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PETITIONS
Handguns
10 pm
Mr. Ernie Ross (Dundee, West): This petition has been signed by the citizens of Dundee and area. I say "area" because, when civil servants look at the petition, they will see that, during the holiday period, visitors passing through the centre of Dundee insisted on signing the petition.
The people of Dundee are concerned that the House should introduce legislation to ban the private ownership of handguns. On 13 March, Thomas Hamilton inflicted 17 death sentences and multiple life sentences on the innocent people of Dunblane. The petition that I am presenting this evening carries 3,250 signatures and says:
The Petition of the citizens of Dundee and area:
To lie upon the Table.
Declares that the private ownership of hand guns should be banned. Hand guns are particularly dangerous firearms, they are easily concealed and carried. They are capable of rapidly firing a large number of rounds without reloading and are therefore extremely dangerous in private hands.
The Petitioners therefore request that the House of Commons introduce legislation to ban the private ownership of hand guns, and the petitioners remain, etc.
10.1 pm
Mr. John McAllion (Dundee, East): I, too, wish to present a petition from the citizens of Dundee and area. Like my hon. Friend the Member for Dundee, West (Mr. Ross), I spent most of the summer recess helping to collect signatures in my constituency of Dundee, East, which was part of the citywide petition led by my hon. Friend and myself. Like his petition, mine declares that the private ownership of handguns should be banned, as handguns are dangerous firearms and are easily concealed and carried. They are capable of rapidly firing a large number of rounds without reloading and are therefore extremely dangerous in private hands. The petition reads:
- The Petitioners therefore request that the House of Commons introduce legislation to ban the private ownership of hand guns, and the Petitioners remain, etc.
Maternity Services, Monklands
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Peter Ainsworth.]
10.2 pm
Mrs. Helen Liddell (Monklands, East): I am grateful for the opportunity to bring before Parliament an issue of great concern to my constituents. I am grateful to have this opportunity so soon after the House has returned from the summer recess, because the issue has exercised my hon. Friends and myself during the recess. I sought this debate urgently because of a developing problem that could deprive mothers in my constituency of local maternity services. That is bad enough in itself, but the impact of removing localised services could also have a bad effect on paediatric care in the local district general hospital, putting children, some of whom have life-threatening conditions, at considerable risk.
The problem has arisen because of Lanarkshire health board's desire to close the local Bellshill maternity hospital, which is part of the Monklands and Bellshill hospital trust. It wants to locate maternity provision at a new hospital to be built at Netherton in Wishaw to replace the existing Law hospital. Let me make it abundantly clear at the beginning of my contribution: I do not oppose the establishment of maternity facilities at Netherton. Rather, I believe that the needs of Lanarkshire mothers and children would be best met, if Bellshill should close, by two-site provision at general hospitals in both Netherton and Monklands. It is ludicrous to suggest at the end of the 20th century that expectant mothers should face increased inconvenience, not to mention risk, when one of the main achievements of the first part of the century in Lanarkshire was the provision of more appropriate localised care in that county.
Time is of the essence in this matter as the local health board is currently involved in a consultation exercise that I believe is based on a totally false premise. If the wrong decision is arrived at as a consequence of that exercise, it could have an adverse effect on health care in the northern part of Lanarkshire for a long time. I cannot overstress the importance of those issues. My hon. Friend the Member for Monklands, West (Mr. Clarke) and I represent an area that has the dubious record as one of the unhealthiest places in Europe. I know that the Minister recognises that fact and I urge him to consider my remarks not just in the light of maternity provision, but in the face of the generally recognised need to concentrate on improving health care in Monklands generally. That is particularly true in relation to children.
In seeking to effect the closure of Bellshill maternity, the health board has made an unwarranted attack on the safety of the service that is provided. It is a stand-alone specialist facility that provides top-class care from a committed staff. Both past and present mothers in my constituency have much to thank Bellshill maternity hospital for. Notwithstanding that fact, the health board has suggested that the facility is unsafe, based upon a misreading of the "Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom 1991-1993", which states on page 193 that units on sites away from acute hospitals "should be regarded as unsafe".
Based on that sentence, the health board has taken an insensitive line that is insulting to the staff at Bellshill and has caused alarm among mothers in my constituency who
expected to be delivered there in the near future. That statement is not true. The quotation upon which the health board is relying refers to very small units that do not have blood transfusion and anaesthetic services and are sited more than 20 miles from an intensive care unit. That is not the case with Bellshill--indeed, only a few units in England are affected. I contend that the health board is using the safety argument to avoid the economic arguments.
Bellshill is the largest maternity hospital in Lanarkshire. It has obstetric, midwifery, anaesthetic and paediatric staff who care for between 3,700 and 4,000 women and their babies each year. They are experienced in dealing with normal and abnormal pregnancies. There is a neonatal intensive care unit, which has a successful record in treating very ill premature babies as young as 24 weeks gestation and 500 g birth weight.
Neonatal care in Lanarkshire matches the best provided at the large teaching hospitals, resulting in Bellshill being used as a back-up by hospitals in the north of England and elsewhere in Scotland when their units are full. The staff are recognised widely within their profession, but were they included in the strategic analysis by the health board or invited to comment on the completed review? No, they were not. The board claimed that the working party comprised a sound body of local expertise, yet no identities were revealed. Why were local experts kept in the dark? Is that the way to devise an accurate and unbiased strategy?
