National Maternity and Neonatal Investigation

Lord Winston Excerpts

Monday 6th July 2026 Lords Chamber

[Baroness Merron (Lab)]

It is a challenge to take on a deep-rooted culture, but we are doing that and it will require action at every level, without doubt. The main thing, as the noble Baroness said, is putting women, babies and their families at the heart of care. This has not been the case. NHS England’s chief executive brought all trust chief executives to London on the day the report was published to discuss the urgent actions trusts can take on this and to focus on the next 100 days. All perinatal leadership teams have also completed a culture and leadership programme, which I believe will strengthen collaboration across maternity and neonatal services. Those are just two of the actions we will take, but this is absolutely fundamental to all the system changes.

[Lord Winston (Lab)]

My Lords, I listened to this short debate with a bit of amazement. We are looking at the end results, but we need to look a little further up the channel. My noble friend Lady Blackstone touched on a very important point, as indeed did the noble Baroness, Lady Pidgeon, which is much more crucial than we may perhaps understand. First, as has been said, these people come to hospital not to access maternity services but to have a baby. They are not ill. That is different from the rest of the NHS, even though they are in the NHS. What we are partly seeing here is a cultural situation that is a problem throughout the NHS, not just in maternity services. It is bad in maternity services for the obvious reason that, in the main, these people are healthy, although some are not terribly fit. We are losing the plot a bit.

For example, the noble Baroness, Lady Pidgeon, said that there is a need for much better psychological support, and I agree. We tend to forget that a woman who is having a baby, even a normal baby who is fully alive, is losing a life within her uterus. She feels a loss when that happens. It may not be expressed as a loss—it is expressed as happiness—but it is an extraordinary change of feeling, which psychiatrists know is very common in maternity. We forget that this affects not just women but men as well.

We also sometimes assume, as we have done in this report—certain things are obvious—that it is much better not to have a caesarean section. That has been suggested, but it turns out that a caesarean section is safer than a vaginal delivery, if you want to be absolutely safe. This has been shown through various studies. I am not advocating caesarean section, of course, but I am pointing out that we sometimes deplore it when it may actually be a useful thing to do.

We have to understand that we are looking at not a broken service but a service under great stress, and we have to deal with that. The noble Baroness, Lady Blackstone, pointed out that its manning is very inadequate. It needs to be a consultant-led service and people have to stay in overnight, but there is not always enough conversation between midwives and obstetricians. There needs to be much closer understanding between the two. Above all, the culture should be one of kindness. Kindness is what we must ensure.

[Baroness Merron (Lab)]

I absolutely agree with what my noble friend said about kindness; when we had the Statement last week, we discussed compassion as well. It is disappointing to have to talk about it, because it should be a given, but we have found that it is not. I totally agree that pregnancy is not an illness—I was once quoted as very sharply telling an interviewer that. I am not aware that it is, and it is not, but it is worth restating, in my view. On the role of men, I am very careful to speak about women and families; that is the right thing. I also clarify that, in this Statement, I do not believe anybody is suggesting that one form of birth is preferable to another. I think we would probably all agree that it is about the form that is safest and the right one for the circumstance.