National Maternity and Neonatal Investigation

Debate between James Murray and Caroline Nokes

Tuesday 30th June 2026 Commons Chamber

[The Secretary of State for Health and Social Care (James Murray)]

With permission, Madam Deputy Speaker, I shall make a statement on the national maternity and neonatal investigation.

Less than a week ago, I stood at this Dispatch Box to respond to the report by Donna Ockenden that exposed devastating failings over more than a decade in Nottingham. As many right hon. and hon. Members rightly made clear following my statement, the shocking report into what had happened was far from the first: in 2015 we learnt of the failures at Morecambe Bay; in 2022 we were appalled to hear about what had happened at Shrewsbury and Telford; and that same year the Kirkup inquiry exposed failings in East Kent. There were also other reviews and reports over the years on specific issues related to maternity care, and it is deeply upsetting to recognise that Donna Ockenden is preparing to undertake further reviews into failings in Leeds and Sussex. Despite all the warnings, the NHS is still failing women, babies and their families on a scale that shames our society.

Bereaved and harmed families are hearing once again the unbearably painful and distressing consequences of the opportunities that have been missed to put things right. As I stand here, I think of how they must be feeling. I know from meeting some of the Nottingham families that their unwavering determination is accompanied by a sense of exhaustion—a sense that however many times they have told their stories, however hard they have campaigned for justice and accountability, and however strongly they have fought to stop what happened to them from happening to others, hardly anything has changed. That feeling will be shared by mothers and their families up and down the country who have suffered so appallingly too, and there will be deep sadness and distress as they are forced to relive their trauma. The burden they bear must sit with us all.

That is why my right hon. Friend the Member for Ilford North (Wes Streeting) decided last year to announce a national investigation into maternity and neonatal services. That investigation has been carried out by Baroness Amos, whose report is published today. I put on record my thanks to her and her team for the comprehensive and compassionate way they have carried out their work.

The Amos investigation gathered evidence from more than 10,500 people, with Baroness Amos and her team personally meeting more than 450 affected families. They visited 12 NHS trusts and heard from over 9,000 staff through surveys, site visits and one-to-one discussions. Although they found that many women experience good and safe care, the report paints a bleak picture of failings at every stage for too many: from pregnancy, labour and delivery to the first hours, days and weeks after birth. When I read about those systemic failures, I found them not only shocking and upsetting but devastatingly familiar, because they are explicitly repeated in review after review. Baroness Amos found a system that is fragmented, overly complex and far too slow to learn. It needs to be radically overhauled.

Last week I spoke about the need to avoid having review recommendations accepted but then sitting on a shelf gathering dust. Other hon. Members agreed with the need to break that cycle, so that is what we will do. As I told the House last week, the national maternity and neonatal taskforce, which I chair, will create a comprehensive action plan by the end of this year.

Today’s recommendations from Baroness Amos include a proposal for a modern service framework in line with the 10-year health plan to support system change and drive consistent, quality care. Those recommendations, along with the national-level recommendations from Donna Ockenden, will feed into our plan, which will make sure that women and babies receive safe, compassionate care no matter where they live. But I do not want people to have to wait for the plan to be completed for us to start making progress, so I am also taking immediate measures in response to Baroness Amos’s investigation, which I shall now set out for the House.

In considering Baroness Amos’s recommendations, the words of a Nottingham mother I met ring loudly in my ears. She said that “accountability drives action”, so today I can confirm that, in response to these recommendations, the Government will appoint the first ever maternity and neonatal commissioner. The holder of this new statutory role will have responsibility for driving change across all parts of the NHS, including those who provide, regulate and investigate care. They will co-chair the national taskforce, along with me. They will hold the system to account, and their role will be to champion the voices of women, babies and families; to ensure that those voices are heard within Government when decisions are made and implemented.