Furthermore, the board claims that it has based its conclusions on projected births to Lanarkshire women by 2005. How did it come to those conclusions? Where is the evidence that it has taken account of the significant inward investment in Lanarkshire from both Chunghwa and Lite on, which will inevitably cause an increase--we are very glad of it--in the number of people moving to Lanarkshire? The board assumes that 30 per cent. of mothers will want to give birth in Glasgow. On what does it base that conclusion? The geographic difficulties associated with travelling from the northern part of my constituency to Wishaw could leave mothers with no choice but to make the longer journey to Glasgow, as trans-county transport in Lanarkshire is extremely bad. If the birth rate in Lanarkshire falls to between 52 to 55 per cent., which is what the projections could lead to, the viability of the new unit at Netherton could be in question and mothers in my constituency would be further disadvantaged.
In the past week, obstetricians and midwives in Lanarkshire have conducted a mini-survey of 100 mothers in antenatal units throughout the county. If Netherton were the sole Lanarkshire site, 91 per cent. of mothers in Coatbridge say that they would have to travel to Glasgow. In Airdrie, the largest town in my constituency, 69 per cent. would have to travel to Glasgow and, from Viewpark, 57 per cent. So it continues. Geography does matter and that is why I do not make an exclusive case for maternity facilities to be provided only at Monklands general hospital.
Lanarkshire health board has a duty to provide health care for all the mothers of Lanarkshire, not to offload some of that responsibility to Glasgow to make its accounts look neater. Its approach will remove true choice from mothers and it looks suspiciously like an accounting exercise to reach the economically attractive figure of 4,000 deliveries. Any deliveries over that number would
make the proposed Netherton unit unsafe. I urge the Minister to challenge the health board on why it is discounting the needs of one third of Lanarkshire mothers.
The health board survey that was conducted among mothers was also seriously flawed. The mothers consulted were those who had, thankfully, normal births and therefore did not require follow-on care. It is precisely the mothers who do not have normal births, or who have babies in need of neonatal intensive care, who should be taken into account. The sampling was not done by a professional polling organisation, as it was in Edinburgh when a similar case arose, and serious questions must be asked about how truly significant the analysis has been.
The survey defies common sense, quite apart from random sampling techniques. If a mother is in a maternity hospital for more than two days, it is usually for a significant reason--either she or her child is poorly. If we site maternity provision at Netherton, mothers who are not physically or emotionally at their best will have to undertake a difficult journey. My constituency is not a wealthy area and we do not have high ownership of private cars as people do in other parts of Scotland. It is difficult to envisage how some of those mothers and their families could cope with the journey across the county to a facility at Netherton. It would be equally difficult for mothers from the south of Lanarkshire to travel to a unique facility in Monklands district general hospital.
If Bellshill is to be closed, the costs of submerging a stand-alone facility into two general hospitals, with the economies of scale that that would involve--together with the clinical arguments--seem to make a self-evident case for a two-site facility. Why has that idea been given the brush-off by Lanarkshire health board?
The local people, whenever I talk to them about the facility, say that they believe that the consultation has nothing to do with their needs and everything to do with cobbling together an attractive private finance initiative deal for the new hospital. If that rumour is true, it is a scandal that outweighs any that we have seen so far.
I spoke earlier about general health in Monklands. An analysis of maternal morbidity in north Lanarkshire in the past three years shows that Hamilton, Airdrie, Coatbridge and Motherwell have the highest levels of morbidity requiring in-patient stay. Neonatal morbidity shows a similar pattern, and Hamilton, Airdrie, Coatbridge and Bellshill have the highest incidence of low birth weight babies. Even among so-called normal births, there is a shift towards the north of the county in relation to admissions to high-dependency neonatal care. Those figures show that there must be easy access to a unit close to those areas of high morbidity if the situation is to be contained and reversed.
Paediatric care pops up almost as an afterthought in the health board's deliberations. That afterthought could completely destroy the advances of the past 20 years in ensuring that sick children in Monklands have the best care when they most need it. The issue of paediatric services did not form any part of the remit of the original strategic review. It has now sneaked in and could have the most serious repercussions for Monklands hospital and the patients it serves.
I received a letter from Dr Marie Brookes, who is an accident and emergency consultant at Monklands district hospital. I urge the Minister to listen closely to what she
has to say. Dr. Brookes points out that 22,000 children under 15 years of age are treated in A and E at Monklands hospital. They comprise one third of the work load of her department. Two thousand of those children are ill enough to be admitted to hospital, yet under the health board's proposals, there will be no beds at Monklands. Four hundred children are currently admitted to the infectious diseases unit through A and E. That unit is to be taken away as well.
Monklands provides the acute head injury service for children in north Lanarkshire; that will cease, too. Dr. Brookes says that her anaesthetist colleagues join A and E in the intensive care of critically ill or injured children who may require to be admitted to Monklands hospital or transferred to Yorkhill. If the paediatric A and E emergency service at Monklands is lost, children will face a journey without prior resuscitation. Is that acceptable?
With her colleagues, Dr. Ian McLaren and Dr. Martin Watt, Dr. Brookes states that in line with national recommendations they would not be willing to provide an A and E service for children at Monklands without the on-site support of senior paediatric colleagues. She states:
"The scenario of the transfer of up to 2,000 children by ambulance to other units is one which we would not wish to face and which will deplete the Department of Medical and Nursing Staff and increase the demands on the Scottish Ambulance Service."
Dr. Brookes continues:
"Your constituents and their children will be forced to take their sick and injured children either to Netherton or Glasgow. At best, this may be inconvenient, economically (for them) unacceptable, and for a minority of children, a life-threatening scenario. Our recent experience with meningitis confirms that time is of the essence and that the delays inherent in these plans are medically and ethically unacceptable."
She concludes:
"That these matters have not even featured in the discussion documents, must be a measure of ignorance or ineptitude of those who have formulated and promulgated these proposals."
That is a warning that I find chilling.
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