Who is accountable for maternity safety? The case for a maternity commissioner following the birth trauma inquiry.

The safety of maternity services in England has been under intense scrutiny in recent years. A series of high-profile investigations have exposed recurring failures in NHS maternity care, prompting calls for meaningful reform and renewed debates centred around accountability and systematic failures within the healthcare system.

Former Made In Chelsea star and author Louise Thompson has teamed up with Theodora Clarke MP to lead a national campaign for the appointment of a dedicated Maternity Commissioner (the Petition). At the time of writing, the Petition (which closes on 7 July 2026) currently has more than 150,000 signatures. The Petition follows recommendations made in the 2024 Birth Trauma Inquiry Report (the Report).

The Report, which heard evidence from over 1,300 women and healthcare professionals, identified recurring themes including failures to listen to women, inadequate postnatal support and significant variations in maternity care across the country. These concerns have also been highlighted in major investigations such as the Ockenden Review and the Reading the Signals Report for the government by Dr Bill Kirkup.

Opening the parliamentary debate on 20 April 2026, Tony Vaughan KC MP noted that approximately 750 recommendations have been produced throughout repeated maternity inquiries, yet concerns relating to unsafe care, failures to listen to women and weak oversight persist. He argued that maternity care continues to be characterised by fragmented leadership, inconsistent implementation of guidance and what campaigners describe as a “postcode lottery” in standards of care.

A recurring theme throughout the debate was that responsibility for maternity safety is scattered across various organisations, including the Care Quality Commission, NHS England and professional regulators. Several MPs suggested that where accountability is fragmented, meaningful change can be difficult to achieve. As Tony Vaughan MP remarked “when everyone is responsible, nobody is accountable”.

Supporters of the proposal for an appointed Maternity Commissioner argue that it could provide a single point of leadership, oversee implementation of recommendations and identify emerging safety concerns before they develop into systematic failures. Michelle Welsh MP, Chair of the APPG on Maternity, argued that such a role would need genuine independence and authority, including the power to act and real time data access. She also describes the existing framework as having failed too many families. However, the debate also highlighted that structural reform alone may not solve deeper problems. Andy MacNae MP cautioned against viewing a commissioner as a “magic sticking-plaster” for longstanding systematic issues.

From a clinical negligence perspective, the Petition and debates around maternity safety are significant. Maternity claims continue to account for a substantial proportion of the NHS’ negligence liabilities, in which medical negligence can lead to death or serious injury to babies, and birth injuries to the mother. While litigation provides compensation where standards of care have fallen below acceptable levels, inquiries repeatedly conclude that the priority should be preventing avoidable harm rather than responding to it after the event.

The full debate and Petition can be found at: Appoint a Maternity Commissioner to improve maternity care for mums and babies - Petitions

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