Maternity Services

Katie White Excerpts

Tuesday 25th February 2025 Westminster Hall

[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.

[Katie White (Leeds North West) (Lab)]

As I am the Member for Leeds North West, the hon. Member may have spoken to my constituents, Dan and Fiona, who tragically lost their baby Aliona after only 27 minutes. Despite the fact that the inquest found a number of gross failings, the figures for Leeds, which came out only last night, are horrifying. Does the hon. Member agree that there are grounds for an independent review of maternity services in Leeds?

[Jess Brown-Fuller]

The hon. Member is absolutely right to raise the case of Dan and Fiona. I was lucky enough to have them give up their time to share their heartbreaking story with me. They are at the forefront of the fight for an independent inquiry in Leeds. The Secretary of State for Health and Social Care said that he would look at whether there is cause for an investigation but those families are still waiting to find out if that will go ahead.

I met with families like Dan and Fiona to ensure that the questions I ask the Minister today are the questions that those families would ask if they had the opportunity. I cannot begin to imagine how exhausting it is to relive the moments that their lives changed forever, over and over again, in the pursuit of better outcomes for the next family. I will include a number of their questions to the Minister in my closing remarks, but I reflect that the families who were able to share their experiences with me were, overwhelmingly, white, middle class, often highly educated and that many had medical backgrounds or academic careers before going through this trauma. Lord Darzi’s report found that black women are almost three times as likely to die in childbirth as white women and that neonatal mortality in the most deprived areas is more than double that in the least deprived. Who speaks up for those families? Who ensures transparency and accountability for those with a fundamental distrust of the medical profession, or those who have learning disabilities, or English as their second language, because those people are not supported in navigating the complex systems that are in place?

Negligence claims in obstetrics account for just 13% of the volume of litigation received by NHS Resolution in 2023-24 but cost over £1 billion every year—nearly 60% of the total cost of clinical negligence claims. Beyond financial costs, those failures carry a devastating human toll. If we truly invest in our maternity services, in both professionals and facilities, more than money is saved; lives are saved.

In conclusion, I would like to ask the following questions of the Minister. First, the previous Government were supportive of the Ockenden review, and previous health Ministers had made assurances that maternity services were going to get the support they desperately needed. I know the Secretary of State for Health is supportive of the Ockenden review and has met many bereaved parents since the general election. He has assured those parents that fixing maternity is a priority for the Government, and that actions would be outlined publicly before Christmas 2024. He came back shortly after Christmas saying they needed more time. That response is now two months overdue. Can the Minister assure me that those families will hear an update in the near future?

Do the Government support all the Ockenden report’s immediate and essential actions arising from the review into the Shrewsbury and Telford trust? How will the Government ensure that all integrated care boards and trusts across the UK implement all the actions? What support will be provided to the trusts to achieve that, and prevent a postcode lottery of maternity care?

If those IEAs are implemented, what will be the Government’s measure of success? We currently have no national data regarding preventable deaths. It is the charitable sector that has determined that more than 800 baby deaths a year could have been prevented. One of the IEAs is a long-term plan to secure a safe maternity workforce and improve training. Can we expect to see maternity care professionals, including neonatologists, obstetricians and anaesthetists, included alongside midwifery colleagues in the refresh of the 10-year workforce plan for the NHS?

An overriding theme in my conversations with bereaved parents was the CQC’s hesitancy to prosecute. Cases were often supported in the first instance, but families were then informed, just days before the three-year statute of limitations expired, that the CQC would no longer be seeking a prosecution, with the families having no time to appeal that decision. Does the Minister believe that a three-year statute of limitations is appropriate when families dealing with bereavement are often not even considering a case in the first 12 months?

Does the Minister have any concerns about the CQC’s ability as a regulator? Or does she agree with the parents that there is a reluctance to prosecute by the leadership of CQC when there have been failures in patient care? Does the Minister support calls from Sands and Tommy’s charities for all triage phonelines to be recorded, as currently they are not?

Finally, parents repeatedly reported to me that the bereavement care they received felt like a tick-box exercise, with a lot of focus on the mother and a lack of communication and support for the father, when both have suffered that bereavement. Does the Minister agree that communication could be vastly improved across maternity services in all cases, so that both parents have the opportunity to understand what happened in those most vulnerable hours?

I would like to finish by thanking every Member who has come to talk about this important issue. I also thank Donna Ockenden and all who contributed to the creation of the review. My greatest thanks go to all the families who gave up their time to share their stories with me, reminding me that those babies were people, not statistics. They are loved, they are missed, and they deserved better.