Ian Roome

I totally agree with my hon. Friend that the problem is extending and forcing problems on to neighbouring maternity units. I know that the maternity unit in Exeter is now under pressure because it is having to cope with the births coming from North Devon. I appreciate the Government’s maternity adviser meeting me last week. She speaks passionately about fixing the crisis in our maternity units across the country. When the new Prime Minister addressed this question in this House, he was up front that North Devon is just the tip of the iceberg when it comes to structural weaknesses in NHS maternity services. Things have clearly come to a head in the south-west. First, Yeovil maternity unit suffered a staffing crisis and closure last year, and now Barnstaple has suffered the same. In Yeovil's case, a full reopening took almost a year. I am told privately by senior figures that there are other NHS trusts around the country that are also perilously close to something similar. Just like North Devon, their maternity units hang in the balance. The national maternity and neonatal taskforce’s new action plan is due in December, and I want the Government to treat this sorry episode as a case in point. Maternity units should not be suddenly suspended out of the blue. Our trust wrote its own continuity plan for our maternity services, set its own staffing benchmark below which closure would be needed, and decided its own reopening criteria. If the unit at North Devon district hospital can reopen with a fully staffed doctors’ rota, we are at least protected against this happening again in a few weeks’ time, but without national guidance on when suspensions should happen, we are running this unit on an operational cliff edge of the trust’s own design. We know that the trust was struggling with maternity recruitment since at least December last year, which continued right through to the spring. It is no wonder that my constituents are angry; it seems impossible that no emergency alarm was ringing months ahead of this crisis reaching boiling point. Why does it take a sudden suspension and a national media backlash, driven by me and local Maternity Matters campaigners, to get this issue to the very top of the chief executive’s to-do list? Secondly, the Government’s workforce plan is already overdue, and it needs to have a special focus on maternity services in at-risk areas. For example, I am told that when the deanery decides placements for trainee consultants, especially in their final years, the trend is towards large urban centres that offer them more specialised teaching. The unintended consequence is that many of those candidates stay in whichever area they last trained and already know well. That boosts the ability of urban hospitals to recruit, even while hospitals in remote areas such as North Devon are crying out for doctors. I ask the Government to work with deaneries to ensure that trainee consultants are able to do their final years in rural and coastal acute hospitals. I believe that that would help to tackle the maternity workforce crisis in smaller maternity units. On 2 October, North Devon district hospital’s consultant body passed a vote of no confidence in the trust’s senior management. When senior NHS staff with years of experience and dedicated service say that something is wrong, it should be a wake-up call. I am shocked to learn that senior figures in the trust have not even taken the opportunity to win hearts and minds by being present on site at North Devon district hospital during the crisis. Such things are completely symbolic, and that is entirely the point. Thirdly, my constituents are owed a full, independent review into how this crisis came about. We need the official record to show what led to the suspension in North Devon, what happened, how it might have been averted and how we ensure that it never happens again. The trust has appointed Audit South West Assurance to conduct the review, but a letter that I received from the trust’s chair of the board on 12 October implies that the terms of reference for a review are being set by a sub-committee of the trust’s board of directors. If that is true, I ask the Minister if the Department of Health and Social Care has an official standard for the impartiality of reviews such as that one. Many of my constituents will suspect the tell-tale signs of a whitewash in the making—something that does not improve health outcomes for anyone—and I hope that we can count on the Government’s support. Fourthly, what accountability exists for strategic failings in the NHS? A well-established structure exists to pursue clinical negligence and medical malpractice, but how can the NHS stamp out corporate failings, bad decision making or simply a lack of attention given by senior managers? I have asked that question of many organisations already, but I am yet to get a clear answer. If this crisis had been even worse, as it might be at someone else’s local hospital next month, what recourse would the public have? I was utterly shocked this week to read that the NHS Alliance’s lead director for acute care had told The Guardian that as many as 20 NHS maternity units across the country may be forced to close entirely. In more remote parts of the country, that should be unthinkable. When services are centralised again and again, it is always remote communities such as mine that pay the price. There are many more questions that my constituents need answering, but above all, the question is: how can it be that senior NHS figures feel less publicly accountable for suspending maternity services entirely than they do for staffing an open maternity unit? To answer that question, I am forced to turn to the ultimate policymakers in government. Short of defending this country from attack, I can see no greater duty for the British state than ensuring that the next generation can be born safely. Most people would struggle to think of any NHS spending that should take priority over that sacred responsibility. As such, my final question is whether the Minister understands that in remote rural and coastal communities such as mine in North Devon, which has suffered this nightmare for the past nine weeks, losing maternity services would be seen as the beginning of the end for the national health service itself.