Emily Barley is co-founder of the Maternity Safety Alliance. She was formerly leader of the Rotherham Council Conservative Group, and the Conservative candidate for Wentworth & Dearne in 2019.
To most ordinary people, babies are the most precious beings in the world. And yet we have a maternity care system that is failing so badly that every year hundreds of babies die because of negligent care, and even greater numbers suffer avoidable, life changing and often life limiting brain injuries.
Many mothers suffer physical and psychological injuries too, but we do not know how many – because the NHS does not bother to count them.
A few years ago, as Donna Ockenden’s review of maternity care at Shrewsbury and Telford Hospital NHS Trust was underway, the common understanding was that hospitals with problems were bad apples in an otherwise good system. That belief has now been shattered.
It has become ever clearer that far from being isolated incidents the problems in maternity care are system wide, present to some degree in every maternity unit in England. Indeed, over the last year or so the Care Quality Commission has found that 67 per cent of maternity units do not reach the standards it sets out for safety, with mums and babies being put at risk of serious harm.
But the tolerance of failure is so ingrained in the system that some hospitals are still rated ‘good’ even when multiple babies have been killed by negligent care. The latest statistics now show that instead of getting better things are actually getting worse, with deaths of babies before, during, and after birth on the increase and deaths of mums rising too.
My daughter, Beatrice, is one of these victims of NHS failure.
Beatrice died during labour at Barnsley Hospital in May 2022. She was a perfectly healthy full-term baby, and when I went into hospital in labour I was excited to be finally meeting my girl. She died because when we needed an emergency caesarean, we did not get one.
Instead, midwives and doctors stood around me shrugging, rolling their eyes, and at times even laughing as I pleaded for help. I was repeatedly dismissed as a dramatic first-time mum, even when monitoring of Beatrice’s heart showed in stark black and white that she was struggling and then dying.
I have now joined together with other bereaved parents and families affected by negligent maternity care to form the Maternity Safety Alliance. Together we are campaigning for a statutory national public inquiry on maternity safety because we believe this is the only way to truly fix this broken system.
Every other method has been tried, including local investigations like the one at Shrewsbury, a plethora of national schemes and programmes, and even an increase in spending.
The reality is that failings in maternity care are simultaneously simple and complex.
Simple because the clinical negligence involved is almost always around the most basic issues: midwives and obstetricians who do not listen, do not follow best practice, do not keep proper notes, do not talk to each other or work as a team, and do not pay attention when blaring alarm bells are ringing to say mum or baby is not OK.
But these failings are complex too, in that despite them being repeatedly made clear over the last decade, nothing has really changed.
There’s something going on in the NHS that prevents the learning that is so desperately needed. It seems Health Service leaders, and indeed the Government, are content with babies like Beatrice dying when they would live if they had received the very basics of half-decent care.
But instead of acknowledging that these deep-seated problems with culture, attitudes, and leadership are causing deaths, injuries, and untold trauma to women and babies, much of the debate around maternity care focuses on money.
If you ask many stakeholders and commentators they will tell you that the problem is straightforward: 13 years of Conservative austerity has led to an underfunded and understaffed NHS, where overworked staff with the best of intentions sometimes make mistakes. To these people, the solution is to spend more money. Simple.
I wish they were right, because that would be a much easier fix than the problems we actually face in maternity care. Of course, more money would help in some ways.
But finances are not the main cause of negligence in maternity and therefore cannot be the solution.
I am clear that adding more staff would not have made a difference for Beatrice: there were already three midwives and two doctors in the room as she died, doing nothing, totally complacent and indescribably cruel. Through my work with the Maternity Safety Alliance I have learned that my experience is far from being a one-off, instead it is more common than people may want to believe.
Sadly, the Government too has fallen into this money trap as every time they are asked about maternity care they provide the same tired comment, pointing to the extra money invested and the extra midwives being trained.
Ministers’ refusal to face facts is such that it is now six weeks since I, and a large group of parents and grandparents of dead babies, wrote to ask for a public inquiry, and we have still not received even the courtesy of a response or even an acknowledgement.
Instead, we are being roundly ignored – as the tiny bodies of babies killed by NHS negligence pile up.
