A new editorial published today in the BMJ and co-authored by the NCMD warns that NHS charging for maternal care could contribute to health inequalities and neonatal and maternal mortality.

The new editorial explains the current system, whereby women who are not ordinarily resident in the UK are asked to pay for maternity care in advance. The authors highlight how this practice, and its inconsistent application across different NHS trusts, can exacerbate inequality of health outcomes for mothers from vulnerable groups – including those from black and minority ethnic backgrounds, low-income families and single mothers.

The authors of the piece – GP Nikesh Parekh, Director of Maternity Action Rosalind Bragg, NCMD Programme Manager Sylvia Stoianova and Clinical Professor of Public Health Allyson Pollock – also set out steps to make charging more equitable. These include ensuring that no one is denied access to care, careful identification of patients who meet the criteria for free care, and greater support for women who are charged.

The piece also highlights the lack of routine data collection on NHS charging and its health impacts. Without such data gathering, firm evidence on the scale of the problem is impossible. This is why the NCMD, and the child death overview panels who report to us, have stepped up – commencing reporting on the issue as part of the child death review process. However, cases including the death of a child represent only the very worst instances of gaps in healthcare provision, and more could be done to establish regular and complete reporting on the impacts of maternal charging.

Read the full editorial in the BMJ:

Maternity charges in NHS widen health inequalities