Photo by Nikki Powell

11 min read14 min

Michelle Welsh has a heart-shaped womb. It sounds beautiful. This ‘concave’ uterus did, however, contribute to her having a complicated pregnancy. “Not complicated in the sense that the baby was going to die,” she clarifies. “It should have been very straightforward: C-section.”

Particularly as her baby was breech, a C-section was what the doctors ordered. But when she went into labour before her planned caesarean, Welsh called Nottingham City Hospital, expecting they would follow their own advice to admit her straight away. Instead, the midwife told her she didn’t have time to check her file, and she would not be let onto the ward.

When Welsh was eventually admitted to the maternity unit, her waters had broken. They went to check her baby’s heartbeat; the first two machines didn’t work and the third couldn’t find one.

“No one comforted me. No one held my hand. No one explained to me what was going on,” she recalls. “I sat next to a machine when my baby had stopped moving, and the machine was flatlining. They were telling me, ‘You don’t need to have a C-section till nine o’clock.’ This was two o’clock in the morning. ‘So, you’re telling me I’ve got to wait seven hours for my baby to be born? Seven hours?’”

In telling her birth story, Welsh reveals to The House that staff performed an internal examination without consent, which amounts to assault. “I had an internal examination with no painkillers and no warning. The pain – I cannot describe the amount of pain that I was in. I was already contracting, and they hadn’t given me any painkillers,” she says.

“I can understand that there aren’t enough people on a ward. I can understand that people have done more work than what they should, so they’re rushed off their feet. I can understand somebody making a mistake because of that. What I’ll never be able to get my head around is why did they treat me, personally, so bad? With such contempt and disdain? So awful to me and my unborn baby.

“I would never, ever talk to anybody like that. I certainly wouldn’t talk to somebody like that who is vulnerable, in pain and at risk of losing their child.”

Welsh nonetheless describes herself as “lucky”. When a new midwife came on, she read her notes and saw what was happening. Next, Welsh heard an argument outside her room with a consultant, who “begrudgingly” returned and – still without having said a word to the birthing mum – admitted to the midwife, “Yeah, you’re right, we need to get her down now.”

“There was mad, mad panic, and the bit that always gets to me, that I get flashbacks about, is… sorry,” Welsh pauses. Her emotions come to the surface most when remembering the experience of her partner, Richard.

“I didn’t realise until I was in that room how significant that first nappy is: you pull it out and it’s so tiny. Richard always says when he pulled out the nappy, there was a realisation then that at any moment now there was going to be a baby, and it was going to be out, and it was going to be ours.

“I don’t know where his head was at the moment, but I think he still had complete faith that everything was going to be okay. I didn’t. I didn’t say anything to him, because I was trying to protect him in all of this.

“I felt so ill, as well. I just felt so ill. There he was, holding his baby’s first nappy, pushing a heart machine, because there was nobody to push the heart machine beside my bed, with his son’s heartbeat flatlining. That was his start to fatherhood.”

She ended up having an emergency C-section and her son, William, lived. The trauma didn’t end there, though: although she was told they would be checked on every 10 minutes, when she woke up from a nap – of, she thinks, about 90 minutes – he was covered in his own sick.

Thankfully, Welsh walked out of hospital with her baby. “Billy’s a bit of a miracle,” she says of her only child, now six years old. He came as a surprise after a decade of trying to conceive, made difficult by her polyendocrine metabolic ovarian syndrome and endometriosis.

Too many other parents have not left the same hospital with their babies. The Nottingham maternity scandal, now the largest in NHS history, has triggered a review by midwife Donna Ockenden who is investigating around 2,500 cases of baby loss and harm to mothers and babies at Nottingham University Hospitals (NUH) NHS Trust. It is running alongside an investigation by Nottingham police, ‘Operation Perth’.

Ockenden is expected to deliver her report later this month, around the same time as the final conclusions of the national maternity inquiry being conducted by Baroness Amos.

Welsh, who says she has spoken to almost 1,000 affected families, refuses to attribute these failures to NHS resourcing constraints alone. “In some cases, it’s quite clear there was a staffing issue. But in other cases,” she concludes, “it was a cultural issue.”

“I’m not saying there aren’t great people working in Nottingham – there are. But there was a systematic cultural issue within Nottingham that went on for years that was never challenged,” she adds.

“Honestly, I cannot believe – after everything I know now, and everything I’ve read – that they didn’t know they were putting my son’s life and my life in danger. I just don’t believe it. I think they were prepared to take the risk.”

The MP for Sherwood Forest was further convinced of this when, a few months ago, a critic of the Ockenden inquiry asked for an appointment at her surgery to argue against the need for it. She turned out to be on obstetrician still working at NUH. “So, not only is she sat there in front of me, she’d been involved in my care – but there she was, telling me, ‘There’s nothing to see, it’s not that bad’. That’s a problem.”