Last week I announced that the Government would roll out Martha’s rule, so that women and their families can demand a second opinion if they feel their concerns are being ignored. That meets a key and familiar concern that the Amos investigation pointed to: women not being listened to as a common factor in maternity failings. Because those concerns are too often batted away before women even arrive at hospital, I can today confirm that we will this week publish new national standards for maternity triage, so that care is consistent across the NHS and women’s concerns are recognised, valued and acted upon at every turn. I expect every trust to prioritise the implementation of these standards and I have asked NHS England to make sure that this is the case and to report progress directly to me.

Some of the starkest examples of racism, discrimination and inequality happen in maternity and neonatal settings, as the Amos report laid bare. The result is that the risks are notably higher for some women and babies and, as Baroness Amos points out, this is a critical safety issue. Black babies are still more than twice as likely to be stillborn as white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women. While tackling inequalities will be a core component of the national action plan, we will make a start straightaway by rapidly expanding the roll-out of the perinatal equity and antidiscrimination programme to every trust. All teams will be mandated to receive hands-on support, to hear first-hand experience, and to undertake face-to-face learning and development programmes. Every trust will have completed the programme by the end of next year.

Births that are safe for mothers and babies depend on health services having skilled, trained midwives. As Baroness Amos rightly identified, staff shortages can have a dangerous impact, with examples of some services being forced to delay admissions when they get too busy. Since coming to office, we have recruited 2,000 more midwives, and last year our graduate guarantee gave 850 more newly qualified midwives an immediate route into the profession. I can tell the House today that we have now created a further 1,000 temporary roles to help newly qualified midwives join the NHS. These new posts will be accompanied by investment, too, and I can confirm that we are investing an extra £41 million, on top of the £145 million already invested, to upgrade outdated and rundown maternity and neonatal facilities.

Alongside these practical measures comes a far more profound challenge that we must face. It is clear from my conversations with affected families, with Donna Ockenden and with Baroness Amos, and from the findings of all the reports, that culture is where so much of the responsibility lies. That culture is the most deep-rooted cause of the failures we have seen, and the most fundamental thing we must change. We know that when families have been in distress and looking for answers, they were too often ignored, sneered at, disbelieved, blamed and lied to. We know from review after review that wrongdoing is covered up and that bullying towards staff who try to sound the alarm is rife, so we will dismantle toxic dynamics, boost staff morale and support better teamwork between midwives, doctors and other clinicians.

We need not only the right policies, procedures and processes to be in place, but a fundamental reset in the culture of a service that too often puts the desire to protect itself above its duty to protect women and babies. That culture change must come from the top. It is time for trust leaders, executives and senior clinicians to pay attention to what is happening on their watch, to put professional tribalism aside, to lose the bunker mentality when things go wrong and to ensure that the safety of women and babies always comes first.

This has to be a watershed moment. We must break the cycle of recommendations sitting on a shelf gathering dust. We cannot go on having review after review while women and babies, as well as their fathers and other family members, continue needlessly to suffer injury, death and lasting trauma. We should all feel a responsibility to ensure that this opportunity is not squandered. We owe nothing less to every family the NHS has failed in the past, and to every family who will rely on it in the future. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

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[James Murray]

I thank my right hon. Friend for his comments, and again put on record my thanks and tribute to him for having initiated the investigation that Baroness Amos published today. He has been a committed champion of change in maternity services in this country.

I could not agree with my right hon. Friend more about the importance of accountability in culture change. Without accountability, we will not have culture change across maternity services, and the culture of cover-ups will continue. Senior clinicians will feel that they can continue to get away with any mistakes. They will feel that they can avoid scrutiny when investigations take place, and will continue, in too many cases, to be more concerned with protecting themselves than with protecting women and babies.

