Maternity services. Volume I, Report together with appendices and the proceedings of the committee.

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

Licence: Open Government Licence

Credit: Maternity services. Volume I, Report together with appendices and the proceedings of the committee. Source: Wellcome Collection.

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    ‘““A midwife should be given every opportunity to participate in the maternity care of her patients to the fullest extent to which her skill and experience entitle her”’. and that ‘General Practitioner maternity beds [should be] situated within, or very close to consultant maternity hospitals or general hospitals with maternity departments. A consultant obstetrician should have overall responsibility for supervision of General Practitioner maternity beds’’.!? 20. In September 1967 the Minister of Health appointed a sub-committee of the Midwifery Advisory Committee under the Chairmanship of Sir John Peel with the following terms of reference:— ‘To consider the future of the domiciliary midwifery service and the question of bed needs for maternity patients and to make recommendations”. The Peel Committee’s Report Domiciliary Midwifery and Maternity Bed Needs was presented to the main Committee in 1970. Amongst its recommendations were the following:— “We considered that the resources of modern medicine should be available to all mothers and babies, and we think that sufficient facilities should be provided to allow for 100 per cent hospital delivery. The greater safety of hospital confinement for mother and child justifies this objective”’. ‘Medical and midwifery care should be provided by Consultants, General Practitioners and Midwives working as teams’’. “Small isolated obstetric units should be replaced by larger combined Consultant/General Practitioner units in general hospitals. In the latter units, all beds and facilities should be shared”’. 21. The 1974 reorganisation of the NHS and local government transferred community midwifery, nursing and health visiting services from local authorities to the newly formed health authorities, which were also responsible for hospital services. Despite the fact that general practitioners remained independent, the practice continued of sharing overall responsibility for care between hospitals and general practitioners, with much of the care being given by hospital and community midwives. Since 1974, hospital and community midwifery services have become increasingly integrated. 22. Public attention was again focused on the maternity services in the late 1970s, by a campaign in the media and Parliament launched in response to two Government reports. These were the report of the Committee on Child Health Services, which described Britain’s perinatal mortality rates as a ‘holocaust’; and the DHSS policy document ‘Priorities for health and personal social services in England’, which suggested that as birth rates were falling, funding for maternity care could be reduced. In response to this, the Social Services Committee set up its first enquiry into perinatal and neonatal mortality. In its report, published on 19 June 1980, the Committee stated that it had responded to: : “Mounting public concern that babies were unnecessarily dying or suffering permanent damage during the latter part of pregnancy and the earliest part of infancy”’. 23. The report had 152 recommendations. Amongst these were:— ‘An increasing number of patients should be delivered in large units; selection of patients should be improved for smaller consultant units and isolated GP units; home deliveries should be phased out further’’. “We consider that the safety of the mother and baby in labour are of paramount importance and recommend that the labour ward should be regarded as an intensive care area and that staffing and equipment be optimal”’. “Patient care throughout the National Health Service should be given by fully trained doctors in career posts, and that a significant amount of work at present done by junior doctors should be transferred to consultants”. “It should be mandatory that all pregnant women should be seen at least twice by a consultant obstetrician—preferably as soon as possible after the first visit to the GP in early pregnancy and again in late pregnancy”. ibid ibid, p. |