Health and Social Care Committee

Paulette Hamilton Excerpts

Thursday 16th October 2025 Westminster Hall

[Mr Clive Betts (in the Chair)]

We start this afternoon’s sitting with a Select Committee statement. Paulette Hamilton will speak on the publication of the third report of the Health and Social Care Committee, “Black Maternal Health”, for up to 10 minutes, during which no interventions can be taken. At the conclusion of Paulette’s statement, I will ask Members who want to put questions on the subject to do so, and then call on Paulette to respond to each of those questions in turn. Questions and responses should be brief, please, as we have only 10 minutes, and that will help everyone to get in.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

Thank you, Mr Betts. It is an honour to serve under your chairmanship.

I wish to make a statement on the recent publication of the Health and Social Care Committee’s report on black maternal health. I speak on behalf of the Committee, which I formally thank for all its hard work and dedication to this inquiry. I also wish to speak for the black mothers whose lives have been forever changed by failings in maternity healthcare, although I note that many of the issues raised with the Committee affect all women who use maternity services.

I thank all those who gave evidence, written or oral, to this inquiry, and I extend my deepest sympathies to anyone affected by maternal health failings. The voices of black women are at the heart of this report, and I thank them in particular for their powerful and often painful testimonies.

Despite repeated policy commitments and public concerns from multiple Governments, black patients still receive poorer-quality maternity care and support. The support they receive often fails to meet their emotional and cultural needs, which has led to black mothers in England being more than twice as likely to die during childbirth than white mothers. The figure for 2014 to 2016 was almost five times higher, which appears to show that there has been progress in this area, but I stress that the reduction is partly due to worsening outcomes for other groups, not improvements for black women.

Our report follows a comprehensive inquiry that identified three key areas where action is urgently needed: culture, leadership and racism. Racism is one of the core drivers of poor maternal healthcare for black women, and it must therefore be tackled urgently and effectively. Black women suffer stereotyping, bias and racist assumptions during childbirth, as was made explicitly clear to us throughout our inquiry. The testimonies we heard were harrowing.

Let me share some examples. First, women suffer due to the “strong black woman” trope. During active labour, one woman was denied pain relief and given only paracetamol—her baby was born 10 minutes later. Another woman was told that she could handle the pain despite losing a concerning amount of blood.

We also heard of a midwife who chose to blame an African pelvis for slow labour, rather than check for complications. Another mother was told that she was making noise when she pleaded for help during childbirth, having been ignored by staff. Another experienced racism in its purest form, being told, “This isn’t Africa, you know,” when she had family members visiting. We also heard of a black woman receiving no breastfeeding help or support from white midwives, which changed only when a black student midwife came on shift. A report from Five X More described similar experiences.

Racism in the NHS not only harms patients; it affects healthcare professionals from minority ethnic backgrounds who encounter and experience the same discrimination and structural barriers, just in a different context. That, alongside the host of other evidence that we received, led us to call for mandatory cultural competency and anti-racism training in the NHS. Currently, where it does exist, it is optional or limited in scope.

We also call for leadership to be held accountable for creating inclusive and anti-racist environments, as we have heard that NHS trusts can refuse even to acknowledge that racism exists in their services. When we spoke to the Minister, Baroness Merron, she agreed that greater accountability is needed. That is welcome, and we will continue to hold her and the wider Government to account on this issue.

The second key area for improvement is the workforce. The NHS currently faces a shortfall of 2,500 midwives. On top of that, 74% of midwives cite unrealistic workloads, and 87% report unsafe staffing levels. Those shortages directly impact the quality and continuity of care that all mothers receive. It is essential that there are firm commitments in the upcoming workforce plan to deliver safe staffing levels for maternity services. We also know the importance of continuity of care to both midwives and mothers in building trust, tailoring support and spotting warning signs early. That used to be a national target, but it was abandoned three years ago due to workforce pressures. We call for that target to be reinstated in the upcoming plan.

Workforce diversity is also paramount. We have heard that, despite almost a third of the workforce coming from minority ethnic backgrounds, that is true of only 12.7% of senior NHS managers, and 95% of midwife educators are white. The plan must therefore include specific targets to diversify maternity leadership and education, backed by robust monitoring.

