Health Bill [HL]

Once again, as the non-professional, I shall speak on behalf of the consumers of these services. I listened very closely to the noble Baroness, Lady Cumberlege. Something worried me about her whole contribution and perhaps the Minister will comment on what she said. In the 1980s, a row took place in Workington when the local health authority decided that it wanted to close a maternity unit. Then there were arguments about further maternity units in Cumbria. One of the objections was that people simply wanted their children to be born in a particular area because it goes on the birth certificate. It might not seem particularly relevant for us when we are considering matters of health, but where people or their children are born features on the agenda. One argument regarding the closure of maternity units in Workington was about where babies would be born. I wonder whether, in the event that we develop a system that allows people effectively to opt out of using the local maternity unit—that is what we will do by providing a system of direct payments to independent midwives, as I understand it—we will pursue a policy that could lead to a reduction in the number of maternity units in an area, which will have consequences. If a maternity unit is taken away from an area, the distance travelled by anyone wanting maternity services is much greater. Consequently, some women might feel under pressure to have the baby at home, which may not be what they would choose. They may want to have the baby in a maternity unit, but may not want to travel a great distance or such a distance from where they live that their relatives are not in a position to visit them. This is a consumer perception of how this would work in the system. I do not want to do anything which would lead to a reduction in the number of maternity units. It might be that I have completely misunderstood what the noble Baroness, Lady Cumberlege, was advocating. But the consequences of what she seemed to be advocating would be a reduction in the number of maternity units, along with the availability of obstetric facilities and expertise.