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Health and Social Care Bill

Amendments Nos. 204A and 204B have been tabled as a result of concerns that women expecting a multiple birth will receive only the same level of grant as a woman expecting one baby. I fully understand noble Lords’ concerns but there are two important reasons why we do not support the amendment. First, I recognise that some women may use the health in pregnancy grant to support their nutritional needs during pregnancy. I know that some noble Lords are concerned that women with multiple pregnancies may have greater nutritional needs and should therefore be paid a higher grant to reflect this. However, there seems to be no reliable evidence to support that view. The availability of the health in pregnancy grant will trigger a discussion with a health professional and bring down the startling figures that the noble Earl mentioned on the number of women who are not receiving nutritional advice. That is one benefit of the existence of the grant. Of course all pregnant women need to pay attention to their health and nutrition. The Department of Health’s advice on nutrition for pregnant women is based on the recommendations from the independent Scientific Advisory Committee on Nutrition. The committee’s view has always been that there is no evidence to support the view that women with multiple birth pregnancies have greater nutritional needs. We were provided with additional evidence to the contrary by the Twins and Multiple Births Association. We therefore asked the independent committee to look at this evidence—we took it extremely seriously—to see whether its advice would change as a result. It did not. In the conclusions of the committee’s report on this issue, which I am happy to make available to noble Lords, it stated: "““The Committee concludes that the evidence fails to support the assertion that women deliberately increasing their nutritional intakes beyond current recommendations in multiple pregnancy can improve the outcome””." We also contacted the chair of the Scientific Advisory Committee of the Royal College of Obstetricians and Gynaecologists to see what assessment he made of the available evidence. He said that, "““there is no evidence indicating that additional nutritional supplement will influence the preterm delivery rates or the low birth weight rates. There are some personal communications and surveys which indicate there might be some benefit but certainly there are no scientific studies to back them up””." Secondly, there are the additional costs involved after a woman gives birth to more than one child. There are existing support schemes to help mothers in this situation, where money is paid per child, including the Healthy Start voucher scheme, child benefit and the Sure Start maternity grant. I have indicated that the Government have taken this issue seriously and have sought to determine whether there was a justification for any change on the basis of multiple births. In the light of these arguments, I hope that the noble Earl will feel able to withdraw his amendment.