The third area is data. Without complete data, disparities in maternal outcomes cannot be accurately identified, let alone improved. That is particularly relevant in two areas. First, the current frameworks for monitoring maternal morbidity do not have the same scope or rigour as those for baby deaths or maternal mortality. Successive Governments have discussed implementing a maternal morbidity indicator to track and measure non-fatal complications such as sepsis, eclampsia and postpartum haemorrhage, but progress has been shockingly slow. Developments must be accelerated on that measure, and there must be a clear timetable for implementation.

Secondly, too many ethnicity entries in the maternity services dataset are recorded as “unknown” or “not stated”. In a 2022 example from the Shrewsbury and Telford hospital, more than 9,000 missing ethnicity background details were identified. Better data is crucial to improving results for those with the lowest outcomes in maternity health: black women. The upcoming workforce plan must also include support and training for effective data collection.

The final area I would like to discuss is funding. All the issues relating to maternity care that I have spoken about today simply cannot be fixed without adequate funding, yet the maternity service development fund has recently been cut from £95 million to £2 million, which is deeply concerning. Although the NHS said that the money is still available and has just been moved elsewhere in the budget, we are concerned that, without ringfenced funding, maternity services will be deprioritised and will continue to cause harm to all mothers. We therefore call on the Government to restore the dedicated, ringfenced funding for the maternity service development fund to its previous amount.

Since 2019, the NHS has faced a £27.7 billion bill for maternity negligence. That exceeds the total maternity budget for the same period by almost £10 billion. I know there are funding pressures across the NHS, but that clearly shows that greater investment here would have the potential to more than pay for itself. Since we launched the inquiry, the Government have announced a rapid national investigation into maternity and neonatal services, which is welcome. Addressing the racial disparities in maternal outcomes must be one of the core aims of the investigation, and I hope to see it as a prominent feature in the investigation’s work.

[Mr Clive Betts (in the Chair)]

Order. I am sorry, but we need to move on to the questions. Time is very short, so can we please have questions, rather than reviews of the report?

[Jen Craft (Thurrock) (Lab)]

I very much welcome the report and the leadership that my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton) has shown throughout its production. I have the honour of serving on the Health and Social Care Committee, and this is one of the standout pieces of work that we carried out while she was interim Chair.

One of the things that stood out to me as we undertook this investigation was the huge need for cultural change in maternal care, which struck me as very impactful. How can a woman at the most vulnerable point in her life feel safe receiving healthcare from a trust that has been called racist? The need for that cultural change was the key takeaway for me. Does my hon. Friend agree that, on a widespread basis across maternal services in the NHS, this change is desperately needed?

[Paulette Hamilton]

I thank my hon. Friend, who is a brilliant member of the Committee, including during the inquiry. She is absolutely right. The issue of cultural change applies to everybody. We need to look at cultural change within maternity services, not just for black women but for all women. If we are to get the improvements in maternity care that we need, we need to look at how we can develop both the cultural awareness training and, more so, people’s mindsets, because of how they think within that system.

[Andrew George (St Ives) (LD)]

I congratulate the hon. Member for Birmingham Erdington (Paulette Hamilton), my fellow member of the Health and Social Care Committee, not only on the manner in which she handled this inquiry but on the manner in which she stepped in, very appropriately, during our work on maternity care. This is a particularly exciting day, because this morning my niece produced a wonderful, healthy daughter, Aria Diana, weighing 9 lb 7 oz, for heaven’s sake—a very healthy baby. They are in hospital but will, I understand, be discharged this afternoon.

In relation to the report, the hon. Member highlights the importance of workforce and workforce planning. Does she agree that it is a pity that the Royal College of Obstetricians and Gynaecologists’ workforce toolkit has not been adopted? And does she agree that we should encourage the Minister, who it is great to see here, and the Department to adopt that as quickly as possible so that we can improve the quality of maternity services for all?

[Paulette Hamilton]

I thank the hon. Member, who is a member of the Committee—I love him to bits. He has been absolutely brilliant throughout, and I absolutely agree with him. I press the Government to look a little more carefully at some of the things that have been put forward regarding workforce, because some of them are simple things that would make a massive difference for maternity services.

[Mr Clive Betts (in the Chair)]

I remind Members of the need for brevity in questions.

[Sarah Russell (Congleton) (Lab)]

The statistics in this report and everything they reflect are completely shocking. I thank my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton) for bringing it forward on behalf of the Committee. Records at Leighton, my local hospital, show that work has been done on improving experiences and outcomes for Asian and black women, but unfortunately, given the quality of data collection, it is quite difficult to be sure whether that is translating into better clinical outcomes for everyone—particularly black and Asian women. Does my hon. Friend agree that we need to urgently push that work forward?

