In response to a question from Nicholas Soames MP on Primary Care Trusts being pressed to close and diminish maternity services, particularly the Princess Royal Hospital in Haywards Heath, Health Minister Ann Keen said that these changes were aimed to improve rather than downgrade the services. She emphasised that the changes were being made to ensure that children have the best possible start in life and that the Royal College of Midwives and Royal College of Obstetricians and Gynaecologists would agree.  She also stated that any changes were happening with the consent of clinicians and the local community.

Sir Nicholas Winterton MP, an honorary president of the Royal College of Midwives, this week questioned the Department of Health about the number of places that would be made available for student midwives and midwifery education to meet the target of 4000 new midwives by 2012. Health Secretary Alan Johnson noted that a large percentage of the 4000 would need new places and that an announcement could be expected around the time of the annual conference of the Royal College of Midwives at the end of May.

Susan Kramer MP tabled EDM 1524 in light of news from the National Toxicology Program in the US that exposure to low levels of Bisphenol A ‘can cause changes in behaviour and the brain, prostate gland, mammary gland and the age at which females attain puberty’.  The text of the EDM is below:

That this House notes that Bisphenol A, or BPA, a monomer used to make polycarbonate and expoxy resins, has been found to leak from the plastic used in many baby feeding bottles, especially when the bottles are heated or are scratched through repeated washing; notes that the National Toxicology Program, part of the US National Institutes of Health, found that, based on animal experiments, exposure to low levels of BPA `can cause changes in behaviour and the brain, prostate gland, mammary gland and the age at which females attain puberty’; further notes that these products are being withdrawn in Canada as a precautionary measure; commends the decision by Asda and other UK retailers to produce BPA-free bottles; joins the National Childbirth Trust in calling for the clear compositional labelling of plastic baby feeding bottles with Bisphenol A so that parents can make an informed choice; and calls on the Food Standards Agency to urgently review the use of BPA in baby bottles in light of the new evidence

Leading clinician and Health Minister Lord Darzi today issued five pledges to the public and staff on how the NHS will handle changes to services. He set out a rigorous process requiring any change to be transparent, clinically evidenced, locally led and for the benefit of patients.

Lord Darzi’s report ‘Leading Local Change’ comes ahead of his final report on the next stage of NHS reform.
This new report, aimed at the public, patients and staff, signals that whilst the NHS must never back away from necessary change to improve services and save lives, there should be important checks which any change has to undergo before it proceeds. This has led to the five pledges on change in the NHS, which PCTs will have a duty to have regard to:

1. Change will always be to the benefit of patients. This means that change will improve the quality of care that patients receive - whether in terms of clinical outcomes, experiences, or safety.

2. Change will be clinically driven. We will ensure that change is to the benefit of patients by making sure that it is always led by clinicians and based on the best available clinical evidence.

3. All change will be locally-led. Meeting the challenge of being a universal service means the NHS must meet the different needs of everyone. Universal is not the same as uniform. Different places have different and changing needs - and local needs are best met by local solutions.

4. You will be involved. The local NHS will involve patients, carers, the public and other key partners. Those affected by proposed changes will have the chance to have their say and offer their contribution. NHS organisations will work openly and collaboratively.

5. You will see the difference first. Existing services will not be withdrawn until new and better services are available to patients so they can see the difference.

The main finding of the report, which covers England, Wales and Northern Ireland, is that stillbirth rates are not declining. Factors such as social deprivation, obesity and the mother’s age are blamed. In 2006 the stillbirth rate in England, Wales and Northern Ireland was 5.3 per 1,000 total births, compared to 5.4 per 1,000 in 2000.

However, the report did find that there has been a reduction in the number of babies dying in the month after birth. These neonatal deaths went from 3.9 per 1,000 live births in 2000 to 3.4 per 1,000 in 2006.

The report also found that the number of babies dying in the neonatal period from twin pregnancies has also fallen, from 22.3 per 1,000 births in 2000 to 19.3 per 1,000 births in 2006.

To view the full report online report, please go to www.cemach.org.uk. 

Tony Baldry has laid down an EDM congratulating the North Oxfordshire Independent Reconfiguration Panel on its decision that services in paediatrics, obstetrics, gynaecology and the

special care baby unit (SCBU) should continue to be provided at Horton Hospital. The Independent Reconfiguration Panel submitted its findings to the Secretary of State in March and recommended that he reject the local Trust’s proposals to concentrate these services in Oxford. It reported that the PCT must develop a clear vision for children’s and maternity services within an explicit strategy for services for north Oxfordshire as a whole and publish a plan outlining how the recommendations of the IRP are to be implemented within one month.

The IRP carried out a review at the request of the Secretary of State for Health, Rt Hon Alan Johnson MP, following a referral to him from the Oxfordshire Joint Health Overview and Scrutiny Committee. The decision is a success for the local communities who fought hard to retain the services provided at Horton Hospital.

Maria Miller MP asked the Secretary of State for Health what role health visitors will play in delivering the Child Health Promotion Programme (CHPP); and what estimate he has made of the number of health visitors required to deliver the target outcomes of the programme.

Ann Keen responded that health visitors are central to delivering the CHPP. She noted that, with their expertise in children, families and public health, together with their background as nurses they are ideally placed to lead the delivery of CHPP in the community.

“The recent review into the future role of the health visitor, ‘Facing the Future’, recommended two roles for health visitors. One of the roles is to lead and deliver the CHPP for a defined population working across general practice and children’s centres. The recently updated CHPP promotes the important role of the health visitor to commissioners and services providers. It is the responsibility of local organisations to commission and develop services to respond to local needs, including the recruitment of health visitors. The operating framework for 2008-09 highlights the importance of children’s services and the need for local organisations to commission and provide the necessary services and work force.”

The Child Poverty Action Group (CPAG) have commented on David Cameron’s statement this week that ‘we can end poverty - I mean it!’  Cameron was speaking at the Conservative Party event to launch the report ‘Making British Poverty History’.

Kate Green, Chief Executive at CPAG says that while they welcome the attention the Conservatives are giving child poverty, “unlike all the other parties, he still won’t make this a promise. Ending child poverty is a marathon not a sprint, but like a marathon, it is achievable. You don’t ask for support to run a marathon by saying you ‘aspire’ to jog for a bit, you have a clear target to run 26 miles. As the only mainstream British party not to have a firm commitment to eradicate child poverty in a generation, it’s time for Cameron to prove he has faith in his party’s proposals and turn the ‘aspiration’ to end child poverty into a promise.’

The Health Select Committee heard that children’s centres needed to integrate with communities if they were to reach families in deprived areas. When asked if there was a model of an ideal early years programme that could reduce health inequalities, Edward Melhuish, Executive Director of National Evaluation of Sure Start, said there was evidence from Sure Start that if they worked to integrate themselves with local health services they would be more effective. He said this helped Sure Start reach families easily so that they could get the services they needed. He went on to say that the use of health visitors and midwives should be expanded and their training improved. He also stated that more cross-agency training was needed so that the different agencies involved could improve communications

Mr Melhuish noted that one example of a reduction in health inequalities the evaluation of Sure Start had shown was an increase in the uptake of immunisation in children. He did however concede that the Sure Start data used in the report had been collected after the control data and therefore may not be completely accurate. He emphasized that for a successful Sure Start programme, it should be well-embedded in the community, have strong leadership with a stable and well-trained staff, a good relationship with local health services and also the local authority.

New Deal for Communities was highlighted as successfully integrating health services and primary care and putting them under one roof so they were more accessible for communities – they also worked with Sure Start on community development issues.