London’s hospitals are running out of babies
Like schools, maternity units face an uncertain future in the capital
Morning — there’s been much focus lately on London schools closing, unable to find enough kids to fill their classrooms. But problems are emerging further up the parental pipeline too: in the capital’s maternity units. Over in north London, the consequence of the city’s falling birth rate is about to be felt, as the NHS decides which of two maternity wards to close permanently.
Locals have called it a “tragedy”, and fear mothers-to-be are losing choice and access to specialist services. But, on paper, the hospitals in the firing line are not so different from many others across the city. The growing uncertainty around giving birth in London is after your Sunday round-up below.
Plus: crossbow attacks, a hidden statue revealed, and London’s most authentic Princess Diana cafe.
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What we’ve spied
🏹 No charges yet in the investigation into ‘linked’ crossbow attacks in Shoreditch, despite a man being arrested last Sunday on suspicion of attempted murder. The 47-year-old man was released pending investigation on Tuesday, following two separate incidents near the square Arnold Circus earlier this month — a 44-year-old woman hit in the head with a bolt on March 4, then ten days later a 20-year-old man struck in the neck about 60m away from the first attack. Both victims were later discharged from hospital with non-life-threatening injuries. Police had found a knuckle duster and “a bottle containing a substance” on the man when he was detained, then found a crossbow, knives and other weapons when they later searched his home. As of writing yesterday, the Met told us “the man remains under investigation while enquiries continue”. All of the big police response now is all a little too late for some Shoreditch residents though, who’ve been criticising the Met for not taking the first incident seriously enough.
🎨 It didn’t take long for someone to deface the new Banksy piece that popped up in Finsbury Park this week. The piece — green paint on the side of a house on Hornsey Road behind a tree, giving the appearance of foliage — appeared on Monday and instantly drew crowds, with local MP Jeremy Corbyn among those first on the scene to get a snap. But by Wednesday, pictures on social media surfaced showing that white paint had been thrown over the mural — to the disappointment of Islington council, which had praised the “powerful piece” and pledged to protect it, rather than getting its graffiti teams to remove it. The defacement might also disappoint the owner of the painted house, landlord Alex Georgiou, who had told the Mail that while he wouldn’t be raising the rent for the current tenants, he would happily sell up “if somebody offered me millions”. Still, the Finsbury Park piece lasted longer than Banksy’s last outing in the capital — his piece of drones on a stop sign in Peckham was stolen within the hour of it being confirmed by the street artist in December. More mural madness: a fish and chip shop owner in Greenwich has refused to back down after the borough council told him to remove a Union Jack mural he’d painted on the side of his shop.
⚽ While we’re on public art in London: the Harry Kane statue that was hidden away in storage for years has finally been revealed. The Big Issue landed the scoop this week, acquiring photos of the statue of the England captain, which had been originally commissioned by Waltham Forest Council back in 2019 for £7,200. It’s been tucked away for so long because the council couldn’t find a place to put it — at one point it proposed putting it somewhere on the Overground station at Chingford, where Kane grew up, but the idea was blocked on the grounds it could be targetted by rival fans. Waltham Forest hasn’t given up though, and a spokesperson for Kane says he’s “really excited” about the council eventually finding a spot. Fans have savaged the actual design though — many have pointed out its Easter Egg chocolate-like qualities — and others wonder if that £7,200 couldn’t have been better spent. Maybe it’s a bad time to bring up new figures this week that show nearly half of London boroughs have hiked average council tax to over £2,000 a year.
🚇 Save the dates — Tube drivers are planning to strike on Monday, April 8 and Saturday, May 4. The strike’s been called by Aslef, the union which represents nine out of ten drivers on the Underground. It’s also the same union that kicked off earlier this year, when it said it had been left out of Sadiq Khan’s last-minute offer to avert a massive week-long strike in January, organised by the RMT union. Elsewhere on the capital’s transport network: there’s been some drama about a Ramadan message that was displayed at King’s Cross station this week, while TfL has banned an advert from the Tube that claimed social media was “killing” Muslims.
🍾 One of London’s all-male private members’ clubs has been dragged quite suddenly into the spotlight. The Guardian got hold of the Garrick Club’s members list on Monday and — surprise surprise — it’s full of the names of leading lawyers, politicians, civil servants and heads of arts institutions. There’s currently a campaign to let women into the Garrick, which has been all-male since it was established near Leicester Square in 1831 and for decades has been a prime mingling spot for the British establishment. Following the Guardian’s reporting, there have been calls from equality groups for some current Garrick members — Benedict Cumberbatch, Brian Cox, Stephen Fry — to quit in protest. For more trouble in London’s clubland, you can read our report from last year.
