NCT Watch

The Lords this week agreed to the Nursing and Midwifery (Amendment) Order 2008 which makes amendments to the framework legislation for the regulation of nurses and midwives including to the Governance of the NMC. Detailing the statutory instrument, Government Whip Baroness Thornton noted that the reforms are aimed at enhancing confidence in the ability of regulatory bodies like the Nursing and Midwifery Council.

The NMC will now become a fully appointed council, rather than partially elected and elections for this year have been cancelled. In addition, the NMC’s annual report would include a description of its arrangements for ensuring equality and the NMC would be given greater prescribing rights in an emergency and the ability to strike of registrants barred from working with children of vulnerable adults. The Royal College of Nursing is supportive of the need to change.

Responding, Conservative Shadow Home Affairs Minister Baroness Hanham expressed concern that the NMC was being reorganised and questioned the expertise of the Appointments Commission in appointing members of the NMC. She also questioned who else would be involved in making decisions of prescribing in the case of emergencies. There was also some concern over the decision to make the council fully appointed and the need to have representation from general nurses, midwives and community nurses on the Council

Pat McFadden MP, Minister for State in the Department of Business, Enterprise and Regulatory Reform this week confimed that, whilst the maximum number of hours a pregnant woman can be required to work is 48 hours per week, his may be reduced if the hours of work pose a risk to the expectant mother or her unborn child.

In his response to a question put forward by Tobias Ellwood MP, he noted that employers have a duty to protect the health and safety at work of all employees, including new and expectant mothers and mothers who are breastfeeding. As part of this duty employers are required to carry out a specific risk assessment paying particular attention to risks that could affect the health and safety of the new or expectant mother or her child.

Employers are obliged to do what is reasonably practicable to control risks such as making changes to the working conditions; hours of work or offer alternative suitable work. If none of these steps adequately reduces the risk the employee must be suspended from work on full pay to protect her and her un-born child.

The Department of Health (DH) has used National Breastfeeding Awareness Week (NBAW) to encourage mothers from low income backgrounds to seek help on breastfeeding. A DH press release notes that breastfeeding is a major public health issue in today’s society with significant inequalities in infant feeding practices. Age is a strong factor, with statistics showing that in the UK, 76% of women start breastfeeding, but for mothers under 20, it’s just 51%.

A decision to breastfeed, especially for the first six months of a baby’s life, can have a huge impact on infant health and development. The DH recommends exclusive breastfeeding up to the age of six months, with continued breastfeeding alongside solid foods after six months. ‘Healthy Weight, Healthy Lives’ a cross-government strategy for obesity ( January 2008 ) aims to reverse the rise in childhood obesity and breastfeeding plays an integral role in this. Breastfeeding provides health benefits for mothers too. It can reduce the risk of against ovarian cancer, breast cancer and weak bones later in life.

The NBAW strapline, ‘Breastfeeding: every day makes a difference to your baby’, reflects the message that each day a women continues to breastfeed is another day the child receives important health benefits from its mother. The plans for NBAW are part of the DH’s campaign to address the inequalities that exist in infant feeding practices highlighted in the Scientific Advisory Committee on Nutrition (SACN) review of The Infant Feeding Survey (2005).

During NBAW, the DH launched the Breast Buddy initiative, targeted at young mums aged 16 to 25 years. The initiative is fronted by celebrity mum and Atomic Kitten member Jenny Frost. The initiative encourages young mums to get emotional and practical support while breastfeeding by nominating a buddy from within their circle of friends and family. Young mums who sign up will receive an information pack including the NHS leaflet

Breastfeeding: Off to the Best Start and a fridge magnet featuring breastfeeding helplines including the new National Breastfeeding Helpline (0844 20 909 20). Mother and buddy will also receive texts of encouragement for the first six months. Mums can text BUDDY to 60022 to sign up to the campaign.