Emily Barley is co-founder of the Maternity Safety Alliance. She was formerly leader of the Rotherham Council Conservative Group, and the Conservative candidate for Wentworth & Dearne in 2019.
To most ordinary people, babies are the most precious beings in the world. And yet we have a maternity care system that is failing so badly that every year hundreds of babies die because of negligent care, and even greater numbers suffer avoidable, life changing and often life limiting brain injuries.
Many mothers suffer physical and psychological injuries too, but we do not know how many – because the NHS does not bother to count them.
A few years ago, as Donna Ockenden’s review of maternity care at Shrewsbury and Telford Hospital NHS Trust was underway, the common understanding was that hospitals with problems were bad apples in an otherwise good system. That belief has now been shattered.
It has become ever clearer that far from being isolated incidents the problems in maternity care are system wide, present to some degree in every maternity unit in England. Indeed, over the last year or so the Care Quality Commission has found that 67 per cent of maternity units do not reach the standards it sets out for safety, with mums and babies being put at risk of serious harm.
But the tolerance of failure is so ingrained in the system that some hospitals are still rated ‘good’ even when multiple babies have been killed by negligent care. The latest statistics now show that instead of getting better things are actually getting worse, with deaths of babies before, during, and after birth on the increase and deaths of mums rising too.
My daughter, Beatrice, is one of these victims of NHS failure.
Beatrice died during labour at Barnsley Hospital in May 2022. She was a perfectly healthy full-term baby, and when I went into hospital in labour I was excited to be finally meeting my girl. She died because when we needed an emergency caesarean, we did not get one.
Instead, midwives and doctors stood around me shrugging, rolling their eyes, and at times even laughing as I pleaded for help. I was repeatedly dismissed as a dramatic first-time mum, even when monitoring of Beatrice’s heart showed in stark black and white that she was struggling and then dying.
I have now joined together with other bereaved parents and families affected by negligent maternity care to form the Maternity Safety Alliance. Together we are campaigning for a statutory national public inquiry on maternity safety because we believe this is the only way to truly fix this broken system.
Every other method has been tried, including local investigations like the one at Shrewsbury, a plethora of national schemes and programmes, and even an increase in spending.
The reality is that failings in maternity care are simultaneously simple and complex.
Simple because the clinical negligence involved is almost always around the most basic issues: midwives and obstetricians who do not listen, do not follow best practice, do not keep proper notes, do not talk to each other or work as a team, and do not pay attention when blaring alarm bells are ringing to say mum or baby is not OK.
But these failings are complex too, in that despite them being repeatedly made clear over the last decade, nothing has really changed.
There’s something going on in the NHS that prevents the learning that is so desperately needed. It seems Health Service leaders, and indeed the Government, are content with babies like Beatrice dying when they would live if they had received the very basics of half-decent care.
But instead of acknowledging that these deep-seated problems with culture, attitudes, and leadership are causing deaths, injuries, and untold trauma to women and babies, much of the debate around maternity care focuses on money.
If you ask many stakeholders and commentators they will tell you that the problem is straightforward: 13 years of Conservative austerity has led to an underfunded and understaffed NHS, where overworked staff with the best of intentions sometimes make mistakes. To these people, the solution is to spend more money. Simple.
I wish they were right, because that would be a much easier fix than the problems we actually face in maternity care. Of course, more money would help in some ways.
But finances are not the main cause of negligence in maternity and therefore cannot be the solution.
I am clear that adding more staff would not have made a difference for Beatrice: there were already three midwives and two doctors in the room as she died, doing nothing, totally complacent and indescribably cruel. Through my work with the Maternity Safety Alliance I have learned that my experience is far from being a one-off, instead it is more common than people may want to believe.
Sadly, the Government too has fallen into this money trap as every time they are asked about maternity care they provide the same tired comment, pointing to the extra money invested and the extra midwives being trained.
Ministers’ refusal to face facts is such that it is now six weeks since I, and a large group of parents and grandparents of dead babies, wrote to ask for a public inquiry, and we have still not received even the courtesy of a response or even an acknowledgement.
Instead, we are being roundly ignored – as the tiny bodies of babies killed by NHS negligence pile up.