Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what steps they are taking to improve access to healthcare for all mothers, regardless of their wealth or immigration status.

All women regardless of their wealth or immigration status are encouraged to contact their maternity services as soon as they know they are pregnant for a full assessment of their health, risk factors and choices so that a personalised plan of care can be prepared. The latest data shows that over 96% of pregnant women in England received their full health and risk assessment before 12 weeks and 6 days between April and June 2014. Early access to maternity services helps tackle the negative impact of health inequalities from the start of life and supports good health and well-being in mother and baby.

Women with complex social factors do not always access maternity services early, or attend regularly for antenatal care and poorer outcomes are consequently reported for mother and baby. Maternity services need to be proactive in engaging all women. To support National Health Service maternity services engagement with pregnant women with complex social factors, the National Institute for Health and Care Excellence has published clinical guidelines on pregnancy and complex social factors, which describes how access to care can be improved and contact with antenatal care maintained.

Maternity services feature prominently in the key objectives set out in the Mandate between the Government and NHS England. All women, regardless of their wealth or immigration status, should have a named midwife responsible for ensuring she receives personalised care throughout pregnancy, childbirth and during the postnatal period. To help reduce unwarranted variation in service delivery and encourage innovation, NHS England has established Maternity and Children Strategic Clinical Networks.

Entitlement to free NHS hospital treatment in England is based on being ‘ordinarily resident’ in the United Kingdom. Except in rare circumstances, nationals of countries outside the European Economic Area must also have ‘indefinite leave to remain’ in the UK in order to be ordinarily resident here. Anyone not ordinarily resident here is subject to the NHS (Charges to Overseas Visitors) Regulations 2015, and will be charged for any treatment they receive unless an exemption from charge category applies.

Chargeable treatment which is considered by clinicians to be immediately necessary, must never be withheld from an overseas visitor. Guidance to NHS trusts makes clear that all maternity services – including routine ante-natal treatment - should be regarded as immediately necessary. This means that no woman will be denied maternity services, even if she cannot pay in advance, although she will still be charged for treatment and expected to pay later.