Welsh was raised on a council estate in Nottinghamshire by a postman father and a mother who worked in cafés before becoming a childminder. Growing up around “absolute poverty” shaped her politics early.

“We would get a knock on the door from someone down the road that my mom knew, who would say, ‘Have you got anything I can feed the kids for tea?’” Welsh struggled to explain the injustice of their circumstances: “These are people who would give you their last 50p, but they’re poor. How is it that these good people are poor?”

With both parents involved in Labour, Welsh joined the party at 16. She worked through sixth-form and university in elderly care, as well as doing stints in Next, Co-op, chicken and soft drinks factories. As an Oasis fan, she had a gig habit to fund. It took her years to be able to eat chicken again.

She had hoped to pursue sport, but that dream ended when she broke her leg badly while playing football at 17. Instead, she read history and politics at Leeds. From there, a US summer camp led to several years setting up projects for vulnerable children across the east coast. The stark inequalities she saw alarmed her.

Back in Britain, Welsh managed a “huge project” across Nottinghamshire for the New Labour government, supporting disadvantaged children and setting up Sure Start centres. In 2010, Coalition cuts came in: “Literally overnight, all these projects that I was running, and all this funding, was just ripped apart… It massively woke me up to the reality of what politics was all about.” She got a job for the local council leader, then MP Vernon Coaker, and was six months pregnant when he lost his seat.

Elected as the Labour MP for Sherwood Forest in 2024, Welsh became chair of the Maternity All-Party Parliamentary Group. A ‘harmed mother’ herself, she has now been appointed by government as the first-ever national maternity adviser.

Her new role, she says, does not supplant that of the maternity commissioner, which so many campaigners have called for.

“The national maternity adviser is something needed now, here in the present, but it should not be instead of a maternity commissioner. A maternity commissioner would sit up here, have a team around them, have regular data sent to them, so we don’t have another situation like Nottingham, Shrewsbury or Telford,” she explains, listing the areas recently subject to maternity inquiries.

“When data starts looking skew-whiff, not as it should be, the maternity commissioner goes to that hospital with their team. A bit like an Ofsted inspection, but in a supportive way: ‘What is going on?’ If there is something going on, they send people in straight away, no messing around. We’re not going to wait for more babies to die.”

What must go, she says, is “soft criteria” allowing NHS trusts to implement their own interpretations of recommended policies.

“You’ve only got to look at the bereavement care pathway: one will have a cupboard somewhere with some posters; others will have a really nice room; others will have a dedicated midwife. But all of them will report back to NHS England, ‘We deliver the bereavement care pathway’. Not good enough.”

Sometimes staff prioritise avoiding litigation risks, which stops them seeing patients as real people. After all, 2025 figures showed the NHS has reached the point where it spends more on maternity litigation than on running maternity services. At the same time, there is the need for more accountability. How would Welsh resolve those tensions?

“It’s hard,” she admits. But she is clear that the regulators – the Care Quality Commission, Nursing and Midwifery Council and General Medical Council – are not working.

“The CQC, the NMC, and the GMC are unfit for purpose,” the MP says. “Those three organisations need to go, and we need to establish an umbrella organisation that allows for when things go wrong, midwives, doctors, obstetricians to have a safe place to be able to say, ‘This is what went wrong, and why that happened’. Families have to have a place where they can say, ‘This went wrong. I want you to tell me what went wrong and why.’

“Does that lead to a ‘no-fault’ place? No, I don’t think it does, at this stage. To rush into that, when you have the attitudes of what I have described working in our maternity services, would be wrong.”

Families in Nottinghamshire, she points out, never received birth debriefs, which are offered as standard in London hospitals, for example. And yet many traumatised parents say they simply want to know what happened and hear the word ‘sorry’.

“Because you accept that sometimes things do go awfully wrong, but the minute people try to keep that away from you, or don’t give you your notes, or redact your notes…” she trails off.

“I passed out. I lost consciousness. There are no notes that exist that talk about the fact that I nearly dropped my baby on the floor and was unconscious for a period of time, and Richard thought I was dead. He actually thought I’d died on the table. There’s no notes anywhere. No one can tell me what happened. I have to frequently say to Richard, ‘It did happen, didn’t it?’”

She wants the right to a debrief introduced everywhere, as well as continuity of care, which would extend throughout the whole of pregnancy until at least two months after birth. “It’s not good enough that when you get home, they say, ‘You have to go to the health visitor now. We’re done with you. Sorry.’” The change sounds simple but would make a radical difference to maternal experiences.

Many campaigners say an inquiry without statutory powers is insufficient. What does the national maternity adviser think?

