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Category: Health

  • Wes Streeting – 2022 Speech on the Health and Social Care Leadership Review

    Wes Streeting – 2022 Speech on the Health and Social Care Leadership Review

    The speech made by Wes Streeting, the Labour MP for Ilford North, in the House of Commons on 8 June 2022.

    The Secretary of State has picked quite the week to talk about standards in leadership.

    I give a huge thanks to NHS staff and leaders for the work they are doing against the most extraordinarily difficult backdrop. I also thank General Sir Gordon Messenger and Dame Linda Pollard for carrying out the review. Its seven recommendations are sensible, and I am pleased the Secretary of State has already committed to implementing them.

    As this is a rare example of decisiveness from the Health Secretary, can he tell us when he intends to publish his implementation plan? All too often, the senior leadership of the NHS still does not represent the diversity of the population it serves. Instead of throwing red meat to his Back Benchers, for reasons that will probably be obvious to everyone, I would like to hear how, in particular, he intends to ensure that equality, diversity and inclusion will be improved, so that the best leaders are incentivised into the most challenging roles and are able to provide inclusive healthcare for the breadth of diversity in our great country. Can he explain why the review has not covered leadership in primary care or social care in any detail? Surely this is a missed opportunity. Let us face it: although he is trying to dress this up as the biggest shake-up in history, I am not sure that giving staff an induction on joining the NHS is a revolutionary development, and it hardly meets the scale of the challenge.

    The NHS faces the biggest crisis in its history. NHS staff are in a system under pressure like never before, and there are simply not enough of them. There are currently 106,000 vacancies across the NHS, and staff are leaving in droves. In some specialties, such as midwifery, they are leaving faster than we can recruit them. I do not know how the Health Secretary expects NHS managers to demonstrate good leadership and deliver the best outcomes for patients when there are no staff to lead. For an organisation the size of the NHS, one of the biggest employers in the world, not to have a plan for its workforce is unbelievably negligent. What is the NHS meant to do until he eventually delivers his long-term workforce strategy, which he has been promising for some time? How are managers meant to lead effectively when instead of thinking about patient care as their primary driver, they have become buildings and facilities managers, because the ceilings are falling in? The only place where more than 40 new hospitals really exist is in the Prime Minister’s imagination.

    The Health Secretary said that we should accept only the highest standards in NHS management, so let me ask him not about the generalities, but about the specifics. Last month, it was reported that North East Ambulance Service bosses oversaw cover-ups of negligence, leaving about 90 families not knowing how their loved ones died. He said yesterday that he is still considering whether to launch a review. Is he seriously considering protecting managers who cover up bad practice, instead of standing up for grieving families? Staff in that service were reportedly paid to sign gagging clauses, and I understand that attempts to get them to sign such clauses are still under way. In a written question, I asked how many non-disclosure agreements had been signed in the NHS since the Government said that they would be banned in 2014. He does not know and he is refusing to investigate the use of gaging clauses in the NHS. So how can he claim to be shaking up NHS culture and dealing with bullying when he has no interest in what is going on under his nose?

    Of course the NHS needs good leaders, but when it comes to examples of poor leadership in the NHS, the Health Secretary did not need the Messenger review; he just needed to look in the mirror. This is the man who described the NHS as Blockbuster Video

    “in the age of Netflix”,

    as if it was the greatest revelation since Moses received the 10 commandments. Who has been in government for the past 12 years? On his watch, on this Government’s watch, we have the highest waiting times in the NHS’s history; the lowest patient satisfaction since 1997; longer waiting times for cancer in every year since 2010; heart attack and stroke victims left waiting for about an hour, on average, for ambulances; and patients at risk of serious injury because the hospital is crumbling around them. He kicked off his own Health Week expecting applause for the fact that, despite his best efforts, there are still 9,000 people waiting for more than two years for treatment. He knows, I know, NHS staff know and the public know that with this Government, NHS staff are lions led by donkeys, wanting and inadequate.

  • Sajid Javid – 2022 Statement on the Health and Social Care Leadership Review

    Sajid Javid – 2022 Statement on the Health and Social Care Leadership Review

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 8 June 2022.

    With permission, Mr Speaker, I will make a statement on the independent leadership review of health and social care.

