Maternity Commissioner

Ben Coleman Excerpts
Monday 20th April 2026

(1 day, 12 hours ago)

Westminster Hall
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Tony Vaughan Portrait Tony Vaughan (Folkestone and Hythe) (Lab)
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I beg to move,

That this House has considered e-petition 751174 relating to a Maternity Commissioner.

It is a privilege to serve under your chairship, Sir Alec. The petition calls for the appointment of a maternity commissioner to improve maternity care for mothers and babies. I thank the petitioners, Louise Thompson and Theo Clarke, two formidable women and campaigners who have raised this issue relentlessly over several years. They have spoken powerfully, alongside many others, including the Birth Trauma Association, the MASIC Foundation, Make Birth Better, the Maternal Mental Health Alliance, Five X More and Mumsnet. I also thank the more than 153,000 people, including 203 of my constituents in Folkestone, Hythe and Romney Marsh, who signed Louise and Theo’s petition so quickly after it was launched.

We should remember that most births in the UK are safe, and I acknowledge and thank the NHS midwives, nurses and doctors on the frontline, and all those working across the health service, who do outstanding work to care for mothers and babies across our nation every day. However, at the same time, there are clear, deep-rooted and long-standing problems in our maternity and neonatal services, in connection with which I will mention four statistics.

First, the maternal death rate in the UK is one of the highest in western Europe, and UK stillbirth rates are also high. Secondly, the NHS currently spends more on payouts for medical negligence than on the entire frontline maternity service budget. That money should be going towards safer frontline care, not litigation. Thirdly, according to the Care Quality Commission’s latest national review of maternity services, almost half the maternity units it inspected between 2022 and 2023 were rated as “requires improvement” or “inadequate”, with only 4% rated as “outstanding”.

Fourthly, over the past two decades, we have seen a heartbreaking succession of maternity scandals. There was the same pattern across Morecambe Bay, Shrewsbury and Telford, East Kent—which serves my constituency—and now Nottingham: women raised concerns, saying that something was wrong and that they were in pain or frightened, but were not listened to. That failure to listen is a theme running through every major maternity report of the last decade, with around 750 recommendations across those various reports reflecting that failure, alongside the issues of unsafe care, toxic culture and weak oversight.

Unfortunately, those were the experiences of petitioner Louise Thompson, who advocated for a C-section but was denied it, resulting in a massive obstetric haemorrhage. My constituent Jo Page also experienced those systemic failures when her son was born at William Harvey hospital in Ashford some years ago. A birthing injury was misdiagnosed and she did not receive the right treatment and support for what was, in fact, a fourth-degree tear. As a result, she has suffered years of pain and indignity, cannot stand for long periods and needs to use the toilet frequently. She had to give up her career and cannot do normal activities, such as taking a flight to go on holiday. Her life has been utterly changed.

Jo now works with MASIC, which supports mothers with anal sphincter injuries, to run a support group for local women in Folkestone, Hythe and the wider Kent area. She also trains midwives and doctors to correctly diagnose tears, and was recently involved in the Sky News production, “Birth Trauma: The women who weren’t listened to”, which tells the traumatic stories of three mothers who were cared for in NHS England hospitals. Jo, you are truly inspiring, and I know that the whole House would join me in expressing thanks for all the work that you do for women up and down the country.

When I spoke to Jo last week, she told me that she continues to receive messages from women who have experienced misdiagnoses and did not feel listened to during their birthing experiences. Those women include a police officer and a social worker who had both been so badly injured during birth that they had to give up their careers, got into debt and suffered immeasurably. I am sad to say that, just last month, I was contacted by a constituent who experienced the same failings that they had read about in the Kirkup report into maternity services at William Harvey hospital.

When I spoke to petitioner Louise Thompson, she said that she is constantly hearing from women who have post-partum physical injuries and mental health issues, and has known people who have committed suicide following maternity service and post-partum system failures. She also spoke of the profound strain on partners, who must support a recovering mother, assist in caring for a newborn and continue to work, all at the same time. She pointed out that a third of women in the UK who give birth experience it as traumatic, and that every year between 4% and 5% of them develop post-traumatic stress disorder, which is around 30,000 women in total. The impact of trauma can last a lifetime, affecting a mother’s bond with her baby, her relationship with her partner, her ability to work and her long-term mental health.

Why is this happening? The petitioners believe that one key reason is a lack of unified leadership and consistency across maternal care in the UK, over many years. When petitioner Theo Clarke was the hon. Member for Stafford, she chaired the first ever birth trauma inquiry with the hon. Member for Canterbury (Rosie Duffield). They heard from 1,300 patients, including patients from marginalised communities, and from professionals about their experiences of maternity services across the four nations of the UK. The inquiry was prompted by Theo Clarke’s own traumatic birth experience, which she bravely and publicly spoke about in the House, describing it as:

“the most terrifying experience of my life.” —[Official Report, 19 October 2023; Vol. 738, c. 495.]

In submissions to that inquiry, mothers reported being mocked or shouted at, being denied the most basic assistance such as pain relief, and being left feeling “terrified”, “humiliated” and “ashamed”. The word “broken” appeared more than any other. The inquiry’s May 2024 report was called “Listen to Mums: Ending the Postcode Lottery on Perinatal Care”, and its 14 recommendations were headed by a call on the Government to publish a national maternity improvement strategy, led by a new maternity commissioner reporting to the Prime Minister. The petitioners believe that these measures would fill a void.

Ben Coleman Portrait Ben Coleman (Chelsea and Fulham) (Lab)
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I am most grateful to my hon. and learned Friend for calling this important debate. I am also very grateful to my constituent Louise Thompson for having the guts and the decency to parlay what was an absolutely horrible experience into a determination to make life better for women across this country and improve maternity services for everybody. I am very grateful for what she is doing—she is in Public Gallery today and I very much welcome her.

As my hon. and learned Friend may be aware, I am a Member of the Health and Social Care Committee. Recently, we produced a report on black maternal health and many of the issues that he has described today also emerged in that report. There is a huge amount to be done.

When it comes to making these changes and making them stick, I echo my hon. and learned Friend’s support for a national maternity commissioner to drive them through. However, if the Government are not minded to appoint a maternity commissioner, how else does he think we might get the drive and the determination to make the changes stick right across Government permanently?

Tony Vaughan Portrait Tony Vaughan
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I thank my hon. Friend for his intervention, and I echo his comments about the petitioner Louise Thompson and her advocacy on this issue.

The petitioners’ analysis is that there has been a vacuum of leadership and accountability across the system. I know that the Government are considering how best to address that, and we will hear more from the Minister later about that; but whatever happens, there has to be a structural way of providing that leadership and avoiding fragmentation and different interpretations of different guidance documents across the system. We need clear systemic change to cure this, because it has been an ongoing problem for many years and so far no answer has been put forward.

The petitioner Theo Clarke told me a story that illustrates the point about the postcode lottery in maternity care, which the petitioners strongly believe would be prevented by measures to create expert national leadership and tighten up the rules. She told me that an obstetrician in London who she had spoken to recently told her that there are 87 different pieces of guidance that apply in maternity care. That does not sound like a framework; to many people, it sounds more like a large number of disparate documents, which leads to variations in interpretation between different areas. Theo Clarke’s strong view is that that leaves room for interpretation, which results in different approaches to care in different areas. In practical terms, that means that something as basic as training midwives in recognising and treating birthing injuries varies hugely between different areas.

My constituent who I spoke about a moment ago trains midwives on this issue, but that training is not available everywhere, and certainly not in the same way as delivered by MASIC.