Patricia Hewitt has taken the unusual step of replying personally to a recent article in the Guardian on maternity care in the UK. She probably did not write the article herself but it must have been initiated by her and will have crossed her desk before it went out.

That a Cabinet minister, responsible for one of the most important government departments, should be replying personally to articles in a newspaper is a sign of desperation.

That the reply should be so breathtakingly duplicitous both demeans her office and calls her probity into question. I suppose we should be used to it by now. As the ageing Greek commentator pointed out a few weeks ago, Hewitt is already up there in the pantheon of great political liars.

“Classics of the genre, you may recall, are such as these:

I am not a crook.
- Richard Nixon, 1974

I'm a pretty straight kind of guy.
- Tony Blair, 1997

The NHS has just had its best year ever.
-Patricia Hewitt, 2006

Staggering falsehoods, every one of them; statements so diametrically at odds with the truth that they seem almost to warp the fabric of space and time around them." (Mr E)

Hewitt’s article was published yesterday in the Guardian.

Of course we must do more for mothers-to-be. And we will

Many women are denied the maternity care they prefer. We will give them choice, says Patricia Hewitt

Thursday April 12, 2007 The Guardian

Your article claims the NHS has "too few midwives to achieve even the basic levels of care for families" (Birth care promise is unattainable, April 7). This is untrue.

The UK remains one of the safest countries in the world in which to have a baby,

[Like so many things that Hewitt says, the superficial truth masks a lie. Yes, the UK is indeed “one of the safest countries in the world in which to have a baby.” It is safer, for example, to have a baby in the UK than it is in Chad, where the maternal and peri-natal mortality rates are particularly high. But we should be right at the top of the list. What Hewitt does not say is that the maternal and peri-natal mortality rates in the country have been rising. And that is shameful.

The National Patient Safety Agency, which is part of the NHS, has reported on this recently. Go to their site here, and click on the link to:

The Confidential Enquiry into Maternal and Child Health (CEMACH)
The link does not work. The CEMACH report has disappeared from the NHS. Why might that be, Dr Crippen wonders?
And could someone explain to Dr Crippen why this report is confidential?

Fortunately, confidential or not, the CEMACH report is available here. Those not wanting to read it in full may like to refer to a recent article, with up to date figures, by Sophie Goodchild, Jonathan Owen and Ian Griggs in The Independent:

Record numbers of women are being harmed or dying as a direct result of childbirth in what doctors are labelling a "crisis" in maternity care. There has been a rise of 21 per cent in deaths of pregnant women in the care of NHS maternity services. Deaths over the past three years now total 391, up one fifth on the comparable period, and 17,000 women have suffered physical harm while on labour wards.

Figures obtained from the National Patient Safety Agency (NPSA) reveal that over the past three years, 17,676 mothers have been injured on maternity units. Serious cases include women with perforated bowels whose injuries are so severe they have needed temporary colostomies.

The UK now has one of the highest rates of maternal mortality in Europe, with 13 deaths per 100,000. Britain ranks below countries including Poland and Hungary, and is above Bulgaria, Bosnia, Belarus, Romania, Armenia and Albania.]

and 80% of women are satisfied with the maternity care they receive.

Not according to The Independent:

A survey of nearly 5,000 women's experiences of maternity from the Healthcare Commission, to be published to coincide with Mother's Day later this month, is also expected to highlight a lack of satisfaction among patients with medical care during labour and delivery.]

Of course, more needs to be done if we are going to deliver our manifesto commitment that, by the end of 2009, every woman will have choice over where she gives birth and what pain relief to use, supported by a named midwife throughout her pregnancy. That's why last week we set out how, for the first time, women and their partners will be guaranteed this choice.

[We are back to Alice in Wonderland here.

`Have some wine,' the March Hare said in an encouraging tone.

Alice looked all round the table, but there was nothing on it but tea. `I don't see any wine,' she remarked.

`There isn't any,' said the March Hare.

`Then it wasn't very civil of you to offer it,' said Alice angrily.

There are not enough maternity units. Hewitt is closing them down. There are not enough midwives to provide a safe service in hospitals, never mind at home.]

Your piece quoted selectively from research, suggesting that "more women want midwives they can trust than wish to be able to make choices about their care". Of course mothers-to-be want doctors and midwives they trust. But we also know they want to be given a say over the care they receive. Women want a range of options - from consultant-led care in hospitals, to midwife-led units and home births - and their choice will depend on what's best for them and their baby.

We know that more women would choose home births if the choice were available. Where the NHS locally employs enough midwives to support genuine choice, 10-12% of women choose a home birth compared with only 2-3% nationally. That's a lot of women currently denied the option they would prefer.

[Dr Crippen does not want, on this occasion to reopen, yet again, the debate about the safety of home births as opposed to hospital births, but it is dishonest of Hewitt to purport to offer “all” women the “right” to a home birth without discussing safety. If she means that only a highly selected group of women, alleged to be low-risk, are to be offered a home birth subject to the availability of a midwife prepared to conduct it, she should say so]

High-quality services that support genuine choice must not be the sole preserve of the articulate middle classes. That's why tackling inequalities in maternity care is at the heart of our approach. We know that providing more ante- and post-natal services in the community, including through Sure Start and Children's Centres, helps improve access to care - and outcomes such as low birth weight - among hard-to-reach communities.

[Experts are warning that 10,000 more midwives are needed to prevent a further rise in blunders and deaths. They say there is also a shortage of trained obstetricians, desperately needed now that doctors perform more Caesarean sections, largely because of staff shortages. More than one in five births in Britain are by Caesarean section, a figure significantly higher than World Health Organisation guideline of 15 per cent. (Independent)]

Under Labour, the budget for maternity services has increased from £1bn to £1.7bn. As the chancellor announced in the budget, an additional £8bn is being invested in the NHS this year alone. Labour's investment and reforms, and the hard work of NHS staff, will deliver the quality and choice of maternity care all mothers want, and deserve.

[An increase from £1bin to £1.7 billion over ten years is a little over 5% a year, and thus barely keeps pace with inflation. In terms of the real money that is needed to expand the service, it is next to nothing.]

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Patricia Hewitt’s reply might be acceptable from a government which had been in power for ten weeks. They have been in power for ten years. The time has passed for more promises of more action to be taken in the future.

After ten years, the people of this country are entitled to ask not what will be done, but why it has not already been done.

We are desperately short of midwives

We are short of medically trained obstetricians

We are short of maternity units.

We may be doing better than Chad, but more mothers and babies are dieing during or shortly after labour since this government came to power.

This truly is new labour.

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Comments may of course be made below as usual, but please comment under Patricia Hewitt's article in the Guardian (here)