On what we can do to change that culture, culture is deep-rooted and requires us to take a number of different actions, but the duty of candour is the single most powerful change we can make clearly, loudly and publicly, because the message it will send to senior clinicians thinking about what to do in the future if they make a mistake, or if they are tempted to cover up things that go wrong, is that one day they will be held to account, and there is no avoiding that. With a duty of candour in place, there will no longer be an opportunity for clinicians, in particular senior clinicians, to refuse to engage in that process, to refuse to be held to account and be part of the justice process. People will face up to two years in prison if they refuse to co-operate, so it is a serious measure. I very much agree with him on the importance of ensuring that the Hillsborough law gets on the statute book so that this duty of candour can apply to future maternity investigations.

[Madam Deputy Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

May I also add my thanks to the Secretary of State, to Baroness Amos and her team, and to the families that have relived the pain of their experiences to bring about this report? But the Amos report tells us little that we did not already know—indeed, it confirms our worst fears. Maternity services in England are fundamentally broken with the cost of political neglect being paid in trauma, injury and lost lives. Figures revealed by the Liberal Democrats in the last week show that the first quarter of 2026 saw the worst rate ever recorded for maternity injuries. In fact, while the number of reviews into NHS maternity services has steadily ticked up, we have also seen rising maternal mortality rates.

Four years ago, I spoke in this Chamber in response to the findings of the Shrewsbury and Telford review, which were devastating for my community. Last week, I stood here really distressed, actually, as we heard further traumatic reports from the Nottingham review. But anger is not enough. The Government must meet this moment now and implement Baroness Amos’s recommendations in full and without delay, or the families simply will not forgive them. To do this, we need genuine accountability through the NHS and the Department of Health and Social Care, accompanied with the investment needed to make Britain the safest country in the world to have a baby.

I welcome the Government’s commitment to a national maternity commissioner—a long-standing Liberal Democrat campaign—and the other urgent and immediate actions that the Secretary of State has outlined in the last week. They are all urgent and are signs that this is being taken seriously. But we need to recognise that a commissioner alone cannot fix the broken system. I urge the Secretary of State to work with us and look at our maternity rescue package for inspiration for his action plan—it has a great degree of overlap with Baroness Amos’s recommendations. Our package would ensure one-to-one midwifery care for every woman in labour, additional senior midwives, an obstetrician on every ward, and mandatory updated annual training. Will the Government commit here and now to implementing all those recommendations and working with us to deliver the change we need?

[James Murray]

I thank the hon. Lady for her comments, and she puts it well when she talks about Baroness Amos’s investigation confirming our worst fears. I was shocked but not surprised, sadly, to read the investigation report. It was devastatingly familiar to read what it set out as being the failings across the country. The report’s recommendations will now become part of the work of the taskforce, which I chair, to produce the comprehensive action plan by the end of this year. My intention is that the taskforce will take all the national recommendations from Baroness Amos’s report, as well as the national-level recommendations from Donna Ockenden’s report last week and recommendations from any other investigations and reports, and ensure that the action plan it produces comprehensively addresses all the issues raised. I think that we would all agree that there is not—one, two, three—a small number of actions that we need to take; this has to be a comprehensive plan to truly transform the service.

[Madam Deputy Speaker]

I call the Mother of the House.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Ind)]

The Secretary of State will know that many women are never more vulnerable than in childbirth. It is about not just the vulnerability, but the horror of what women and their babies are exposed to in childbirth. We see inquiry after inquiry, and nothing seems to improve. Very many of those who suffer during childbirth are black women and their babies. The Secretary of State said himself that

“Black babies are still more than twice as likely to be stillborn than white babies, and black women are almost three times more likely to die during pregnancy or shortly after birth than white women.”

The whole House wants to see progress, but it is not enough to have another inquiry or another report; what black women want is equity of treatment and fewer black women and their babies dying.