Public Health Minister, Dawn Primarolo welcomed the commencement of the week long initiative to make breastfeeding as easy as possible for mothers across the country, asserting that it was essential to demonstrate that breastfeeding was the normal and natural way to feed a baby.

The National Breastfeeding Awareness Week (NBAW) saw retailers such as ASDA, Woolworths and Mamas and Papas becoming ‘breastfeeding friendly’ places, providing comfortable seating, water and a positive attitude towards breastfeeding. Breastfeeding Friendly Places will show a window sticker to let customers know they are ‘breastfeeding friendly’ – this is part of a wider campaign to promote breastfeeding, particularly targeting young mums during NBAW 2008.

Breastmilk is the best source of nutrition for babies and the Department of Health recommends exclusive breastfeeding up to the age of six months, with continued breastfeeding alongside solid foods after six months. Studies have shown that breastfed babies are less likely to get infections or asthma, become obese or get diabetes in later childhood and that breastfeeding can prevent mums having health problems later in life.

Research shows the majority of mums would like to breastfeed their babies but often give up in the early stages, so it is important to let mums know there is support available to help them continue. Many mums-to-be are put off breastfeeding because they are concerned about breastfeeding in public, it is therefore important for organisations to make it clear that breastfeeding is welcome. Highlighting organisations that adopt a breastfeeding friendly policy is just one of the ways in which breastfeeding mums are being supported. Support is also available through their local breastfeeding groups, from their midwife or health visitor and through helplines such as the National Breastfeeding Helpline – 0844 20 909 20.

The British Medical Journal (BMJ) has issued details of a study regarding breastfeeding and rheumatoid arthritis as published online ahead of print in the Annals of the Rheumatic Diseases.

According to the research, women who breastfeed for longer have a smaller chance of getting rheumatoid arthritis. The study also found that taking oral contraceptives, which are suspected to protect against the disease because they contain hormones that are raised in pregnancy, did not have the same effect. Also, simply having children and not breastfeeding also did not seem to be protective.

The researchers compared 136 women with rheumatoid arthritis with 544 women of a similar age without the disease. They found that that those who had breast fed for longer were much less likely to get rheumatoid arthritis.

Women who had breastfed for 13 months or more were half as likely to get rheumatoid arthritis as those who had never breastfed. Those who had breastfed for one to 12 months were 25 per cent less likely to get the disease.

The proportion of women breastfeeding for more than six months has increased dramatically over the past 30 years. The authors concluded that it was difficult to say whether there was a connection between higher rates of breastfeeding and a corresponding fall in the number of women affected by rheumatoid arthritis, but that the results of the study provided yet another reason why women should continue breastfeeding.

The Prime Minister used a Commons statement to MPs on Wednesday to set out a raft of future policy plans in his proposed legislative programme for the 2008/09 session of Parliament. The early notification of the proposals is also designed to be an attempt to listen and respond to the public and MPs’ views via a consultation process.

In total there were plans for 18 full bills, linked under four themes of: economic stability; “making the most of your potential”; personalisation and improvement of public services; and “handing back power to the people”. The list of 18 includes an Equality Bill and an NHS Reform Bill which is aimed at taking forward proposals arising from Lord Darzi’s ‘NHS Next Stage Review’ of the NHS in England that would require legislation to enable their implementation.

An independent review by Sainsbury’s human resources director Imelda Walsh recommended that the right to flexible working should apply as widely as possible. The right is currently restricted to parents whose children are under six or disabled but could be extended to parents of children up to the age of 16.

The government has said it will now consult on how the proposal can be implemented. The review said that any change should be implemented at once rather than staged and added that more needed to be done to raise awareness of the right to request flexible working, among employees and companies.

Around six million workers currently have the right to ask for flexible arrangements, although the government believes more than 14 million people work flexibly. More than nine out of 10 requests to work flexibly were approved last year.

TUC general secretary Brendan Barber said: “Any extension of the right to request flexible working is great news for parents struggling to combine work with their often hectic family lives.”

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.