Key Takeaways
- Donna Ockenden, the midwife leading the inquiry into maternity failures at Nottingham University Hospitals NHS Trust, is charging NHS England up to £26,000 a month for her advice.
- Ockenden’s daily rate is £850 for every 7.5 hours worked, and her monthly invoices do not include additional costs such as wages, expenses, and office space, which can exceed £300,000 a month.
- The arrangement has been changed to allow Ockenden to work through her limited company, potentially offering tax advantages.
- The high costs of the review have been noted, with Ockenden’s daily fees exceeding the UK’s weekly median wage.
- The review is part of a series of investigations into maternity and neonatal services in NHS trusts, with concerns raised about the provision of safe and reliable care.
Introduction to the Inquiry
The midwife leading the biggest inquiry into maternity failures in the history of the NHS is charging NHS England up to £26,000 a month for her advice. Donna Ockenden, who has been chairing the review into maternity failings at Nottingham University Hospitals NHS Trust since 2022, is paid an £850 daily rate for every 7.5 hours she works. This arrangement has raised questions about the high costs of the review and the tax implications of Ockenden’s limited company.
The Cost of the Review
The monthly charges for Ockenden’s advice do not include the wider costs of the inquiry, which are charged to NHS England. The additional costs, such as daily expenses, wages of the clinical review and administrative team, transcription, insurance, office space, and HR services, can exceed £300,000 a month. Ockenden has stated that there is a "profit element on the provision of clinical and administration services, but this is needed partly in order to meet various miscellaneous costs that do not come within the charges that are passed across to NHSE under the agreement". The high costs of the review have been noted, with Ockenden’s daily fees exceeding the UK’s weekly median wage of £766.60.
Tax Implications and Arrangements
Ockenden was initially on the NHS England payroll and taxed at source, but the arrangement was changed in January 2024 to allow her to work through her limited company, Donna Ockenden Ltd. This change has potentially offered tax advantages through structuring income as a combination of salary and dividends to minimize tax and national insurance costs. Ockenden has stated that "the payment details you have are correct. I am working long hours on the review. I anticipate devoting the vast majority of my time to the review up to the point of publication in June 2026". She also noted that "the current contractual arrangement provides value to the taxpayer, and involves my running every aspect of the review including coordination of a large team of clinical reviewers".
Previous Work and Reputation
Ockenden has been praised for her work, including a previous review in Shrewsbury and Telford. In October, she said she had the backing from affected families to take on a similar role investigating Leeds Teaching Hospitals NHS Trust. She also expressed her willingness to chair the inquiry in Leeds as well as a further maternity review at University Hospitals Sussex NHS Trust, describing it as an "honour" to be considered. However, the health secretary, Wes Streeting, later stated that Ockenden would not be leading the Leeds review due to her existing commitments.
Government Response and NHS Statement
The health secretary, Wes Streeting, told Woman’s Hour on BBC Radio 4 that Ockenden would not be leading the Leeds review, citing her existing commitments and the need to protect the work she is already doing. An NHS spokesperson stated that "following the then secretary of state’s appointment of the independent review’s chair in spring 2022, NHS England has worked to ensure the review meets its terms of reference for families, initiating a new contractual agreement in January 2024". The spokesperson also noted that "women and families deserve answers and improved maternity services in Nottingham, and the publication of the review’s final report no later than June 2026 will be a critical step to achieving this".
Conclusion and Concerns
The high costs of the review and Ockenden’s tax arrangements have raised concerns about the provision of safe and reliable maternity care in the NHS. Despite a significant number of independent investigations and reviews of maternity and neonatal services in NHS trusts since 2015, England is "still struggling to provide safe, reliable maternity and neonatal care everywhere in the country", according to Baroness Amos. The publication of the review’s final report in June 2026 will be a critical step in achieving improved maternity services in Nottingham and addressing the concerns raised about the provision of care.