The House Article | It is no surprise that the public is worried about maternity care

(Alamy)

4 min read1 hr

In new polling on the public mood around the NHS, published by the Prosperity Institute, maternity care was an issue of specific focus. The particular importance of the issue is obvious, given how significantly a couple’s or a mother’s experience of birth can touch their lives.

It is concerning then that a full half of the public are now, by instinct, worried about the state of NHS maternity care. Yet it is no surprise, given the sheer number of headlines about NHS trusts failing in this area. Back in September, the government announced that 14 NHS trusts in England were having their maternity services examined as part of a rapid review.

Behind the decision to review these trusts lie stories such as the death of nine babies at Gloucestershire Hospitals NHS Trust between 2020-23 due to “missed opportunities”.

Such stories — as well as high-profile outliers, such as the Lucy Letby scandal — undoubtedly stick in the minds of current and prospective parents and are arguably an underappreciated factor in our declining birth rates, as people avoid or delay having children due to concerns about care.

Anxiety around childbirth is understandable, but it is damning that this anxiety is only reinforced and not assuaged by reality. The initial 50 per cent of worried voters rises to 59 per cent when pollsters share the facts of care.

What kind of facts could have this effect? There are plenty to choose from.

For instance, out of 131 NHS maternity units inspected by the Care Quality Commission between August 2022-24, not one was rated ‘outstanding’; 47 per cent were ‘requires ‘improvement’, and 18 per cent ‘inadequate’.

Another example: over the last decade, in 21st-century Britain, maternal mortality rates have increased by 20 per cent.

There is a surprising divide between the generations in attitudes to maternity care. Among 25 to 34 year olds — the group currently making most use of maternity services — 68 per cent think NHS maternity services are going well or very well. This contrasts with just 38 per cent of 45-54 year olds and 25 per cent of 65+ year olds.

One might imagine that older groups would have a better view of care, basing their views on memories of when they had their own children roughly 20-40 years ago, at a time before the decline in care that has marked the last decade and a half.

Younger women, by contrast, are those most exposed to current dysfunction and so should, one imagines, have a worse view of services. But older voters remain exposed to the system via younger relatives and can track the decline in standards. The young, however, have never known anything different.

Defenders of the health service may cite marked improvements for infants, such as rates of stillbirths, neonatal mortality, and perinatal mortality, all of which are significantly better than during the 1990s. However, these areas have plateaued since the 2010s despite peer nations continuing to improve, and there is a pervasive sense that although things may have improved for children, they have gotten worse for mothers. Older voters seem to have noticed this. This suggestion that more exposure leads to lower opinions of care is also borne out in the fact that 48 per cent of men think NHS care is going well, compared to just 37 per cent of women.

What do voters think needs to be done? A common trend across Prosperity’s new polling is that voters are rejecting the idea that the solution to NHS failures is simply more funding. 46 per cent instead blame poor management, with only 24 per cent blaming funding and only 9 per cent blaming staff.

Serious problems have bred serious concerns, and it seems that the public is willing to countenance serious solutions.

Rhys Laverty is Editorial and Research Director at the Prosperity Institute