MPs debate Nursing and Midwifery Council

Ben Bradshaw informed MPs that there had been a complete breakdown of relations among the leadership of the Nursing and Midwifery Council (NMC). He said that a report on the NMC by the Council for Healthcare Regulatory Excellence (CHRE) had been “devastating”, showing that the NMC was failing to carry out its statutory duties. The Minister said that the NMC would need to put in place an action plan to implement all of the recommendations of the CHRE report. He stressed that the locus for ministerial interference in the NMC was limited given that it was a professional regulatory body.

Patient Services in South Wales East

In response to a comment by William Graham AM which drew attention to high risk pregnancies and the fact that mothers from Royal Gwent Hospital were being sent to hospitals in Bridgend and Bristol to give birth, the First Minister, Rhodri Morgan, clarified the situation so far. He noted that he believed Edwina Hart, the Minister for Health and Social Services, had issued a written statement saying that there was an unacceptably low level of staffing among midwives and indicating to Gwent Healthcare NHS Trust that it should up its game considerably in this area, mostly by way of recruiting additional midwives. He believed the figure of 15 was suggested and stated that he would ensure Edwina Hart followed up with William Graham informing him of any further updates.

Equality and Human Rights Commission calls for a more flexible approach to maternity and paternity leave

The Equality and Human Rights Commission has launched a public consultation into maternity and paternity leave entitlement. Presently women are entitled to 52 weeks of maternity leave and fathers 2 weeks but the Commission is worried that the discrepancy between women’s and men’s rights is damaging women’s careers. Nicola Brewer, Chief Executive, called for a more flexible approach to work and called for less of a focus on the need for ‘maternity’ leave and more of a focus on allowing parents to decide who takes parental leave after the first 6 months.

Secretary of State for Work and Pensions makes statement on welfare reform

Making a statement on Welfare Reform, Secretary of State for Work and Pensions, James Purnell stressed that the welfare state was a vital means to support those who were vulnerable and in need of help. However, he stated that by failing to update the welfare system for the modern age, the principles upon which it was established had been neglected. He suggested in particular that the third principle of the Beveridge report had been neglected, and the system had not been used to help people back into mainstream society. The Secretary of State stated that the new reforms would allow for an 80 per cent employment rate, and would meet the Government’s targets for ending child poverty and for equality for the disabled.

He stated that there were 5 main goals. Firstly, the reforms sought to end the system where there was a choice between claiming and working. Mr Purnell explained that there would be work programmes as a sanction for those abusing the system, and a requirement for all claimants to work when they were able; and a requirement for people with drug dependency to seek support, which he argued would increase their capacity to work.

He then explained that the second goal was that nobody would be written off. He stressed that the Government had created a Pathways to Work programme to support people coming off Incapacity Benefit. This benefit was to be fully replaced by the Employment Support Allowance (ESA) between 2010 and 2013 and all existing claimants would be reassessed. All people would be entitled to support, but would be obliged to take work where a doctor advised it, he added.

The third goal was to improve the conditions of the benefit. He explained that specialist services would ensure that anyone that could benefit from access to work could do and that individual budgets would put disabled people in control.

The fourth goal would be to end child benefit with parents on benefits keeping all of their maintenance payments.

Finally, there would be devolution to advisors, providers and communities. He stressed that this would allow greater flexibility and a service that was focused on local needs – Job Centre Plus would have greater opportunity and flexibility to determine how they dealt with their clients.

Mr Purnell confirmed that all the reforms in the Freud report would be fully implemented. These reforms would simplify the benefit system and would abolish income support and move people onto Job Seekers Allowance (JSA), he stated. He went on to say that the conditionality regime would be appropriate for both the JSA and the ESA, and would not change for carers or parents.

He insisted that in consulting further on these proposals the Government would engage with the public, providers and academics.

Guidance for NHS boards on locally delivered healthy weight strategies to be published in Scotland

Shona Robison, Minister for Public Health responded to a question laid down by Mary Scanlon MSP about the action proposed by the Scottish Executive to assist obese pregnant women as early as possible during their pregnancy to reduce the risk of complications for mother and child.

She said that NHS boards are responsible for organising maternity care at a local level in line with national guidelines. The Framework for Maternity Services in Scotland supports the principle that good health before and during early pregnancy benefits both mother and baby. Care is tailored to the needs of the individual woman, including careful monitoring of the mother and her babys development. Women are encouraged to eat as healthily as possible and the government is making available funding of 19 million between 2008-11 to improve nutrition of women of childbearing age, pregnant women and children under five in disadvantaged communities.

She noted that by the end of 2008 the government will publish guidance for NHS boards on locally delivered healthy weight strategies. This will highlight the needs of key groups such as pregnant women.

Updated NICE guideline published on the support women should receive when induction of labour is offered

The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Women’s and Children’s Health (NCCWCH) have issued updated guidance to doctors and midwives on how to support and care for women being offered and undergoing induction of labour. The guidance revises areas where new information has become available since the original guidance was published in 2001.

It recommends that midwives and doctors provide women with evidence-based information about a range of key issues such as why induction is being offered, the risks and benefits of induction and different pain relief options, so they can make decisions that are right for them and their baby. Key recommendations from the guideline include:

o Women should be informed that most women will go into labour spontaneously by 42 weeks.

o At the 38 week antenatal visit, all women should be offered information about the risks associated with pregnancies that last longer than 42 weeks, and their options.

o Healthcare professionals should explain the following points to women being offered induction:

– The reasons for induction being offered

– When, where and how induction should be carried out

– The arrangements for support and pain relief

– The alternative options if the woman chooses not to have induction of labour

– The risks and benefits of induction of labour in specific circumstances and the proposed induction methods

– That induction may not be successful and what the woman’s options will be.

o Women with uncomplicated pregnancies should usually be offered induction of labour between 41+0 and 42+0 weeks to avoid the risks of prolonged pregnancy

o If a woman has preterm rupture of the membranes after 34 weeks, the maternity team should discuss the following factors with her before a decision is made about whether to induce labour, using vaginal prostaglandin E2 (PGE2)

– Risks to the woman (e.g. sepsis, possible need for caesarean section)

– Risks to the baby (e.g. problems relating to pre-term birth)

– Local availability of neonatal intensive care facilities.

o If induction fails, the subsequent management options include:

– A further attempt to induce labour (timing should depend on the clinical situation and the woman’s wishes)

– Caesarean section.

Labour loses the Glasgow East by-election to the Scottish National Party

The Scottish National Party (SNP) has overturned a Labour majority of more than 13,000 to win by just 365 votes. With a turnout of 42.25 per cent, the SNP’s John Mason won 11,277 votes to 10,912 for Labour’s Margaret Curran. The Conservatives were third with 1,639. The constituency, the party’s 25th safest seat in the country and its third most secure in Scotland, had been held by Labour for half a century.

Mason, a 51-year-old accountant and city councillor said the people of Glasgow had sent a “message that it is a time for change”.  MSP Curran said she would continue to fight against inequality in the east end of Glasgow from her seat in the Scottish Parliament, which was a “Labour cause”.

Scotland Office minister David Cairns said Gordon Brown’s future would not depend on the result of a single by-election. He blamed the defeat on the difficult economic circumstances and Labour’s failure to select a candidate early enough.