    This is an important report that comes at a critical time. This Government are embarking on a huge programme of reform to tackle the covid backlogs, to improve people’s experience of the NHS and social care, and to place this system on a sustainable footing for the future. But we cannot seize this opportunity and deliver the change that is so urgently needed without the best possible health and care leadership in place, because great leaders create successful teams, and successful teams get better results. So a focus on strong and consistent leadership at all levels, not just on those who have the word “leader” in their job title, will help us in our mission to transform health and care and to level up disparities and patient experiences.

    This review, which I have deposited in the Libraries of both Houses, was tasked with proposing how to deliver a radical improvement in health and social care leadership across England. It sets out a once in a generation shake-up of management, leadership and training, as well as how we can make sure that health and care is a welcoming environment for people from all backgrounds, free from bullying, harassment and discrimination.

    The review was led by General Sir Gordon Messenger, former Vice-Chief of the Defence Staff, and Dame Linda Pollard, the chair of Leeds Teaching Hospitals NHS Trust. I thank them both for taking on this role and providing their varied experience of leadership, along with everyone in their review team who has contributed to this important review.

    Before I turn to the recommendations of the review, I shall update the House on its findings. The review found that, although there are many examples of inspirational leadership within health and social care, from ward to board, these qualities are not universal. The report states that

    “there has developed over time an institutional inadequacy in the way that leadership and management is trained, developed and valued.”

    As a result, careers in management are not viewed with the same respect and prestige as clinical careers. The review also found

    “too many reports to ignore”

    of poor behaviour, and that the acceptance of bad behaviours like discrimination, bullying and responsibility avoidance has become “almost normalised” in certain parts of the system.

    We must only accept the highest standards in health and care, where failures in culture and leadership can make the difference between life and death. So we must do everything in our power to share and promote brilliant, innovative management and to act firmly where standards fall short. This means culture change from the top of the system to the frontline. The review identifies a number of areas where improvement is needed, and it makes seven transformative recommendations. I will quickly update the House on each of them in turn.

    First, the review recommends new measures to promote collaborative leadership and to set a unified set of values across health and care. This includes a new national entry-level induction for new joiners to health and care, and a new national mid-career programme for managers.

    Secondly, the review recommends that we should agree and set uniform standards for equal opportunities and fairness, with more training to ensure that the very best leadership approaches become ingrained. The Care Quality Commission must support this work by measuring progress through regular assessments. This does not mean more people working in diversity but fewer. In my view, there are already too many of these roles and, at a time when our constituents are facing real pressures on the cost of living, we must spend every penny with care. Instead of farming out this important work to a specific group of managers, it must be seen as everyone’s responsibility, with everyone being accountable for extending fairness and equal opportunities at work.

    Thirdly, the review recommends a single set of unified leadership and management standards for NHS managers. These standards will apply to everyone, including those who work part time and flexibly, with a curriculum of training and development to help people meet them. This modernisation is well overdue, and completing the training should be a prerequisite for advancing to more senior roles.

    Fourthly, the review recommends a more simplified, standardised appraisal system for the NHS, moving away from variation in how performance and career aspirations are managed towards a more consistent system that takes into account how people have behaved, not just what they have achieved.

    Fifthly, the review identifies a lack of structure around careers in NHS management. It proposes a new career and talent management function for managers at a regional level, to oversee and support careers in NHS management and to provide clear routes to promotion, along with training and development.

    Sixthly, the review recommends that the recruitment and development of non-executive directors needs to be given greater priority due to their vital role in providing scrutiny and assurance. It proposes an expanded specialist appointments team in the NHS, tasked with encouraging a diverse pipeline of talent.

    Finally, there is currently little or no incentive for leaders and managers to move into the most challenging roles, as the barriers are often seen as simply too high. I want leaders in the NHS to seek out those roles, not shy away from them. It is essential that we address that and get great leaders into areas that feel left behind. The review proposes an improved offer, with stronger support and incentives to recruit top talent into those positions.

