Women in labour turned away by NHS maternity units

Women in labour are being refused entry to overstretched maternity units and told to give birth elsewhere, NHS hospitals admitted yesterday in response to an application under the Freedom of Information Act. They disclosed that maternity wards in almost 10% of trusts closed their doors to new admissions on at least 10 days last year. One trust in North Yorkshire closed 39 times between October and January because it did not have enough staff to provide a safe service.

The NHS encourages mothers planning a hospital delivery to make a booking early in pregnancy and get to know about the facilities during regular check-ups with a midwife. Most mothers discuss a birth plan with a consultant obstetrician, including choice of pain relief. These preparations are made on the assumption that the hospital will have enough capacity to deal with unpredictable peaks in demand when women go into labour. But information disclosed to the Conservative party under the FoI Act showed 42% of trusts could not get through last year without turning women away at least once.

Andrew Lansley, the shadow health secretary, said the results showed large maternity units closed most often. The University Hospitals of Leicester NHS trust - the second largest unit in England, with 9,470 births last year - shut 28 times. The North Bristol NHS trust closed its doors 17 times. It said the problem was caused by a high birth rate at its Southmead hospital, the largest maternity unit in the south-west, which delivers about 5,500 babies a year. The trust that closed the maternity unit most often was Scarborough and East Yorkshire Health Care, which had only 1,615 births last year. Overwhelmingly, the trusts with most closures were dealing with double that number of births.

Lansley said: "Labour are fixated with cutting smaller, local maternity services and concentrating them in big units. But women don't want to have to travel miles to give birth. And they certainly don't want to have to travel even further because they're turned away by the hospital of their choice. Conservatives are committed to supporting smaller maternity units because the evidence shows they do better."

Lansley's disclosure coincided with a decision by an independent panel to reject NHS plans to close maternity services at Horton general hospital in Banbury. The Independent Reconfiguration Panel - set up by the government to take responsibility for unpopular decisions away from ministers - said access to services would be "seriously compromised" if Oxford Radcliffe Hospitals NHS trust went ahead with plans to centralise its paediatric, gynaecological and obstetric departments.

The Royal College of Obstetricians and Gynaecologists said the increasing frequency of maternity unit closures emphasised the need for more resources. Richard Warren, the honorary secretary, said: "Our current calculation is that 400 extra consultants are immediately required across England and Wales."

Louise Silverton, deputy general secretary of the Royal College of Midwives, said: "The key issue here is what the women want. Women want to know and develop a relationship with their midwife and not feel as if they are on a production line. Midwives want to be able to deliver the best possible individualised care and not feel like they are working in a baby factory."

A spokeswoman for the Department of Health said: "It is difficult precisely to predict when a mother will go into labour and sometimes, at times of peak demand, maternity units do temporarily divert women to nearby facilities. When this does happen, it is often only for a few hours and to ensure mother and baby can receive the best care possible."

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Australia: Hospitals cook the books

NSW Health says altering hospital records to show better treatment times in emergency departments is not a widespread practice. Falsified records from Gosford Hospital showing faster emergency treatment times had been forwarded to the Independent Commission Against Corruption (ICAC), NSW Health director of performance improvement Dr Tony O'Connell confirmed today. But audits of numerous public hospitals revealed that the practice was not widespread, he said.

"We've been doing both internal and external audits of numerous hospitals and there's no evidence that this is widespread," Dr O'Connell told AAP. "In fact it was from an internal audit at Gosford hospital that it was discovered that there was one person who was doctoring results, and that was reported to ICAC and ICAC were satisfied with the actions which the area health service proposed to take to address that issue."

Dr O'Connell denied that NSW Health had been covering up the results of the audits and said they had not been released because they were "standard" reports. "We haven't released them because they're kind of standard ... that any big organisation would do and they don't show anything wrong with the way that the data is collected," he said. "So we haven't released it, but gosh I think we should now."

Dr O'Connell said any staff caught altering hospital records would be dealt with under the department's fraud guidelines. "Any behaviour by staff which corrupts data deliberately is fraudulent behaviour and would be addressed in the department's fraud guidelines, which all staff when they start work are made familiar with," he said.

Hospital staff understood they needed to treat patients in emergency departments quickly and better hospital resources would assist them, Dr O'Connell said. "Our intent is to get patients through our (emergency departments) in the clinically appropriate time. We want patients not to be queueing, we want patients not to be waiting an inappropriate length of time."

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