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[James Murray]

My hon. Friend draws out an important point: a key part of developing the national action plan is to ensure we have the right metrics and mechanisms for monitoring its implementation and the right structures in place to make sure it is implemented across all trusts. In working with members of the taskforce, I will ensure that those accountability mechanisms for the delivery of the plan are in place, because I have spoken many times today about the importance of recommendations not sitting on shelves. We need to ensure we have the structures in place such that the actions in the national action plan are implemented, we can see they are being implemented, and we can give people confidence that that is the case.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I, too, thank Baroness Amos, her team and, most especially, the families who so bravely gave the evidence that has formed this report. Further to the conversation about accountability, the Secretary of State will have noticed that some families are concerned that the commissioner is just one person, and that there is too much for them to do. Can he make clear that the buck stops with him and, indeed, the PM, and that he will not let go of this? The commissioner will report every six months to the Health and Social Care Committee—we welcome that—and once a year to Parliament. Further to that, will he personally commit that the Secretary of State will seek permission from Mr Speaker to make a statement to the House once a year, so that they can be held personally accountable for the progress made too?

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[James Murray]

I will take away the right hon. Gentleman’s suggestion and think on it, because it is critical that we have accountability. As I said in response to earlier questions, I find the decision of senior clinicians not to take part in the Nottingham inquiry utterly unacceptable, and incomprehensible on a personal level. We must ensure that that never happens again.

[Madam Deputy Speaker (Caroline Nokes)]

I call Dr Ben Coleman.

[Ben Coleman (Chelsea and Fulham) (Lab)]

I am not a doctor, but thank you so much, Madam Deputy Speaker. Perhaps I am a doctor from the university of life—who knows?

I pay tribute to Baroness Amos for this excellent report, and to my right hon. Friend the Member for Ilford North (Wes Streeting) for commissioning it. It is a remarkable piece of work. It follows on from Ockenden, and the report on black maternal health done by my Health and Social Care Committee—its Chair, the hon. Member for Oxford West and Abingdon (Layla Moran), sits on the Opposition Benches. We see the same problems again and again: misogyny, racism and a lack of accountability. I am therefore delighted that this plan will be developed in six months, through the taskforce, and that we will have a maternity commissioner. I know that my constituent Louise Thompson, who has been campaigning hard for this position to be created, will be delighted. However, like me, I think she will have a question about timing. Will it be possible for the commissioner, who will be introduced on a statutory basis, to be brought in quickly enough for them to have a full role in shaping and creating the plan that will be before us in six months? If not, why not?

Puberty Blockers

Debate between James Murray and Caroline Nokes

Tuesday 23rd June 2026 Commons Chamber

[James Murray]

The MHRA has introduced additional safeguards. As a result of its dialogue with the trial sponsors, the amended protocol published last week increases the level of safeguards. That means that if the regular monitoring, which will happen at least every three months—it can be more regular during the trial—shows any sign of increased risk of harm, that will lead to increased monitoring, clinical review and, when considered against objective criteria, automatic withdrawal from the trial.

It is a question of monitoring this trial, possibly more closely than any trial before—the level of scrutiny is very great indeed—to ensure that at the first sign of any increased risk of harm, action will be taken. That is the assurance that I have sought in interrogating this matter carefully in recent days, and that is the basis on which I am talking to the right hon. Gentleman and others in the House today.

We must come to a fair and settled conclusion on this matter to move forward as a country, and I believe that we should follow clinical advice and establish the clinical evidence gathered in a highly scrutinised trial with all the safeguards in place that I have described. Only that approach will give us the confidence about where we settle on this matter in the future. On that basis, the Government oppose this motion.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

Pathways Study: Puberty Suppression

Debate between James Murray and Caroline Nokes

Monday 22nd June 2026 Commons Chamber

[James Murray]

As my hon. Friend will know, the recommendations in Dr Hilary Cass’s review set out how to establish better services for young people in the future. The focus of today’s statement, the clinical trial, is just one part of the wider work on how best to support young people who need extra support in this situation. It was welcome that there had been, at least until recently, a cross-party consensus that Dr Cass was finding the right way through this difficult matter.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State for advance sight of his statement. The Liberal Democrats have long highlighted the need for better access to specialist healthcare for children and young people struggling with gender identity. The closure of the Tavistock clinic and its inadequate rating by the Care Quality Commission demonstrated that urgent change was needed. Young people struggling with gender identity face serious challenges. They have been badly let down for years by low care standards and extremely long waiting lists. On top of that, they have to contend with a toxic public debate, which comes at a huge cost to their wellbeing at a particularly vulnerable stage in their life. The average three-year wait for a young person to see a specialist can be extremely harmful at such a vulnerable age.

