Maternity Care Independent Review slammed for lack of inclusion

This week, it has been revealed that an inquiry meant to explore consistent levels of poor and inadequate maternity healthcare in one of the country’s leading hospitals, desperately failed to include sufficient numbers of Asian and black families in its inquiry quotas. Given that in recent months there has been much focus on disparities in deaths between white maternity patients and their Asian and black counterparts, the decision to only include 20 out of 250 families from ethnic minorities in an inquiry into the quality of care at Nottingham University Hospitals, has been slammed as yet more evidence of institutional racism at work.

Healthcare Watchdog warned of standards ‘below what is legally required’

The inquiry, which was hailed as a ‘flagship’ project, was triggered after a series of warning letters had been issued to the Nottingham University Hospital Trust, by the healthcare watchdog. The letters noted that the care levels at the hospital, which had in previous years been recorded as ‘inadequate’, had since fallen ‘below what is legally required’. 

The limited number of Asian and black families who were asked to contribute to the inquiry reported a ‘deepened mistrust’ of the service at the hospitals and they felt that they were ‘easy to ignore’.

Deteriorating relationships

Donna Ockenden, who was appointed as Chair of the independent review, responded to the allegations by claiming that Asians and blacks were among the ‘hard to reach groups’. She said that she has since written to the Trust raising concerns about the lack of trust and the ‘deteriorating relationship’, which patients had reported between them and the trust. Ms. Ockenden attempted to justify the low levels of inclusion of ethnic minority patients in the inquiry, due to the fact that the inquiry’s work she said, is taking place ‘against a very difficult background’ as many families were reluctant to contact the inquiry due to lack of trust in the Nottingham Hospital Trust.  In a letter to the trust sent by Ms Ockenden and which she has made publicly available, she said:

‘The feedback that I received from local Black and Asian women is that mistrust of the NUH has deepened and that your communication and relationships with them have progressively worsened rather than improved’

Male Sonographers allocated to Muslim women

‘Local women have told me of a repeated issue of male sonographers being allocated to the care of Muslim women, even when they have specifically asked for a female sonographer…Women have apparently been told, ‘there is no choice and you can go home if you don’t like it’…I know of three women who were repeatedly sent away as there was no female staff member to assist them. This has led to significant delays in important ultrasound scans for these women…Women have also reported that in the Urdu clinics, it is common for a different midwife to appear each time with “women having to repeat their accounts and concerns weekly’

New ‘Inclusive’ Task Force established to deal with shortcomings

The Nottingham Hospital Trust have responded to Ms Ockenden’s letter, by establishing what they have called ‘a new Task force consisting of midwives, doctors, advocates and black and Asian staff and family’ representatives to specifically deal with the issues raised by Ms Ockenden.  

The shortage of Urdu translators had according to the letter, been a huge contribution to the distress caused to non English speakers and Ms Ockenden cited a case of one woman who was experiencing fetal distress in labour and was:

‘unable to communicate with staff caring for her in labour as they spoke only English. The only solution was for the woman to phone her mother in Pakistan who then got hold of a relative who was not in Nottingham who begged her to agree to a caesarean section…All that the relative could translate was ‘baby danger zone’. This case happened within the last fortnight.’

Britain’s biggest Maternity Scandal

A year earlier Ms Ockenden was the author of a report which exposed what was dubbed ‘Britain’s biggest maternity scandal’ – listing a catalogue of failings at the Shrewsbury and Telford NHS Trust and which had concluded that ‘more than 200 babies could have survived had they had better care at birth.’  

There have been innumerable reports in recent months and over several years as well as TV news features and documentaries, all highlighting the shocking facts of disparities in maternity care between white, Asian and black women.

Parliamentary report finds pace of change ‘shameful’

More recently, a parliamentary report published by the Women and Equalities Committee published last month, 18th April 2023, exposed what it described as ‘appalling’ higher death rates among blacks and Asians and concluded that racism was central to the disparities. Asian women are on average dying during childbirth at twice the rate of their white counterparts and black women as much as four times the rate.  The Chair of the Women and Equalities Committee, Caroline Nokes, commented:

‘It is frankly shameful that we have known about these disparities for at least 20 years – it cannot take another 20 years to resolve’.


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