    We will be accepting these comprehensive, common-sense recommendations in full. The recommendations have been welcomed by groups representing people who work throughout the NHS, including by the NHS Confederation and NHS Providers. By taking the review forward, we can finally bring how we do health and care leadership into the 21st century, so that we have the kind of leadership that patients and staff deserve, right across the country, and so that we make sure that some of our country’s most cherished institutions can thrive in the years ahead.

    I commend this statement to the House.

  • Sajid Javid – 2022 Comments on the Innovative Medicines Fund

    Sajid Javid – 2022 Comments on the Innovative Medicines Fund

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 7 June 2022.

    I want NHS patients to be the first in the world to access the most promising and revolutionary treatments that could extend or save their lives.

    The launch of the Innovative Medicines Fund delivers another manifesto pledge and will fast-track cutting-edge medicines to adults and children to give people renewed hope for a better future.

  • Sajid Javid – 2022 Statement on Monkeypox

    Sajid Javid – 2022 Statement on Monkeypox

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 23 May 2022.

    Following announcements made by the UK Health Security Agency on 7,14,18 and 20 May, I am writing to inform the House that—as of 12 pm on Monday 23 May 2022—a total of 56 monkeypox cases, in three unlinked incidents, have now been confirmed in the UK. Further cases have been identified worldwide, outside the endemic regions of west and central Africa.

    Monkeypox virus in the UK is extremely rare and the detection of monkeypox in unlinked cases indicates community transmission. Prior to May 2022, there were three previous domestically acquired cases—two household transmissions related to an imported case and one healthcare worker related to a separate imported case.

    In the coming days, I expect that further cases will be detected by the UK Health Security Agency’s expert diagnostic capabilities, working with NHS services to ensure heightened vigilance among healthcare professionals.

    The UK was the first country in the world to identify and report this recent emergence of non-endemic cases to the World Health Organisation, which continues to receive reports of further cases in other countries across the globe.

    The infection can be passed on through direct contact with monkeypox skin lesions or scabs; contact with clothing or linens—such as bedding or towels—used by an infected person; and potentially by close respiratory contact via coughing/sneezing by an individual with a monkeypox rash. Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. A notable proportion of cases have been among gay, bisexual and other men who have sex with men.

    The virus does not usually spread easily between people without close contact and the risk to the UK population remains low.

    World-leading experts at the UK Health Security Agency, working in partnership with health protection agencies in Scotland, Wales, and Northern Ireland, are providing the latest scientific, clinical and public health advice. They are also providing testing capability at the Rare and Imported Pathogens Laboratory at UKHSA Porton Down and have stood up additional capacity at UKHSA Colindale. They continue to contact trace, rapidly investigate the source of these infections, and raise awareness among healthcare professionals. Any close contacts of the cases are being identified and provided with health information and advice.

    UKHSA, and its partner public health agencies in the devolved Administrations, will continue to keep the scientific and clinical evidence under review to ensure that decisions are made on the best available evidence despite the fast-moving situation.

    Individuals, especially gay, bisexual and other men who have sex with men, who develop an unusual rash or lesions—such as scabs—on any part of their body, but particularly their genitalia, should contact NHS 111 or a sexual health service. Individuals should notify clinics ahead of attendance and avoid close contact with others until they have been seen by a clinician. They can be assured that discussion will be treated sensitively and confidentially.

    UKHSA has set up a dedicated helpline to support clinicians dealing with monkeypox cases.

    Vaccination and treatment

    The smallpox vaccine, Imvanex (MVA-Bavarian Nordic), although not specifically licensed for the prevention of monkeypox in Europe, has been used in the UK in response to previous incidents. This vaccine has a good safety record; it is made from a smallpox-related virus that cannot replicate and has been demonstrated to be highly effective at preventing infection—when given within four days of exposure—and reducing severe illness, if given between four and 14 days of exposure.

    The vaccination of named close contacts of cases is under way, with vaccine eligibility being kept under close review. As of 10 am on 23 May 2022, over 1,000 doses of Imvanex have been issued or are in the process of being issued, to NHS trusts. There remain over 3,500 doses of Imvanex in the UK.

    We are also exploring procurement options in case any specific antiviral treatment is shown to be effective against this virus; further details will be provided in due course.

    I can confirm to the House that it will be kept abreast of updates as the situation evolves.