We agree that treatment should first be based on talking therapies, so that patients are given the space and support that they need, but it is crucial that young people can start those therapies as a matter of urgency, not after years of delay. Decisions about these young patients’ futures should be made in an informed way, with expert clinicians and based on the best possible evidence, which the NHS must build up safely and effectively. We support prioritising clinical evidence, so that patients’ interests are put at the heart of decision making in all areas of healthcare. Guidance and decisions around puberty blockers must be led by experts and clinical evidence, and not influenced by ideological opinion. That is why we supported the decision of the former Secretary of State, the right hon. Member for Ilford North (Wes Streeting), to pause the Pathways clinical trial while concerns raised by the MHRA were thoroughly addressed. Will the Secretary of State confirm whether the MHRA has confirmed that the concerns that led to the withdrawal of the trial have been substantially addressed, and how many children are expected to take part in the trial now that its parameters have been altered?

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[James Murray]

I absolutely agree with my hon. Friend about the importance of following clinical evidence and taking a clinically led and evidence-based approach to this decision. As I said, I have felt uncomfortable and uneasy about some of the challenges raised by this matter, but for me, the right way to move forward is to follow the clinical advice, and to base future decisions on clinical evidence, given that I have received the most robust assurances about the safeguards that are in place to protect young people involved in this trial from harm.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I welcome the statement and this approach. I thank the MHRA for engaging with the Committee when we asked it specific questions about this. It told us that the role of the regulator is to ensure that participants in any clinical trial are kept safe and are exposed to medicine only if there is a reasonable expectation of a positive effect, and that is what was foremost in its mind. It also reassured us that if it had not felt 100% assured, it would have not allowed the trial to go forward.

There was a lot of disquiet about the iterative process that the trial has gone through—that it was stopped, paused and then started again. Could the Secretary of State outline for the House how usual or unusual that is? What support can the NHS offer those families who might have hoped to be part of the trail but now find themselves excluded from it?

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[Madam Deputy Speaker]

Order. The hon. Gentleman’s question is far too long. I call the Secretary of State.

[James Murray]

Despite our different conclusions on this matter, I respect my hon. Friend. Part of taking decisions as Health Secretary involves sometimes approaching issues where one might feel uncomfortable on a personal level, but none the less being guided by the right principles in order to take decisions for other groups of people in the country and for the country as a whole. I am not in any way disputing how difficult a matter this is; it is one where I, as Health Secretary—and my predecessors—have had to carefully consider how we ensure that the clinical basis for any future decisions is robust and that we can point to it as a foundation for where this matter settles.

Before Dr Cass did her review, the situation at the Tavistock clinic was totally unacceptable, as the right hon. Member for South Holland and The Deepings (Sir John Hayes) recognised, and we must never go back to a position where the situation is out of control in the way that it was then. In working out how to move forward, I believe that, as uncomfortable as it may make myself and others on an individual basis, focusing on the principle of following clinical evidence, demanding the highest possible safeguards and protections for the children involved, and setting objective criteria for them to be withdrawn or for action to be taken if the risk of harm increases, is the balanced and correct way to proceed.

