A recent inquiry into maternity care within the Nottingham University Hospitals (NUH) Trust has found over 500 mothers and babies were subject to avoidable death or serious harm between 2012 and 2025.
The details of these cases are appalling: in one instance, a woman’s bladder was erroneously removed during an emergency hysterectomy, while another has been left unable to work with PTSD after receiving inadequate anesthetic during a c-section.
Several women reported receiving no care while in labour for up to six days, leading to serious infection and their babies’ deaths. Twice, in separate cases, women who had developed brain tumors died after red flags like slurred language were dismissed as ‘language barrier’ issues.
As a result of this care, hundreds of babies under the care of NUH have been left with severe injuries, brain damage, or died needlessly after clear warning signs were missed.
Toxic culture
The inquiry, headed by independent senior midwife Donna Ockenden, states that these horrific cases in Nottingham were precipitated by chronic understaffing and a toxic, bullying, and racist culture in NUH’s maternity units.
These conditions saw midwives often assigned to nine babies at once in neonatal units, while on maternity wards it was common to be charged with overseeing several people in labour concurrently. Some 59 percent of NUH maternity staff surveyed regularly worked over their scheduled hours.
“In a harsh working environment, you survive by becoming hard,” explained one staff member. “The bullying culture is a way of managing your anxiety.”
This culture saw families’ concerns over the quality of care regularly dismissed, black and Asian women derided as “too loud” and “too demanding” as patients, and staff who did speak out about the conditions of care dismissed and mocked.
This disregard for the quality of care didn’t end even in death. In one case, the report found, an ‘early gestational baby’ was ‘accidentally disposed of as clinical waste’ by laboratory staff, adding immeasurably to the distress of these grieving parents.
“Shames our society”
The extent of the breakdown in care in Nottingham is astounding, but by no means is it an isolated case.
A few days after the details of NUH came to light, the findings of the Amos Review – an urgent national review into maternity care in England – were published.
Its findings support those of the Nottingham inquiry completely: it found that services overstretched by chronic understaffing are failing mothers and babies on a scale that “shames our society” and that, once again, racism is “embedded throughout” these services.
It also warns that these services are “fragmentented, overly complex and too slow to improve”. The dire state of maternity services has been public knowledge for years, yet nothing has been done – nearly half of maternity services in England are currently rated as requiring improvement or inadequate.
Accordingly, the UK has some of the highest maternal mortality rates in Europe. In 2009, almost twenty years ago, the then Labour government set an ambition to halve the rate of maternal deaths – yet today, after just as many years of brutal austerity, maternal mortality rates have risen by 20 percent.
Listening and learning?
These two inquiries lay out in sickening detail exactly how the crisis in the NHS is having a deadly impact on women and babies. What is not clear in these reports, however, is what is to be done about it.
Primarily, they recommend measures amounting to ‘adopting a compassionate and learning culture’ and ‘listening to women’. Such recommendations operate at a complete disconnect with the actual findings of these reports and will fall flat upon contact with reality.
The critical failures of care that these reports document are not because of random, unfortunate instances of a ‘bad culture’ but the direct consequence of underfunding and understaffing.
In 2018, staff on the maternity unit at NUH even wrote to the trust management with concerns that the lack of staff would be “the cause of a potential disaster” – predictions which were indeed tragically realised hundreds of times over.
In such conditions, cutting corners becomes not a question of ‘culture’ but necessary for the functioning of the ward. All the worst aspects of capitalist culture are given room to reproduce themselves: bullies rise to the top and exhausted staff do not have time to reflect on their practice, so bureaucrats and yes-men thrive.
Kick out the financiers
Outrageously, at the same time as chronic understaffing is crippling these maternity services, one in three graduate midwives cannot find a job.
How can this be the case? Under the Tories, funding for midwifery courses was upped – but funding for the NHS trusts to actually hire more staff was not. In light of the Amos Review, the government has said it will ‘urgently’ institute a budget for hundreds of new maternity staff roles – but, in the small print, only on a ‘temporary’ basis.
This is the anarchic reality of NHS funding today, with budgets cut to the bone and creeping privatisation everywhere: women and babies are left dying because maternity units are overstretched, while hundreds of trained midwives are forced to find work elsewhere.
A real, long-term solution to this ongoing issue will not be forthcoming as long as the state is subject to the whims of the bankers and bosses.
And those in the government today have no interest in breaking with this pressure to repair our faltering NHS.
For all he pushed for these inquiries to take place, former health secretary Wes Streeting has accepted in excess of £350,000 in ‘donations’ from those linked with private health care over the last ten years.
Incoming PM Andy Burnham has said he will continue cutting welfare to fund warfare, while current health secretary James Murray is merrily handing over £330 million in NHS contracts to US tech giant Palantir.
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So long as the vampiric financiers are allowed to carry on growing wealthy off our healthcare services, scandals like Nottingham’s will come to pass time and again.
On the basis of the democratic control over the economy by the whole of our class, a plan of proper funding, training, and conditions could easily be implemented in the NHS. Almost overnight, these horrific cases of mistreatment and negligence would be confined to the dustbin of history.
The Lucy Letby case: Who is to blame for the failures of the NHS?
Sarah Nankervis, Oxford
Earlier this year, Netflix released a documentary called The Investigation of Lucy Letby, which reignited interest in this infamous case.
In this documentary, the case presented by the Cheshire Police would have you believe that Lucy Letby – formally a neonatal nurse at the Countess of Chester Hospital – is simply an erratic and malicious serial baby murderer.
Lucy Letby was arrested after her shifts were associated with a higher than average number of infant mortalities between 2015 and 2016. From there, the investigation proceeded on the assumption that Letby was guilty unless she could prove otherwise.
But what has since come to light is that the Countess of Chester Hospital’s neonatal unit suffered from a multitude of systemic failures.
The unit lacked staff, and qualified staff in particular; the building was too cramped to be fit for purpose; and, most concerningly of all, raw sewage would often enter the ward through the sinks.
This is hardly a surprise: in 2015, Britain was at the height of the Tories’ devastating austerity campaign, crippling the NHS.
Misconduct and neglect flourish in these conditions: staff are overworked and underpaid, and those clinical staff best informed to make management decisions are excluded from the decision making.
And so, Britain’s infant mortality rates remain high compared to other European countries, with deprived areas seeing rates three times higher than wealthy ones.
You can imagine exactly how – knowing how dire things were, and knowing there is no money for repairs or more staff forthcoming – the hospital’s management would rather deflect blame for these deaths onto an ‘evil’ individual, than acknowledge how deep the issues went.
Whether or not you believe the case Netflix puts forward for Letby’s innocence, what is clear is that these newborns were the victims of a broken NHS – and a criminal ‘justice’ system entirely uninterested in taking on the real enemies of healthcare: the British state and the capitalist system.