  • Maria Caulfield – 2022 Statement on the Introduction of Additional Blood Donor Testing

    Maria Caulfield – 2022 Statement on the Introduction of Additional Blood Donor Testing

    The statement made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 23 May 2022.

    I would like to inform the House that the Government have accepted the advice of the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) and will be introducing additional testing to detect hepatitis B in donated blood from 31 May 2022. The Scottish Government, Welsh Government and Northern Ireland Executive have also accepted the advice of SaBTO.

    The safety of people donating and people receiving blood and blood products is the Government’s priority. We have robust safeguards in place that protect both donors and those receiving this potentially lifesaving intervention, which includes testing all donations for possible infections prior to use in transfusion.

    In 2019, SaBTO established the occult hepatitis B infection (OBI) working group to consider options for further improving pre-donation testing for hepatitis B. The group considered different testing options to identify those donors who have undetectable levels of the surface antibody to hepatitis B, but do have hepatitis B DNA and a core antibody to hepatitis B. These donors are known as occult donors and have been shown to be able to transmit hepatitis B to blood donor recipients. The OBI working group recommended the introduction of core antibody testing, alongside the current testing, for all current donors once, and then all new and returning donors. SaBTO reviewed the findings of the working group and agreed with the recommendations.

    The Government have reviewed the evidence compiled by the OBI working group together with SaBTO’s advice and has accepted the recommendation. The introduction of this new form of testing further improves the rigorous processes we have in place to ensure the health and wellbeing of donors and the safe and consistent supply of blood for patients.

    The Department of Health and Social Care is working with NHS Blood and Transplant to implement this change and the overall impact of the changes will be reviewed in 12 months by SaBTO and the Government.

  • Maria Caulfield – 2022 Speech on the North East Ambulance Service

    Maria Caulfield – 2022 Speech on the North East Ambulance Service

    The speech made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 23 May 2022.

    Can I start by saying how horrified I was to read the concerns raised about the North East Ambulance Service in reports over the weekend? My thoughts are first and foremost with the families affected by the tragic events described. I cannot imagine the distress they are going through. It is hard enough to lose a loved one suddenly, but to have fears that mistakes were made that could have made a difference, and more than that, that the facts of what happened were not revealed in every case, goes further. They have my unreserved sympathy and support.

    In healthcare, a willingness to learn from mistakes can be the difference between life and death, and it is because of this that, as a Government, we place such a high value on a culture of openness and a commitment to learning across the NHS. That is why the allegations raised by The Sunday Times this weekend are so concerning. As was made abundantly clear by the Secretary of State’s predecessor almost a decade ago, non-disclosure agreements have no place in the NHS and reputation management is never more important than patient safety.

    The Government are wholly supportive of the right of staff working in the NHS to raise their concerns. Speaking up is vital for ensuring that patient safety, and quality of services, improve, and it should be a routine part of the business of the NHS. That is why, over the last decade, substantial measures have been introduced to the NHS to reduce patient harm and improve the response to harmed patients, including legal protections for whistleblowers, the statutory duty of candour, the establishment of the Health Services Safety Investigations Body and the introduction of medical examiners. It is also why, in response to a recommendation of the Sir Robert Francis “Freedom to speak up” review in 2015, the Government established an independent national guardian to help to drive positive cultural change across the NHS so that speaking up becomes business as usual. However, when it comes to patient safety, we cannot afford to be complacent. It remains a top priority for the Government and we continue to place enormous emphasis on making our NHS as safe as possible.

    I note the concerns raised in this weekend’s reports. They have been subject to a thorough review at trust level, including through an external investigation, and the trust’s coronial reporting is subject to ongoing independent external audit and quarterly review by an executive director. I also note that the Care Quality Commission has been closely involved. However, given the seriousness of the claims reported over the weekend, we will of course be investigating more thoroughly and will not hesitate to take any action necessary and appropriate to protect patients.

    The Government are also committed to supporting the ambulance service to manage the pressures it is facing. We have made significant investments in the ambulance workforce, with the number of NHS ambulance and support staff increasing by 38% since 2010. Health Education England has mandated a target to train 3,000 paramedic graduates nationally per annum from 2021, further increasing the domestic paramedic workforce to meet future demands on the service, while 999 call handlers have been boosted to over 2,400, so we are very serious about improving resources for the service.

