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Access to NHS Services

The hon. Lady should have attended our debate on maternity services, when we made it very clear that of course we must have proper risk assessment, and that mothers giving birth in places of relatively greater risk must have access to proper obstetric care. I am aware that, around the country, managers are representing the case for service reconfiguration by saying that, as a minimum, there should be 40 hours of consultant cover on labour wards. They make direct reference to what the Healthcare Commission said happened with the 10 tragic maternal deaths at Northwick Park and, in general, they say that there must be 2,500 live births at each hospital. One then asks how many live births there were at Northwick Park at the time, and the answer is 5,000. Another maternity unit had recently closed and a substantial amount of responsibility and additional births had been transferred to Northwick Park, and the transfer was not well organised. In fact, it was tragically badly organised. So there are issues to consider that are different and separate from the mechanistic approach of insisting on 40 hours of consultant cover on labour wards. We have to deal with the evidence, not just with simple management assertions that are driven as much by the European working time directive and financial pressures as by genuine evidence of clinical safety.