Wes Streeting has announced yet another inquiry into NHS maternity safety: this time a national investigation which the Health Secretary wants to address ‘systemic problems dating back over 15 years.’
This rapid review, modelled on the Darzi review of the NHS, will report in December 2025 and will work across the entire maternity system, using the findings of previous reviews and urgently examining the ten worst-performing maternity services in the country.
The resistance within the NHS to being honest about what’s really driving this maternity crisis would make it difficult for any review, inquiry or other format to promise real change
In a speech to the Royal College of Obstetricians and Gynaecologists, the Health Secretary argued that the risk of childbirth to women and their babies is ‘considerably higher than it should be because of the state of the crisis in our maternity and neonatal services here in the UK.’ He listed the scandals which charted those system problems lasting more than 15 years, from Morecambe Bay to Nottingham. The picture he painted of the maternity system was grim – but not an exaggeration, and very familiar to those who’ve been through the maternity system over the past decade and a half. There are rising rates of maternal deaths, babies of black ethnicity are twice as likely to be stillborn, and black women two to three times more likely to die during pregnancy or shortly after birth than white women – with the gap closing slightly, only because more white women are dying too.
Streeting said he had met with families left bereaved, damaged and traumatised by the system, adding: ‘I’ve seen photographs of their children. I’ve seen the ashes of their children in the tiniest little boxes, and I’ve also seen more courage than I could ever imagine mustering if I had to walk a day in their shoes. Carrying the weight of their trauma.’
That paragraph was powerful enough, but the real punch came straight after, when he said that the trauma of those losses had been ‘compounded time and time again’ by the way NHS trusts had then dealt with them. ‘They describe being ignored, gaslit, lied to, manipulated, and damaged further by the inability for a trust to simply be honest with them that something has gone wrong.’
Streeting knows that none of this is really news: the Morecambe report was the first in a library of inquiries into the same kinds of failings, toxic cultures, dogma and refusal to be honest that are clearly endemic in NHS maternity services. He argued today that he was taking a different approach by commissioning this kind of review. Not only will it investigate the problems, it will also ‘pull together the recommendations from the other reviews… to assess progress and provide clarity and direction for the future, so that everyone in the system knows what they’re working to.’
Many campaigners feel that Streeting should have announced a full public inquiry, and there is much to be said for something with the statutory powers to compel witnesses, given the scale of denial and dishonesty within the NHS about individual cases, as well as the way the system is failing.
But if the review really does assess what has happened with the recommendations of previous inquiries, then it will be doing one thing that public inquiries really can’t do, which is ensuring there is change. The current legislation underpinning inquiries means there is no provision for follow-up once they have published their report and recommendations. It contributes to our dysfunctional cycle of scandal, inquiry, promises of lessons learned – and then failure to change.
Either way, the resistance within the NHS and politics to being honest about what’s really driving this maternity crisis would make it difficult for any review, inquiry or other format to promise real change. This review might be different – but then campaigners did hope that with all the ones that came before over the past 15 years too.
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