National Maternity and Neonatal Investigation Debate
Full Debate: Read Full DebateLord Kamall
Main Page: Lord Kamall (Conservative - Life peer)Department Debates - View all Lord Kamall's debates with the Department of Health and Social Care
(1 month ago)
Lords ChamberMy Lords, I thank the Minister for the Statement and the noble Baroness, Lady Amos, and her team for the thoroughness and compassion with which they have conducted this important investigation. Above all, our thoughts must be and are with the women, babies and families whose experiences lie at the heart of this report. Many have had to revisit the most painful moments of their lives when some want to simply move on. But after years of fighting, they must be heard. Their courage, dignity, determination and persistence place a responsibility on all of us in this House. We owe it to them not simply to listen, but to ensure that their experiences finally lead to lasting change.
Only last week the House considered Donna Ockenden’s devastating findings in Nottingham. Here, the noble Baroness, Lady Amos, presents us with a wider national picture. Once again, we see the same troubling themes emerge—women whose concerns were dismissed, staff who felt unable to speak up, inequalities that remained unchallenged, and organisations that failed to learn from previous mistakes. As Donna Ockenden herself observed, much of what is contained in this report is sadly already known to us, as it was to Governments of all political colours in previous years. That is perhaps the most disturbing and sobering conclusion of all.
The challenge before us is no longer one of evidence. We have had inquiry after inquiry, report after report and recommendation after recommendation. The challenge now is implementation. Families have every right to expect that this report will become the catalyst for sustained improvement across maternity and neonatal services. I am sure that all noble Lords welcome the fact that work is beginning immediately in a number of critical areas, including maternity triage, tackling discrimination, strengthening staffing and addressing urgent estate risks. It is right that today’s expectant mothers be given assurance and reassurance about what will change immediately, not only at the end of the year when the wider plan is due.
A few outstanding questions arise from the Statement. First, can the Minister update the House on the timetable for the Leeds and Sussex reviews? How will the Government ensure that concerns which have already been identified in those services are acted on before these reviews conclude? Secondly, it is welcome that the Secretary of State will publish the new maternity triage standards next week, but by when does the Minister expect every NHS trust to have implemented these standards and will Parliament receive regular updates on trust-by-trust progress so that families can see that improvements are generally being delivered? Thirdly, the Government propose establishing a statutory maternity and neonatal commissioner. Can the Minister explain what powers the commissioner will have to hold trusts, regulators and national bodies to account? How will local leaders remain accountable for the safety of the services that they are supposed to oversee?
The additional midwifery posts announced today are also welcome, but the report from the noble Baroness, Lady Amos, like those before it, identifies workforce pressures as a fundamental challenge to safe maternity care. Do the Government intend to address this issue immediately, or will we have to wait for the long-awaited workforce plan? If it is the latter, can the Minister update the House on when it will be published and whether it will specifically address maternity and neonatal services? I can understand her perhaps raising an eyebrow here, as she rightly and persistently challenged me on this when I was a Minister in her place.
Since the report’s publication, concerns have been raised by Dr Bill Kirkup about the removal of references to so-called normal birth ideology from the final report. Previous maternity inquiries have identified this as a contributory factor. It would not be fair of me to ask for comment on the editorial process, but can the Minister reassure the House that all relevant evidence—including from Morecambe Bay, which found that midwives were pursuing normal birth at any cost—will be fully considered?
Finally, the Secretary of State is right that culture lies at the heart of this challenge. Often, while policy changes and restructures are visible, it can be more difficult to bring about cultural change. Where the Government act with the urgency that this report demands, they will have our support. However, women and families will judge today’s Statement not by new structures, new titles or another report, but by what happens when a woman says that something is wrong. Is she heard? Are warning signs acted on? Is help from senior colleagues available when needed? Are maternity units safely staffed and can staff speak up without fear? Do families receive honesty and compassion when harm occurs? Above all, are we reducing the number of mothers and babies coming to harm?
Families have told their stories. The evidence is clear. We will support and, where appropriate, challenge the Government and the NHS as they seek to bring about this much-needed change. The Minister in the other place has made a good start, and we hope to see further progress.
Baroness Pidgeon (LD)
My Lords, this is another week and another traumatic and difficult-to-read report about the state of maternity services. Behind it are thousands and thousands of women and families deeply affected by these service failures. I thank them all for their contributions to this report, as well as the noble Baroness, Lady Amos.
Women are not being listened to, heard or believed, with serious consequences for safety and quality of care. Racism and discrimination are embedded throughout the maternity and neonatal system. Services are not responsive to the changing profile of women giving birth and the increase in medical interventions during birth. Antenatal, birth and labour, neonatal and postnatal services are just not joined up. From Somerset to Blackpool, the safety of having a baby has become a lottery. Women are silenced and staff who raise the alarm on unsafe care or systemic discrimination are crushed by a culture of fear. We need to see genuine accountability throughout the NHS and the investment necessary to make Britain the safest country in the world to have a baby.
I have a number of questions for the Minister. I welcome the Government’s commitment to a national maternity commissioner, but can the Minister confirm that this post will go to an independent expert and not a political appointee? Will the Minister reassure us that action will be taken before December, rather than waiting for the taskforce to report on its plans? Will the Government guarantee safe staffing at all hours in every maternity ward in the country, so that no woman has to give birth in an unsafe unit?
This inquiry has, once again, raised the issue of poor bereavement support across the NHS after pregnancy or baby loss. The national bereavement care pathway seeks to resolve this by ensuring high-quality and consistent bereavement care across the UK. The trauma of baby death and pregnancy loss can last a lifetime. Parents’ memories of the care they receive at that moment will stay with them for ever. Good bereavement care can help parents and families navigate their bereavement journey, while poor care can just add to the trauma of loss.
The first moments after a baby dies can be the only opportunity parents have to make memories with their baby, and there is only once chance to get this right. After a baby dies, parents often face really tough decisions, and they cannot make informed decisions about their baby without clear and compassionate communication from healthcare professionals. I therefore ask: will the Government roll out all five national bereavement care pathways, including for miscarriage, and actively monitor implementation across the health system? Will they ensure that suitable bereavement rooms are available in all trusts, not as a “nice to have” but as part of dignified trauma-informed care? This would be a step change for so many families.
There is so much more I could say on a topic that has shocked us all. All families, wherever they live and whatever their ethnicity, must be supported to have their babies safely. This has clearly not been the case for too many years. This is the point where things must change, and I really look forward to the Minister’s response.