Maternity Services

Al Pinkerton Excerpts

Tuesday 25th February 2025 Westminster Hall

[Jess Brown-Fuller]

I agree wholeheartedly that we need to change the way that we do litigation, because NHS trusts often argue that they want to learn and grow from poor experiences, but the litigation system means that they rarely have the opportunity to do so, because everybody is so afraid to speak out. We need to change that culture within maternity services and the NHS as a whole.

As a country, we are training more midwives than ever before, yet retention remains a problem and the pandemic exacerbated an already difficult situation, with highly trained midwives with families or caring responsibilities leaving the profession too soon.

[Dr Al Pinkerton (Surrey Heath) (LD)]

I congratulate my hon. Friend on bringing this debate here today. Frimley Park hospital in my constituency received an outstanding report from the Care Quality Commission in 2023, but it none the less identified that inadequate staffing remains one of the highest risks on the maternity register. That has daily implications; many midwives reported, for example, that daily checks were often incomplete, handovers were interrupted and not standardised, and mandatory training was often not completed.

Does my hon. Friend agree that to ensure high-quality maternity care, from admission to discharge, requires not only stringent oversight by trust boards, but far greater care for staff in the setting of the hospital, providing safe spaces where conversations can be had, handovers can take place, and nurses can rest? In that way, we will both retain and also hopefully recruit more of our vital nursing staff.

[Jess Brown-Fuller]

My hon. Friend is absolutely right; the key to providing strong maternity services that benefit both the staff and the patients is making sure that there is a full workforce so that they can do not just the “need to haves”, but the “nice to haves” in a maternity department, which can make such a difference to patients’ experiences when they are going through that service.

The retention issue that we have directly impacts training. Newly qualified and inexperienced midwives need experienced mentors, but if seasoned professionals leave, the next generation lacks the support necessary to transition into leadership roles. Midwives and other maternity staff must train together at every level to be fully equipped for every situation, and ensure that concerns can be escalated effectively. That is why the Ockenden report and the Royal College of Midwives seek a commitment to including midwives in the long-term workforce plan.

In 2017, bursaries for student nurses and midwives were ended, with the Royal College of Midwives warning that that decision threatened the future of our maternity services in England. It has led to one third of midwifery students having debts exceeding £40,000, with 80% of them knowing someone who has dropped out of their course due to financial hardship. Many also take on additional jobs to afford their studies, which detracts from their vital training. To mitigate those pressures on trainee midwives, I encourage the Government to explore alternative routes to support midwifery and nursing students, which have been laid out by the Royal College of Midwives, through new funding options or a scheme where student debt is forgiven after a defined period of service in the NHS.

A similar funding issue affects apprenticeship schemes in midwifery. Despite receiving overwhelmingly positive feedback from trusts across the country regarding the apprenticeship route, many trusts cannot afford to offer those positions due to a lack of backfill funds, so trusts often hand back their apprenticeship levy, as the scheme is undeliverable. I hope the Minister will work with her colleagues in the Department for Education to address this fundamental flaw in the delivery of level 6 and level 7 apprenticeships, which have proven to deliver the midwives of the future.

In preparing for today’s debate, I was invited to my local maternity unit at St Richard’s hospital in Chichester, where as I mentioned I had both of my children. University Hospitals Sussex had its maternity services inspected by the CQC in September 2021, which found all hospitals across the trust to be inadequate or requiring improvement. Although there has not been a formal inspection since, the trust assures me that all actions from the CQC have been completed, with the majority of the Ockenden immediate and essential actions implemented. However, to fully implement all the IEAs will require funding, which currently the trust does not have.

St Richard’s hospital confidently tells me that it is now fully staffed for the first time in a long time, and the director of maternity services is keen to look at how she can further improve patient experience and communication. I know Members across the House are keen to work with their NHS trusts constructively to ensure the best outcomes possible for their constituents. I was reassured by the senior leadership team, those working in the department, and the new parents on the ward, who I had the pleasure of congratulating. Introducing tiny babies to the world was probably the best moment of my recess—it was very bizarre for those parents when the MP walked in and said, “Can I say hello?” I am pleased that the trust is taking seriously its responsibility to provide a much improved service.

It would be a missed opportunity if I, as the chair of the all-party parliamentary group for infant feeding, did not mention how we could do much more as a society to support mothers to breastfeed, if they choose to. The UK’s breastfeeding rates are among the lowest in the world. Only 1% of mothers exclusively breastfeed at six months, despite the World Health Organisation recommending exclusive breastfeeding for this period and continuation, alongside nutritious foods, for up to two years. Some 44% of mothers surveyed wished that they had breastfed for longer and would have done so if they had received better and more tailored support. New mothers need time, expertise and evidence-based information to make informed decisions on their feeding choices, and maternity services play a key role in establishing a feeding plan that works for mother and baby before they go home. But, across the country, community midwifery and health visiting services have been vaporised, so support is patchy and often delivered by volunteers or midwives in their spare time. I hope that the Government will support improved community services such as milk support groups, to give all women, regardless of their feeding choices, somewhere to turn when they need support.

I will take this opportunity, perhaps selfishly, to get on record the name of one of the coolest kids I ever met. Benedict Henry Goodfellow was an absolute dude—[Interruption.] I am not going to cry—and I am proud to call his mum, Steph, one of my close friends and the strongest woman I know. This debate is so important to me because Bendy needed 24-hour care since birth after a case of extreme birth trauma left him with devastating neurological damage. Bendy was loved by everyone who came into contact with him until he died, aged 10. The experience left Steph traumatised and profoundly changed. Bendy was born nearly 30 years ago and yet Steph and Ben’s story is just as relevant today. It should not be.

I am immensely grateful to Donna Ockenden for putting me in touch with families from across the country—including from Leeds, Nottingham, Shrewsbury and Sussex—ahead of this debate to hear their personal experiences of failures in maternity care.