🗳️ A big escalation in the brewing Labour selection scandal in Croydon, with the announcement this week that the Met Police is now getting involved. In November, Labour HQ had paused the selection of a candidate to stand for MP in Croydon East, to investigate complaints from local Labour members that votes in the contest had been tampered with. These members alleged that the contest had been stitched up, and votes rigged using a digital party system. Labour’s apparently finished its investigation into the allegations, but on Tuesday the Met said it would now be taking a look at the case — at the risk of speculating, perhaps based on what the party handed over. Worth reading: journalist Michael Crick’s deep dive into the scandal from late last year.
💐 Tributes are being paid to Richard Taylor, the father of a schoolboy murdered in south London, who has died at the age of 75. Taylor had spent the last 24 years of his life campaigning against knife crime, after his 10-year-old son Damilola was left bleeding to death in a stairwell in Peckham when he was attacked on his way home from a library in November 2000. Among those paying tribute was Brooke Kinsella, a former EastEnders actress whose brother was stabbed to death in Islington: "Richard's courage in the face of unimaginable grief was an inspiration to me. After the horrific loss of his son Damilola, he chose to channel his pain into a fight for a safer future. He turned tragedy into a relentless determination to keep other families from experiencing the same heartbreak.”
🏘️ A big pledge from Sadiq Khan’s re-election campaign this week: the mayor has said he’ll build 40,000 new council homes if he wins a third term in May. That would mean Khan doubling on the numbers from his current term, which has seen work start on 23,000 homes between 2018 and 2024. Khan made the pledge at an official launch event on Monday alongside Labour leader Sir Keir Starmer — perhaps an intentional display of strengthened ties between the pair, after Starmer refused to back Khan’s ULEZ expansion last year. Polling still suggests Khan is far in the lead, with one published on Friday that showed him on 51%, versus 27% for his Tory rival for City Hall, Susan Hall. But Khan also made another call on Lib Dem and Green supporters to lend them his support, over fears he’ll be hit by changes to the voting system that are coming into force for the first time in May. For her part this week, Hall has said she’ll bring back free peak travel on London transport for pensioners, which had been scrapped by Khan. Elsewhere on the campaign trail: London’s muscliest mayoral candidate, Brian Rose, has announced he’s standing again.
🔍 And finally, we leave you with:
As birth rates fall, an uncertain future of London’s maternity services
In December, when NHS North Central London first unveiled plans to close one of two maternity wards, its chief medical officer was armed with a striking statistic. Pregnancies had fallen to such an extent in north London that, on any given day, half of the cots for newborns at Royal Free Hospital in Hampstead are now going unused, she told the BBC in a radio interview. The writing was on the wall — midwives were being spread too thinly. Maternity services at either Royal Free or the nearby Whittington Hospital in Archway would have to close, and some of it relocated elsewhere.
London’s maternity wards have been getting quieter for a while now. Fewer babies are born each year in the city — 128,000 in 2008, versus 107,000 in 2022 — and that’s been reflected in hospital use. 15 years ago, there were typically 1,100 women staying in London hospitals each night to give birth. Today that figure has fallen to 850.
But the case of Royal Free and Whittington has raised an awkward point: what to do about this emptying of London’s maternity wards. There have been notable closures before this latest plan — most prominently the winding down of maternity services at Ealing Hospital in 2015. But many London hospitals have kept going, and are now just as quiet as the two North Central London is considering cutting, according to occupancy data published by NHS England. King’s College, London North West University and Guy’s and St Thomas’s hospital trusts all saw roughly half of maternal beds going unused last year, similar to Royal Free and Whittington. A couple are even emptier, seeing up to two-thirds of maternal beds usually unoccupied in 2023. In the extreme is Edgeware Birth Centre, a standalone midwifery centre that saw just 45 births between April 2021 and March 2022. That’s less than one a week, and the lowest of all standalone midwifery units in the country. London’s health officials are now grappling with the same question as their counterparts in education — in a city losing children, can you still keep services for parents local?