OBR: Resignation of Chair

Debate between James Murray and Caroline Nokes

Wednesday 3rd December 2025 Commons Chamber

[James Murray]

I will not speculate on the outcome of the leak inquiry, but it is under way now, with the Chancellor’s support. The Government take our obligations to this House very seriously, and last week we produced a Budget that delivers on our priorities for the British people.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

[Charlie Maynard (Witney) (LD)]

On behalf of my party, I thank Richard Hughes for his service. We respect his resignation. I also thank Laura Gardiner, Professor Ciaran Martin and Huw Stephens for the very quick turnaround of the investigatory report on the leak. In that report, the point is made that, unlike all other IT systems and services, the OBR’s website is locally managed and outside the gov.uk network. That decision was made, apparently, to ensure the OBR’s full independence from the Treasury. Will the Minister soon report back to the House with a timeline for decisions—between now and the OBR’s next report in spring 2026—on how these matters will be managed in future? Will he provide an outline of how the OBR website will be operated so that it is secure and maintains appropriate separation from the Treasury?

National Insurance Contributions

Debate between James Murray and Caroline Nokes

Tuesday 4th February 2025 Commons Chamber

[James Murray]

The regulations contain a provision for us, in case it is needed. The expectation is that it will not be. As I mentioned, a Government Actuary’s Department report laid alongside the regulations has forecast that the Treasury grant will not be required in 2025-26. The provision in the regulations is a precautionary measure, and is in line with what has happened in previous years. The Government consider it prudent to continue the practice of previous years, and to make provision for the grant in these regulations. I hope that answers the hon. Gentleman’s question.

The regulations enable an increase in child benefit and the guardian’s allowance in line with prices. Without these regulations, HMRC would be unable to collect national insurance contributions receipts, and child benefit and guardian’s allowance would be frozen at the 2024-25 levels. I hope that colleagues will join me in supporting the regulations.

[Madam Deputy Speaker (Caroline Nokes)]

Before I call the shadow Minister, I inform the Liberal Democrat spokesman that I will call him immediately afterwards.

Winter Fuel Payment

Debate between James Murray and Caroline Nokes

Tuesday 10th September 2024 Commons Chamber

[Dame Harriett Baldwin (West Worcestershire) (Con)]

On a point of order, Madam Deputy Speaker. This is the second Government Minister we have heard from the Dispatch Box today, yet only moments ago we saw the Chancellor sitting on the Front Bench. It was the Chancellor who chose to spend billions on setting up Great British Energy. It was the Chancellor who chose to spend billions giving pay rises to their union paymasters. It was the Chancellor—

[Madam Deputy Speaker (Caroline Nokes)]

Order. I thank the hon. Lady, but she will be aware that that is not a point of order; it is more of a speech that she is seeking to make. Perhaps she will find an opportunity to contribute in the debate.

[James Murray]

Thank you, Madam Deputy Speaker. The hon. Member who just intervened, and indeed everyone on that side of the House, might like to reflect on what the legacy of the last Government truly was. It was one of irresponsible overspending, of uncosted commitment after uncosted commitment, and of Ministers running away from taking difficult decisions. As a direct consequence, when we came to power we were faced with a £22 billion black hole in the public finances for this year alone.

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[James Murray]

My hon. Friend is absolutely right. Frankly, it is time for Conservative Members to recognise and accept what they have done to this country, and to show some contrition and accept responsibility. However, no matter what the Conservatives choose to do, we are getting on with the tough decisions that are necessary in government. By changing the winter fuel payment and making it means-tested, we are beginning to take the necessary steps to address the black hole they created, while protecting the most vulnerable in society.

The Prime Minister has said that we must be prepared to be unpopular if we are to govern responsibly, which means facing up to tough challenges and tackling them head-on. The motion laid by the Opposition sets out several “regrets”, but they have never once shown regret for all the reckless decisions they took and the damage they did to our public services, public finances and economy. Our task now in government is to fix the mess they made and to give our country the chance of the better future we deserve.

[Madam Deputy Speaker (Caroline Nokes)]

I call the spokesperson for the Liberal Democrat party.