    I fully appreciate the concerns of right hon. and hon. Members across this House, and we will be pleased to meet any who have constituents affected by the reports this weekend so we can look at the issue more fully.

    Mr Speaker

    Can I just say that it is three minutes—and that means three minutes, not three minutes and 40 seconds—and I am sure whoever writes these speeches can actually time them through? I say to those on both Front Benches that we have to think about Back Benchers, who need to get their hospitals mentioned and their ambulance trusts as well.

    I call the shadow Secretary of State, who I am sure will stick to the allocated time.

    Wes Streeting

    I pay tribute to the courage of the whistleblowers, as well as The Sunday Times journalists David Collins, Hannah Al-Othman and Shaun Lintern, without whom none of this would have come to light. But with respect to the Minister, it should not have taken an urgent question to bring her to the House today. On what she said about the Department further investigating, what form will this investigation take, who will be involved and what assurance can she give the families that there will be both answers and accountability, which is what they deserve?

    Peter Coates died after an ambulance did not reach him in time. An ambulance two minutes away could not be dispatched because the station door was faulty, and staff did not know about the manual override. The ambulance that was dispatched decided to stop at a service station, even though it had sufficient fuel. Information about these errors was then withheld by the service, statements were changed and staff were asked to withhold the mistakes from the coroner. Peter Coates’ family learned the full truth only when contacted by reporters last week. His is just one of what is thought to be 90 cases involving gross negligence, cover-ups and tens of thousands of pounds of taxpayers’ money offered in exchange for staff silence.

    The Minister mentioned the CQC. Why did it fail to spot this, rating the service “good” in 2018? Why did it fail to spot the situation even after being tipped off in 2020? Why is taxpayers’ money still being offered to buy the silence of staff when non-disclosure agreements were supposedly banned in 2014? What role did under-resourcing and understaffing play in this scandal?

    Record ambulance waits exist in every part of the country, with heart attack and stroke victims waiting longer than an hour for an ambulance. As for the North East Ambulance Service, it is advising the public to phone a friend or call a cab rather than wait, while presiding over gross negligence, cover-ups and taxpayer-funded gagging orders on staff. That is the record on its watch. It is a national disgrace. What are the Government doing about it?

    Maria Caulfield

    We take the patient safety element of this extremely seriously. To answer the hon. Gentleman’s questions on who we will be meeting, I am happy to meet all the families affected to hear their concerns and the actions that they want taken. We met with the CQC this morning on this specific example, but we will be meeting with the ambulance trust. I also want to meet the coroner, and we want to hear from the whistleblowers. I am very happy to meet any member of staff who wants to raise concerns so that we can get to the bottom of exactly what has happened.

    This Government introduced the duty of candour. Mistakes will always happen, no matter how much money is put into the health service or how many staff it has, but when a mistake does happen the hospital trust or ambulance trust should be open and up front about it, start a proper investigation, and learn the lessons so that it never happens again.

  • Sajid Javid – 2022 Comments at G7 Meeting on Protecting Countries from Another Pandemic

    Sajid Javid – 2022 Comments at G7 Meeting on Protecting Countries from Another Pandemic

    The comments made by Sajid Javid, the Secretary of State for Health, on 21 May 2022.

    This meeting was a crucial moment for G7 member countries as we learn the lessons of Covid and how to live with the virus.

    I am committed to ensuring we are all better prepared against future health threats including another pandemic and antimicrobial resistance, which is why it was so important we united today to protect the world’s health.

    The UK’s leading the way with our living with Covid approach, and it was great to exchange ideas with my G7 counterparts on how we all move out of the pandemic.

  • Maria Caulfield – 2022 Statement on the David Fuller Case

    Maria Caulfield – 2022 Statement on the David Fuller Case

    The statement made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 19 May 2022.

    Following earlier statements by Department of Health and Social Care Ministers, I would like to inform the House that the independent inquiry into the issues raised by the David Fuller case has today published a progress update on its work to date. This can be found at: https://fuller.independent-inquiry.uk/announcements/.

