NHS Maternity Services

Richard Foord Excerpts

Thursday 22nd October 2026 Commons Chamber

[Ian Roome]

I agree with my hon. Friend. That is precisely the point I am making about rurality and the remote services that many people experience. Many of my constituents would not reach the Royal Devon and Exeter hospital inside two hours. If a hospital shuts down in London, neighbouring units can absorb some extra workload without a dramatically heightened risk to mother or baby, but in this case, no neighbouring hospital exists. Most of the road route is not even a dual carriageway. In terms of journey time, it is like announcing that women cannot have their babies delivered in London and that mothers going into labour must be diverted to Bristol.

It is little wonder that would-be parents across northern Devon and Cornwall are terrified at the extra pressure of getting to Exeter. I have recently been able to get the trust to agree to move some of the triage back to Barnstaple for women over 37 weeks with suspected broken waters, but many of those warned to travel early to Exeter have ended up being sent back to North Devon—a round trip that takes many hours.

Official trust figures record no “incidents” and fewer than five “births before arrival” over the past nine weeks. Will the Minister tell me the NHS’s official view on that? Is it credible to claim that a baby born in an ambulance or non-medical area of a hospital should not qualify as an “incident”? The Daily Mirror has reported that two babies have been born in the back of ambulances, two in accident and emergency, and one in a hospital reception, although I have not been able to verify that. The trust is clear that it reviews every one of those “births before arrival” carefully, and cannot give a more exact breakdown without breaching patient confidentiality. However, it also insists that:

“There is a difference between the NHS definition and a patient’s definition of experiencing an “event-free” birth.”

I am a father and a grandfather who remembers those tense few hours well, and I understand why trust senior management feel the need to be dispassionate about a baby arriving early, but when expectant mothers are travelling so far by ambulance, that kind of statement surely stretches the credibility of NHS guidance to breaking point.

[Richard Foord (Honiton and Sidmouth) (LD)]

I like my hon. Friend’s analogy of pregnant women having to travel from London and Bristol to give birth. The issue is not just that they are having to travel that distance—it is what they find when they get there. A constituent from Ottery St Mary wrote to me earlier this week to explain that the Exeter labour ward has only 10 rooms plus two birthing centre rooms. Does my hon. Friend agree that it is a question not only of distance travelled but of the experience of the queues encountered on arriving?

[Ian Roome]

I totally agree with my hon. Friend that the problem is extending and forcing problems on to neighbouring maternity units. I know that the maternity unit in Exeter is now under pressure because it is having to cope with the births coming from North Devon.

I appreciate the Government’s maternity adviser meeting me last week. She speaks passionately about fixing the crisis in our maternity units across the country. When the new Prime Minister addressed this question in this House, he was up front that North Devon is just the tip of the iceberg when it comes to structural weaknesses in NHS maternity services. Things have clearly come to a head in the south-west. First, Yeovil maternity unit suffered a staffing crisis and closure last year, and now Barnstaple has suffered the same. In Yeovil's case, a full reopening took almost a year. I am told privately by senior figures that there are other NHS trusts around the country that are also perilously close to something similar. Just like North Devon, their maternity units hang in the balance.

The national maternity and neonatal taskforce’s new action plan is due in December, and I want the Government to treat this sorry episode as a case in point. Maternity units should not be suddenly suspended out of the blue. Our trust wrote its own continuity plan for our maternity services, set its own staffing benchmark below which closure would be needed, and decided its own reopening criteria. If the unit at North Devon district hospital can reopen with a fully staffed doctors’ rota, we are at least protected against this happening again in a few weeks’ time, but without national guidance on when suspensions should happen, we are running this unit on an operational cliff edge of the trust’s own design.

We know that the trust was struggling with maternity recruitment since at least December last year, which continued right through to the spring. It is no wonder that my constituents are angry; it seems impossible that no emergency alarm was ringing months ahead of this crisis reaching boiling point. Why does it take a sudden suspension and a national media backlash, driven by me and local Maternity Matters campaigners, to get this issue to the very top of the chief executive’s to-do list?

