Once again, we are faced with a report detailing the failures in maternity services (Cruel comments, racism and cover-ups: key findings from England’s maternity care report, 26 February, 26 February), highlighting deficiencies in both clinical staffing and care environments. Maternity services in the NHS are in crisis, but this is not new information. As clinicians, we have been aware of these systemic pressures for many years. Reports from the Healthcare Safety Investigation Branch, now Maternity and Newborn Safety Investigations, along with numerous other inquiries, have already identified the core issues. Collectively, they have produced some 748 recommendations that, if properly implemented, could meaningfully improve care.
Instead of directing funding towards implementing these recommendations, resources are being diverted into commissioning yet another review – one that is likely to reiterate what we already know. It is time to redirect investment to where it will make a tangible difference. We must return maternity services to strong, safe foundations: high-quality support, meaningful training and sustainable staffing levels for hardworking clinicians who continue to deliver care in chronically underresourced environments. These professionals strive daily to meet increasingly complex and often unrealistic expectations, frequently shaped by social media narratives that do not reflect the realities and risks inherent in maternity care.
National guidance must also be revisited to ensure that it is realistic, flexible and responsive to individual clinical needs rather than promoting a rigid, one-size-fits-all approach. Above all, we must value and trust clinicians, allowing them to practise as the skilled professionals they are, within supportive systems that prioritise learning and improvement over excessive audits and a culture overshadowed by fear of litigation.
If we are serious about improving maternity care, the solution is not another report. It is meaningful investment in people, training and environments that enable safe, compassionate practice.
Judith Robbins
Senior midwife, London
Lady Amos’s report has been met by a predictable chorus of “why haven’t lessons been learned?” responses. The main lesson not learned is surely that reports listing hundreds of recommendations do not empower healthcare staff. In fact, they often reinforce command-and-control cultures and toxicity in working relationships. Inhumane behaviour follows.
There remains little appetite to implement evidence-based good practice even when it is available. Wes Streeting should spend next year’s inquiry budget on embedding the seven features of safety in maternity units, published by The Healthcare Improvement Studies Institute in 2020. It provides support and guidance for healthcare staff in sharp contrast to futile hectoring.
Alan Willson
Swansea
Your article cites a shortage of midwives, yet according to the Royal College of Midwives, 31% of midwifery graduates are unable to find jobs. Put this together with crumbling midwifery units and managers who create a climate of cover-up. Then add poverty, which impacts maternity outcomes, especially in deprived areas. Bring racism into the mix and we have a boiling pot of mismanagement, austerity and incompetence that is becoming worse, not better.
Christine Connolly
Alnwick, Northumberland
As the father of a bereaved young couple, and grandfather of a beloved granddaughter whose life was tragically brief, I would like to highlight an issue raised in Lady Amos’s interim report. After the massive trauma of an expected joyous event turning to catastrophe, the very least that the parents should expect is humane treatment from the relevant hospital authorities. My daughter and her husband were met with confusion, denial, obstruction, deliberate delay (gaslighting, I believe) at each step of their ongoing four-year struggle for understanding and action, with not one hint of genuine institutional empathy or compassion along the way.
A simple change in attitude of the responsible managers towards bereaved parents during their early coping process could be cost-free and instant. Theirs is the heaviest cross to bear – I can think of nothing worse. So please NHS, help rather than hinder.
Name and address supplied
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