Maternity ‘sidelined by boards and poorly understood by medical directors’

Maternity services, despite numerous scathing reviews, are still sidelined by trust boards and often poorly understood by medical directors, who view them as being outside the mainstream and delivered by “slightly odd folk”, a leading expert has told HSJ.

Bill Kirkup, the senior adviser who quit the national maternity investigation in a dispute over “normal birth ideology”, shared his views on the sector’s response in an exclusive discussion with HSJ’s Health Check podcast.

Dr Kirkup said NHS England chief executive Sir Jim Mackey had detected in his 10-point plan for maternity that medical directors tend to be much less involved in maternity decisions going to the board.

He said few medical directors have an obstetric background, adding: “Therefore, they’re probably in the same sort of trap as… other clinicians that [maternity] is a bit different, we don’t really understand it, and we just leave it to those slightly odd folk who do maternity. It’s not regarded as mainstream in a lot of places, I don’t believe.”

HSJ asked Dr Kirkup about the Amos report’s recommendation of setting up a separate unit within the Care Quality Commission to inspect maternity and neonatal services, despite the regulator’s widespread lack of credibility.

Dr Kirkup said he understood the reasoning was to ensure adequate experience and expertise to investigate.

But he added: “I’m quite nervous about further othering of maternity… It’s already regarded as something that’s kind of different and offshore, and not part of mainstream medicine and surgery.

“I think anything that encourages that… is probably not helpful, given that people using maternity services now are increasingly prone to complications [requiring] input from other specialties.”

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Source: HSJ, 17 July 2026