Secondly, the Government’s workforce plan is already overdue, and it needs to have a special focus on maternity services in at-risk areas. For example, I am told that when the deanery decides placements for trainee consultants, especially in their final years, the trend is towards large urban centres that offer them more specialised teaching. The unintended consequence is that many of those candidates stay in whichever area they last trained and already know well. That boosts the ability of urban hospitals to recruit, even while hospitals in remote areas such as North Devon are crying out for doctors. I ask the Government to work with deaneries to ensure that trainee consultants are able to do their final years in rural and coastal acute hospitals. I believe that that would help to tackle the maternity workforce crisis in smaller maternity units.

On 2 October, North Devon district hospital’s consultant body passed a vote of no confidence in the trust’s senior management. When senior NHS staff with years of experience and dedicated service say that something is wrong, it should be a wake-up call. I am shocked to learn that senior figures in the trust have not even taken the opportunity to win hearts and minds by being present on site at North Devon district hospital during the crisis. Such things are completely symbolic, and that is entirely the point.

Thirdly, my constituents are owed a full, independent review into how this crisis came about. We need the official record to show what led to the suspension in North Devon, what happened, how it might have been averted and how we ensure that it never happens again. The trust has appointed Audit South West Assurance to conduct the review, but a letter that I received from the trust’s chair of the board on 12 October implies that the terms of reference for a review are being set by a sub-committee of the trust’s board of directors. If that is true, I ask the Minister if the Department of Health and Social Care has an official standard for the impartiality of reviews such as that one. Many of my constituents will suspect the tell-tale signs of a whitewash in the making—something that does not improve health outcomes for anyone—and I hope that we can count on the Government’s support.

Fourthly, what accountability exists for strategic failings in the NHS? A well-established structure exists to pursue clinical negligence and medical malpractice, but how can the NHS stamp out corporate failings, bad decision making or simply a lack of attention given by senior managers? I have asked that question of many organisations already, but I am yet to get a clear answer. If this crisis had been even worse, as it might be at someone else’s local hospital next month, what recourse would the public have? I was utterly shocked this week to read that the NHS Alliance’s lead director for acute care had told The Guardian that as many as 20 NHS maternity units across the country may be forced to close entirely. In more remote parts of the country, that should be unthinkable.

When services are centralised again and again, it is always remote communities such as mine that pay the price. There are many more questions that my constituents need answering, but above all, the question is: how can it be that senior NHS figures feel less publicly accountable for suspending maternity services entirely than they do for staffing an open maternity unit? To answer that question, I am forced to turn to the ultimate policymakers in government.

Short of defending this country from attack, I can see no greater duty for the British state than ensuring that the next generation can be born safely. Most people would struggle to think of any NHS spending that should take priority over that sacred responsibility. As such, my final question is whether the Minister understands that in remote rural and coastal communities such as mine in North Devon, which has suffered this nightmare for the past nine weeks, losing maternity services would be seen as the beginning of the end for the national health service itself.

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

I thank the hon. and gallant Member for North Devon (Ian Roome) for raising this very important matter. He calls attention not just to his own constituency but, as we have heard from others, to a broader issue that we face, particularly in our rural and coastal communities. I want to stress that the Government are clear that all women have the right to receive the same high-quality, safe and compassionate care, wherever they have their babies. We need to ensure, and mums need to know, that services are there for them when they need them, including at the time they go into labour.

I thank the hon. Member for North East Fife (Wendy Chamberlain) for sharing the experiences of her constituents Kristie and Tammy today, and I agree that we need to bear such experiences in mind. That is why my right hon. Friend the Secretary of State has chosen to prioritise maternity, and why the work of the national maternity and neonatal taskforce is so important. In particular, the new modern service framework will define the standards needed to deliver care across the country, whether in large inner-city areas or small rural places.

I know the hon. Member for North Devon understands that the North Devon maternity unit was closed for a good reason: the trust could not provide a service that it knew was unsafe. It is really important that we all bear that in mind as we discuss this issue. We must support good, sound clinical assessment, particularly in this area. However, it is unacceptable that, as we have heard from the hon. Member for Honiton and Sidmouth (Richard Foord), expectant mothers are travelling all the way to Exeter or Bristol, and the current situation is not sustainable. I have given birth very healthily three times, and I am grateful for the care that I had. I had to travel only a short distance down the road and, frankly, that was enough, so I empathise deeply with women who have to endure long journeys.

I will not rehearse the recent history that led us to this point, because I know the House is well acquainted with that. As the hon. Member for North Devon knows, the responsible Minister is the noble Baroness Merron, but I will do everything I can to take this opportunity to update him and the House on where we are, and follow up in writing on any specific questions, if necessary.