    The progress update sets out the transition from a local, independent investigation initiated by the Maidstone and Tunbridge Wells NHS Trust to the current independent inquiry that the Secretary of State for Health and Social Care announced in November of last year. It describes how the work already undertaken as part of the independent investigation is feeding into the inquiry, as well as the important common themes that emerged from families and other interested parties which gave rise to amendments to the inquiry’s terms of reference. The independent inquiry published its final terms of reference on 23 February 2022.

    Although the local investigation was constrained from taking evidence while the criminal prosecution of David Fuller was under way, Sir Jonathan Michael does set out some urgent, high-level themes and areas of concern arising from the investigation at the time in his progress update:

    Responsibilities between NHS trusts and contractors/subcontractors

    Security and access

    Policies and procedures versus practice

    Oversight of regulated activities

    Management of areas and services not covered by regulation.

    These themes had been shared with the trust in August 2021 and subsequently with NHS England and NHS Improvement. The trust has been putting its own steps in place regarding its mortuary practices ahead of the substantive, initial report of the inquiry. NHS England and NHS Improvement has continued to work with trusts to provide assurances against current guidance from the Human Tissue Authority (HTA), and on the additional measures that have been taken to improve the effectiveness of security in place for all their mortuaries and post-mortem activities.

    The progress update makes clear that the first phase of the independent inquiry is firmly under way and describes the rapid progress that it has so far achieved. Also, from the inquiry’s engagement with witnesses so far, it has experienced a high degree of co-operation and expects this to continue. Both are testament to the hard work of Sir Jonathan and his team.

    The progress update also sets out the next steps, including a revised timing for the initial report on matters relating to Maidstone and Tunbridge Wells NHS Trust. Due to the volume of evidence that is emerging, the initial report will now be available later this year. This will be followed by a final report next year, looking at the broader national picture and the wider lessons for the NHS and for other settings. While there is real urgency in understanding how Fuller was able to carry out his shocking and unlawful actions, and why these went unnoticed, the inquiry must be allowed the time it needs to fully consider all of the relevant evidence and assemble its findings. The inquiry continues to liaise with Kent police to ensure that if it identifies possible criminal conduct, this is referred swiftly for further investigation, in line with its terms of reference.

    The HTA was asked by the Secretary of State to provide advice on its regulatory framework following the conclusion of the murder trial of David Fuller and the public revelation of his sexual offending against bodies in a hospital mortuary at Maidstone and Tunbridge Wells NHS Trust.

    The HTA advice, received in December 2021, along with a short progress update, has been published today. Both can be found at:

    https://www.hta.gov.uk/news/december-2021-advice-published

    The HTA has focused on three areas since December 2021; preparation for the inquiry, working with stakeholders on licensed mortuary security, and starting the revision of HTA guidance for licensed mortuaries in the post mortem sector, with implementation planned later this year.

    Further details are available on gov.uk via the following link.

    https://www.gov.uk/government/news/the-fuller-inquiry-update-to-the-secretary-of-state-19-may-2022.

  • Sajid Javid – 2022 Comments on Medical Aid for Ukraine

    Sajid Javid – 2022 Comments on Medical Aid for Ukraine

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 20 May 2022.

    Russia’s unprovoked and illegal attacks on Ukraine have created a medical emergency, with Putin targeting healthcare facilities like maternity units, hospitals, and ambulances.

    The UK’s support for our friends in Ukraine is unwavering, giving medicines and equipment they desperately need, which has saved tens of thousands of lives.

    Thank you to the NHS in England, Wales, Northern Ireland, and Scotland for stepping up and donating vital medical supplies.

  • Maria Caulfield – 2022 Comments on the Maternity Disparities Taskforce

    Maria Caulfield – 2022 Comments on the Maternity Disparities Taskforce

    The comments made by Maria Caulfield, the Minister for Women’s Health, on 18 May 2022.

    We must do everything we can to empower women with the information and services they need to ensure a healthy pregnancy for mum and baby, no matter their background or where they live.

    The latest Maternity Disparities Taskforce meeting brought together experts from across the NHS, health charities to share ideas and experiences on how we can ensure women from ethnic minorities and the most deprived areas receive the support they need.

    By listening to women’s experiences we can better understand the issues they face and how to improve care, and I look forward to making progress in this area.