“I think there are questions that will still be left unanswered,” she replies. While she is confident that Amos and Ockenden will be thorough, “I also don’t think they’re going to solve everything.” Services will not improve without “big, bold policies”, the MP adds, so “we have to keep the door open” to a public inquiry.

“I get to celebrate Billy’s birthdays. I got to see Billy’s first day at school. I get to go and see his sports days, work permitting. I get to see him play guitar in a rock concert. I have spoken to hundreds and hundreds of families that have been denied that opportunity.

“Nobody makes me happier than my son. He is everything – absolutely everything – to me. And so, who am I to deny that mother or that father the answers that they need? I’m not ever going to be that person.”

56 million people across the UK visit a pharmacy as their first point of call for medical advice every year. These local healthcare hubs remain one of the NHS’s most trusted and accessible front doors,¹ and the self-care support they deliver can improve outcomes and empower people to manage their own health. 

In my previous article, I explored the role of health literacy in unlocking self-care. But awareness must be matched with access to appropriate medicines. Unless pharmacists have the tools they need at their disposal, including a wide range of safe and effective medicines, much of their impact will be wasted. 

How can we expand access to self-care through medicine switches and by ensuring pharmacists are equipped to support patients to use these medicines safely and confidently?

Ensuring pharmacists have the right medicines to support self-care

The UK benefits from a globally respected medicine regulator in the MHRA. A critical part of its role is ensuring safe and effective general sales medicines can be accessed by patients as part of self-care, without the need for a prescription. 

Switching medicines from prescription-only to pharmacy or general sales list status is one of the most effective ways to expand self-care. PAGB, the consumer healthcare association, has long championed this agenda, working with government and regulators to create a more agile, proportionate switching environment that keeps pace with patient need and clinical evidence.

At Opella, we’ve seen how the MHRA can provide this access first-hand. 

Our allergy treatment, Allevia 120mg, was successfully switched directly from prescription-only to general sales list status. This breakthrough demonstrated that the UK’s regulatory framework can support innovative and responsible access to medicines.

The switch provided patients with tangible, real-world benefits. 

Easier access to effective allergy treatments means people can manage symptoms earlier, reduce disruption to their daily lives, and avoid unnecessary GP appointments. Hay fever alone is estimated to account for millions of lost work days each year in the UK, with poorly controlled symptoms impacting productivity, sleep, and overall wellbeing.²

Improving access to appropriate medicines is not just an issue of convenience; it’s an issue of public health and economic impact.

Improving the switching process

But too often the regulatory process around switching can be slow and inconsistent, denying patients the benefits I describe. To go further, we must build on existing PAGB, industry and government collaboration to streamline switching pathways. 

We can avoid unnecessary duplication of work through greater use of international evidence and alignment with initiatives such as the Access Consortium. This brings together regulators from across countries such as Canada, Australia and Singapore to promote collaboration. 

Furthermore, we need a regulatory and policy environment that actively supports switching and self-care. This includes continued backing for MHRA capacity, as well as aligning with PAGB’s call for a more responsive reclassification framework. We can also provide certainty to industry through clearer regulatory timelines.

These steps would accelerate access to safe, well-understood medicines and ensure the UK remains a leader in self-care innovation.

Ensuring safe use as part of self-care

Expanding access to medicines must go hand in hand with ensuring self-care is delivered effectively. Pharmacists are well placed to guide patients in selecting appropriate treatments, recognising red flags, and ensuring medicines are used correctly.

Taking allergies as an example, greater availability of effective OTC options allows patients to act quickly at the onset of symptoms, rather than waiting for a GP appointment. With pharmacist support, patients can choose the right product, understand how to use it, and know when to seek further medical advice. This combination of access to medicines and professional guidance is what makes self-care both safe and effective.

The system-wide benefits are significant, including reduced pressure on primary care and improved quality of life for patients who can manage their symptoms proactively.

A shared agenda for self-care

Community pharmacies already embody the NHS’s vision for local, accessible points of care, which can be integrated seamlessly into everyday life.

At Opella, we share this vision and believe empowered pharmacies can drive self-care, provide people with the tools, knowledge, and medicines to thrive independently, and help prioritise putting people’s health in their hands. 

By working alongside government, regulators, and representative organisations such as PAGB, we can accelerate the shift towards a system where switching enables better access, pharmacists enable safe use, and patients are empowered to act earlier.

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1. Community Pharmacy England (n.d.) Pharmacy: the heart of our community. Available at: https://cpe.org.uk/learn-more-about-community-pharmacy/. (Last access 6th March 2026).
2. Open Access Government (2026. Workers lose 29 million days each year to hay fever. Available at: https://www.openaccessgovernment.org/workers-lose-29-million-days-year-hay-fever/26729/ (Last access 23 April 2026).