Health Bill [HL]

I shall speak on two issues: learning disabilities, which my noble friend Lady Campbell raised; and what happened in Kent, which the noble Lord, Lord Warner, mentioned. I declare an interest as a regional nursing officer responsible for managing the closure of a large institution. We could not have effected that change without the direct payment system for learning disability clients who went to individual homes, so I fully support it. The noble Baroness, Lady Cumberlege, spoke about independent midwives. I declare an interest as a regional supervisor of midwives for 17 years, with the implementation of independent midwives happening during that time. There were considerable problems with the implementation, but the noble Baroness, Lady Cumberlege, is right that from the mother’s point of view, it was absolutely right. The noble Lord, Lord Warner, raised a question about professional antagonism to changes. Here, we have a problem, because with the independent midwives, just as with any other midwives, the bottom line is the safety of the mother and the baby. As long as that is the bottom line, it can be a very healthy and happy outcome. At the same time, I have sat on and chaired the professional conduct committee for what was the UKCC, where we had one or two cases where the independent midwives had acted as independent and not within the regulations. As long as independent midwives are prepared to accept self-regulation through the Nursing and Midwifery Council and the Care Quality Commission, it will be fine. Travelling from home to hospital has to come into the equation in the assessment of antenatal care. If it is not near enough for the mother to be transferred in an emergency in the case of an abnormality happening during labour, it is the responsibility of the independent midwife to seek assistance. That is part of her role. I raise those points and ask that the Minister might take them into account when he looks at the role of independent midwives.