The trust has set the following three tests before the unit can reopen: first, there must be 24/7 consultant and registrar cover in place through an on-call rota; secondly, three quarters of those staff must be employed full time; and thirdly, new staff must have gone through employment checks, onboarding and induction. Today I can update the House that the outlook on safe staffing was more positive last week, but unfortunately some recruitment has fallen through since then. The trust is still seeking the additional clinical staff that they must have to provide a safe service. As hon. Member for North Devon knows, the issue is not that the roles are not funded. They are generously funded, and the trust has even gone so far as to offer salary top-ups, but the roles remain unfilled. The question is how we attract the best talent to our rural and coastal communities, and show them that Barnstaple and other similar places are among the best in the country to build a life.

I want to thank partners that are working with the trust on recruitment, including the Royal College of Obstetricians and Gynaecologists. The trust is also exploring hiring international candidates, but ultimately we want the unit to have enough staff to provide a safe service that is sustainable—another point that has been well made today—even if a doctor is unwell or otherwise on leave. Every week, the chief medical officer at the trust conducts an assessment to see whether the unit is ready to reopen its doors. Every two weeks, the trust updates key stakeholders on the status of the unit. Once safe staffing is secure, there will be a short period of time to stand up rotas and put services in place. I have had assurances that, during that period, the trust will get in touch with every mother and give them the chance to change their birth plans to Barnstaple, should they want to do so.

[Richard Foord]

I accept that this is a point about recruitment, but it is also a point about retention. A constituent of mine who visited the maternity ward at Exeter hospital heard that the staff temporarily redeployed there from Barnstaple are having to pay the full car parking charge of £20 per day while they are doing the additional service of travelling to Exeter. Does the Minister think that retention also needs to be looked at?

[Karin Smyth]

Yes, of course, and that is what the trust does. I would gently urge all hon. Members to work very closely with the entire trust on these issues to solve these problems. It is absolutely right that the trust is working with MPs. It is reviewing its decision on a weekly basis, and it is important that it communicates openly and transparently with all its partners when those decisions happen. I am always very clear that Members of Parliament speak on behalf of their constituents and can be helpful in communicating those messages, because we want to make this work.

In the meantime, the trust continues to offer a range of maternity services, and it has taken steps to help the women covered by its duty of care. There is a dedicated helpline for women to discuss their birth plans, a maternity triage line for urgent help, special appointments to talk about travel costs and accommodation, free taxis for women who do not have their own transport and are advised by the triage line to go to hospital, and mental health support. These are good and sensible steps, but it is still unacceptable for women to have to travel for two hours while they are in labour.

Trusts in our rural and coastal communities do face systemic pressures, because they have fewer births and because it can be hard for the local NHS to recruit. Last year I visited North Devon district hospital, as part of my remit in overlooking the new hospitals programme, to see how it is using the £30 million the Government have made available to support the rebuild of the 50-year-old staff accommodation block and invest in MRI scanners. We are committed to those services in Barnstaple, and it is important for all hon. Members’ constituents to be clear about that.

Our 10-year health plan, produced last year, clearly set out the issues for rural and coastal communities, which the right hon. and learned Member for Torridge and Tavistock (Sir Geoffrey Cox) noted. We particularly highlighted those communities in the 10-year health plan because we recognise that they have specific needs and do not benefit from a one-size-fits-all approach. However, the broader systemic issues they face, particularly in staffing, must be addressed in our upcoming workforce plan, and I do agree that retention is a key part of that.

Ministers have made it clear to the NHS that we must do everything possible to help reopen North Devon maternity services. NHS England, the ICB and the regional team in the south-west are working with the trust to resolve these issues as soon as possible. As I have said, my right hon. Friend the Secretary of State has rightly made maternity a national priority for this Government. She is chairing the national maternity and neonatal taskforce to drive forward reforms, and to deliver systemic and sustained improvement across maternity and neonatal care, including in relation to the failings exposed in the south-west of England in recent months.

The Barnstaple maternity unit will reopen. I cannot give the hon. Member for North Devon a guarantee from this Dispatch Box of the date when that will happen, because it will depend on securing safe staffing. That is the problem that everybody needs to focus on, and this Government are focused on doing that with the local system. We will do everything we can to help the hon. and gallant Gentleman get those services back on track on behalf of his constituents.

Question put and agreed to.