Maternity services. Volume II, Minutes of evidence.

  • Great Britain. Parliament. House of Commons. Health Committee
Date:
1992
Catalogue details

Licence: Open Government Licence

Credit: Maternity services. Volume II, Minutes of evidence. Source: Wellcome Collection.

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    [Continued [Alice Mahon Cont] moving and we are fully confident the Health Service will need those very clear targets. Alice Mahon: | think people’s expectations of the Patients’ Charter in that particular area will be downed by that reply, Mr Chairman. Chairman: | think the Minister’s comments have been noted. Mr Hinchliffe 819. Can I return, Minister, to the key issue of choice. Mr Shaw referred to consumerism, Mr Edwards said earlier the service ought to be driven by what women choose. I have recent experience of a constituent and a personal friend telling me that she desperately wished to have her child at home. There were no factors in terms of her own health, her husband’s health, or her family background that would give indicators that would suggest there would be problems. She had had a previous child normally. She was told there was no way she could have that child at home. I am saying it is not a realistic choice—- (Mrs Bottomley) Who told her that? Mr Hinchliffe: She was told by the GPs in her area that it came down to obtaining a GP who would be prepared to offer the cover and it simply was not available in her area. Now, realistically there is no choice for many people and I feel the Department ought to be taking some initiatives in this respect. I would like to know what initiatives you are taking in respect of genuinely offering women choice as far as home births are concerned? Chairman 820. Before you do answer that perhaps the statistic which I quoted already, that only 1% of births in this country are in the home, clearly indicates in reality there is not the choice, Minister, you have indicated there is. The whole system works to channel a pregnant woman into hospital for the birth rather than having it at home. (Mrs Bottomley) Health authorities, Chairman, have an obligation to provide midwifery services for home births so I would like—if Mr Hinchliffe wants to give me the example—to know precisely what the local midwife’s view of that event was. Mr Hinchliffe 821. It is not the midwifery cover, it is the GP’s cover. (Mrs Bottomley) But the midwife is able to take responsibility. 822. The sticking point in this particular case, which I am happy to talk to you about, was specifically on the GP cover. That was the sticking point. (Mrs Bottomley) They do not have to have GP cover. Mr Hinchliffe: That was the reason given in this particular person's case. Audrey Wise 823. They are told they must. (Mrs Bottomley) Who by? 824. By GPs. (Mrs Bottomley) But they do not need it. I am very sympathetic with this case. Chairman 825. Dr Walford, can you shed any light on why only 1% have their babies at home if what David Hinchliffe has said is not correct. I personally think it is correct. (Mrs Bottomley) It is correct they provide a midwifery service. The midwives are able to take responsibility for that birth and yet Mr Hinchliffe is saying in this particular case the woman did not accept. Is this because she was more in fear? Audrey Wise 826. No. (Mrs Bottomley) As the midwifery officer is saying, midwives do not need the cover of the GPs in order to take responsibility for the birth, so long as the mother and baby are normal. Mr Hinchliffe 827. I am happy to pass on to the Minister the details of this particular case. This person was an articulate middle class woman who knew her rights and what the Department stated were her rights, tried it out in practice and failed miserably. (Mrs Bottomley) This is such an important area. I very much welcome the discussions of the working group going on at the moment from the Royal College of Midwives and the Royal College of General Practitioners. Chairman 828. Can you tell us, mentioning that, what the state of play is in that particular situation? | understand it is stalemate or have they gone in for another innings? (Mrs Bottomley) 1 very much hope they have. I have seen both of them within the last fortnight. I have great confidence that progress is going to be made. I believe really what Mr Hinchliffe is talking about is the lack of agreement between those two professions. I do not think Mr Hinchliffe’s point has anything to do with Departmental policy. Audrey Wise 829. Of course it has. (Mrs Bottomley) It has to do with the relationship between those two professions and particularly the relationship in his part of the world. If there are difficulties in the discussions between the Royal College of Midwives and the Royal College of General Practitioners, perhaps they could begin on that case to get the discussions moving.