There’s no confirmation yet of exactly which of Royal Free and Whittington is on the chopping block, but the proposals have already awoken fierce opposition. Ahead of the public consultation closing last Sunday, midwives held a demo outside Royal Free, organised by the Royal College of Midwives. They called on the health board to reverse course, stressing the importance of keeping Royal Free’s specialist maternity services open. And at the start of March, Tulip Siddiq, the MP for Hampstead, confronted a government health minister in Parliament over the planned closure. She warned: “Royal Free is uniquely placed to help mothers with diabetes, pregnant women with HIV, and mothers who require interventional radiology … [it] is the only local provider that offers this life-changing treatment 24 hours a day, seven days a week”.
Meanwhile, mothers from Whittington Maternity and Neonatal Voices, a feedback group for those using the unit in Archway, have said the closure would reduce the choice for prospective parents. "It might be that the impact to women would mean they have to travel further, they might not be going to the hospital that they feel the safest in,” said one member, Mayani Muthuveloe. "If the hospital is close to you and your family can support you through that time, if you're further away from that they're removing you from your support network”.
But NHS North Central London has stressed it needs to “adapt” its services to the reality of London’s falling birth rate. Its projections are stark — by 2041, it’s expecting the number of children and young people, those under 18, in its area to decline by 10%. But the health board has also highlighted that this trend isn’t uniform — birth rates are now three times higher in the most deprived parts of north central London compared to the least deprived. At the same time, pregnancies are getting more complex and in need of support, with more pregnant women and people having conditions like diabetes and obesity. Indeed in NCL’s five boroughs, Asian women are twice as likely to have diabetes in pregnancy than white counterparts. Where exactly maternity services are in London, and the communities with access, increasingly matters.
As local midwives and parents-to-be await the decision — the NHS has said it’ll make a call on Royal Free or Whittington by early 2025 — they have an example to study out west. Of all the hospitals we looked at for this piece, Hillingdon Hospital in outer London had the lowest maternal occupancy last year, with 70% of beds going unused on a typical night, significantly emptier than Royal Free and Whittington. The hospital is covered by the NHS North West health board, which insisted it had no “plans to consolidate maternity units” when we contacted it for comment on the stats. But the health board has already embarked on its own controversial reshuffle just a decade ago. In 2013, the board announced it wanted to shut the maternity ward in Ealing Hospital, leading to years of campaigning from locals, interventions by MPs and marches alongside a painted ambulance. Opposition culminated in one notable protest in June 2015, which saw protestors march into the hospital with banners, then sleep outside its entrance in sleeping bags overnight. But it was too late — the unit had stopped taking referrals from new pregnancies that May, and closed for good later that year.
Part of the justification for shutting Ealing had been staff shortages, which the health board had argued was jeopardising the quality of care. Staffing at maternity services is an issue that continues to haunt London today. Last year, the London Assembly’s health committee produced a wide-ranging report into how the capital’s maternity services had coped, and problems around staffing levels were identified as a key issue. And the pandemic had taken a clear toll on headcount — between November 2022 and November 2021, the number of midwives fell in London from 4,930 to 4,858. Trusts now have to figure out how to allocate this diminished workforce. North Central London has cited staffing in its consultation for Whittington and Royal Free, saying its maternity workforce is currently “spread thinly” over its five units.
It all begs the question of where might be next to close in London. Plenty of maternity units are still well used — hospital trusts in Kingston, Lewisham, Greenwich and Barking all had over 80% maternal occupancy in 2023. But other hospitals perhaps have less certainty. Epsom Hospital, just on the border in Surrey but part of the London neonatal network, had similarly low levels of occupancy to Hillingdon and far below Whittington and Royal Free, at 68% of maternal beds unused in 2023. But its health board, NHS South West London, did not offer a response when we asked if services in Epsom were at risk. However, a spokesperson for NHS England separately stressed were currently no plans for consultations on any other maternity services in London.
For those who’ve given birth at Royal Free and Whittington, the threat of closure feels particularly personal. Writing in the Guardian this January, columnist Rhiannon Lucy Cosslett recounts her son’s birth at Whittington, and the support she received from the unit’s obstetricians and midwives. “Many mothers feel a bond with the people who support them through childbirth: seeing them anxious about their jobs is hard to bear,” she writes. Hampstead MP Tulip Siddiq has also said Royal Free’s maternity unit “has a particularly special place in my heart, not just because of the many constituents that it serves but also because I had both of my children there”. But once NHS North Central London finally makes a call, some will be looking at what could come next.