree on the need for litigation reform to improve patient safety.

  3. Positive Interventions: Interventions in the debate are supportive and aligned with the main speaker’s points. For example, Dr Al Pinkerton (Surrey Heath) (LD) congratulates Jess Brown-Fuller and adds to the discussion about staffing and training, reinforcing her points rather than presenting a counter-argument.

  4. Praise and Acknowledgments: MPs express appreciation for each other’s contributions and emphasize the importance of working together. Jim Shannon (Strangford) (DUP) commends Jess Brown-Fuller for setting the scene well and thanks other participants for their contributions.

  5. Constructive Criticisms: Criticisms are focused on systemic failures rather than any policy disagreement between the parties. For instance, Dr Beccy Cooper (Worthing West) (Lab) and Helen Morgan (North Shropshire) (LD) both criticize the government’s response but not in a way that opposes other MPs’ viewpoints.

  6. Shared Goals: The overarching goal of improving maternity services is shared by all participants. There are repeated calls for more funding, better workforce planning, and improved care standards, with no fundamental disagreement on the desired outcomes.

Examples of agreement include: - Jeremy Hunt and Jess Brown-Fuller agreeing on the need for litigation reform in maternity care. - Dr Al Pinkerton agreeing with Jess Brown-Fuller on the necessity of adequate staffing and support for midwives. - Katie White and Jess Brown-Fuller aligning on the need for an independent review of maternity services in Leeds.

In conclusion, the session is marked by a strong consensus and cooperative approach to addressing the problems in maternity services, leading to a rating of 1 for disagreement.