[Paulette Hamilton]

To be brief, we do need to look at data. It is crucial that the rapid review takes on board the data and improves the way that it is collected and used.

[Helen Morgan (North Shropshire) (LD)]

I thank the hon. Member for Birmingham Erdington (Paulette Hamilton) for bringing this statement forward. I am sure that all Members are shocked by the statistics showing that black and Asian women have much worse outcomes than white women in maternity services, but we must recognise that improvement in maternity services has stalled overall as well. Does the hon. Member agree that protecting the ringfenced funding is critical to ensuring safe staffing in the future? I hope the Committee will continue to push for that.

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[Paulette Hamilton]

I absolutely agree with the hon. Member. The ringfenced funding was removed. The Committee was told through its inquiry that the funding can still be used—it is just in other parts of the budget. But if we do not have that funding ringfenced, it will not be prioritised. That means that women will continue to suffer in maternity services. I absolutely agree with the hon. Member.

[Laura Kyrke-Smith (Aylesbury) (Lab)]

I welcome the work of the Committee and I commend my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton) for her personal leadership on this critical issue. Black women are twice as likely as white women to be hospitalised with mental illness during the perinatal period. Does my hon. Friend agree that this is a shocking statistic, and that as we look at the way forward to improve maternity outcomes, we must ensure that mental and physical health are given equal weighting?

[Paulette Hamilton]

Mental health is something that I have been interested in for years. During the inquiry we did not specifically focus on mental health, but it came up through some of the personal statements a number of times. I absolutely agree with my hon. Friend that mental health should have parity of esteem with physical health. Without good mental health, there is no health.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Member for Birmingham Erdington (Paulette Hamilton) and the Committee for what they have brought forward. We live in a society that is multicultural; every part of the United Kingdom of Great Britain and Northern Ireland is multicultural. In my constituency we have people from Kenya, Uganda, Nigeria, India, Pakistan and Afghanistan. They are very welcome. What has come out of this report refers to England and Wales. Would the hon. Lady and the Committee share the information with the relevant health organisations back home to ensure that we can all benefit from what this report tells us?

[Paulette Hamilton]

We will of course share this report far and wide. I am hoping that every parliamentarian has had a copy. We will ensure that it gets anywhere that it needs to go. If Members share where it needs to go, we will ensure that it gets there.

[Bell Ribeiro-Addy (Clapham and Brixton Hill) (Lab)]

As the chair of the all-party parliamentary group on black maternal health, I extend my gratitude to my hon. Friend the Member for Birmingham Erdington (Paulette Hamilton) and all the members on the Health and Social Care Committee for this vital report. Was my hon. Friend disappointed, as I was, not to see any specific mention in the NHS 10-year plan of black maternal health? We have long awaited a target and a plan for ending this disparity. Does she agree that that is something we should look towards?

[Paulette Hamilton]

That is a really important question, and the answer is yes. We were absolutely disappointed not to see it. Several members of the Committee highlighted that it was not there.

[Shockat Adam (Leicester South) (Ind)]

I thank the hon. Member for Birmingham Erdington (Paulette Hamilton) for presenting this report. Does she agree that we need to have a wider conversation about healthcare for black and ethnic minority individuals, especially as there is a chasm in the provision of healthcare? For example, body mass index, ratios and thresholds, and respiratory meters are not measured for black individuals. We are therefore missing out on detecting health conditions, simply because we are using archaic equipment.

[Paulette Hamilton]

I thank the hon. Member for his question—he knows what I am going to say. Yes, I do agree with him. I became chair of the APPG on black health because I feel passionately that there needs to be more equality in this area.

[Mr Clive Betts (in the Chair)]

I call Tom Hayes and then Ben Coleman: two questions and one response.

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[Mr Clive Betts (in the Chair)]

Paulette Hamilton has two seconds to respond.

[Paulette Hamilton]

I would like to thank my hon. Friends the Members for Bournemouth East (Tom Hayes) and for Chelsea and Fulham (Ben Coleman). I absolutely agree with what my hon. Friend the Member for Chelsea and Fulham says. In response to my hon. Friend the Member for Bournemouth East, we do not have long enough to go through what needs to be done, but I think the recommendations in the report would be a good start.

[Mr Clive Betts (in the Chair)]

Order. That is the end of that session. I apologise to the Minister: many Back Benchers wanted to speak and I thought it was right to allow them to. We will move on to the next debate now.