The proposals include new national standards to deliver "more child-friendly services" in hospitals - with dedicated children's units in A&E departments - backed by a £70 million investment in neo-natal intensive care facilities.

That a NSF for children's services should be agreed and implemented as "a matter of urgency" was a key recommendation of the July 2001 report of the inquiry into the Bristol heart babies scandal. The 10-year programme will "set national standards and methods for improving the delivery of social care and health services for children, young people, and maternity services".

The Department of Health said that over the next three years the £70 million investment in neo-natal facilities will provide for up to 75 new cots and other specialist equipment. Additionally the DoH published a report of the expert inquiry into caring for newborn and premature babies, Neonatal Intensive Care Review, which estimates that up to 200-300 lives could be saved every year by the restructuring of services to concentrate the most modern equipment and the most highly skilled staff in a network of specialist centres.

The launch followed February's announcement that the National Institute for Clinical Excellence (NICE) is to draw-up new national guidelines on maternity services in the wake of a damning report which blamed "low care standards" as responsible for 53 per cent of baby deaths in England during labour. Indeed the study carried out by the Euronatal Working Group put England at the bottom of the league with the worst results of the 10 countries studied. Failure to detect intrauterine growth retardation was the most common cause of death of the 1,600 cases of infant mortality studied between 1993 and 1998.

At the launch, Health Secretary Alan Milburn said that the new standards should mean that women will be able to make "an informed choice about where and how their baby is delivered, between a home birth and a hospital birth, about what type of pain relief to have, how much midwife support to choose".

NICE is expected to report back in 2005. In the meantime there is evidence that some vulnerable groups of women may be receiving little or no pre-natal care before they give birth.

Giving evidence to the Maternity Services Sub-Committee's Inquiry into Inequalities in Access to Maternity Services in May, Carolyn Roth of the Women's Health and Family Services Community Group based in East London, said whilst there had been a small survey trying to count the number of women who do not receive any pre-natal care, without proper data it was impossible to properly evaluate the numbers of women in this situation.

"It is a very poorly defined group - of the 33 [maternity departments] surveyed only nine could provide any sort of figures. There were high proportions - four per cent of women delivered without any prior pre-natal care," she said, adding that without wider investigation this study was "really just a snapshot" of the real picture.

The committee heard that social exclusion had a major impact on the availability of maternity services. Such factors as language barriers, a stable address - Lesley Spires, a head midwife at Queen Charlotte's and Chelsea Hospital in London, said that travellers have "a higher rate of maternal death than any other group" - and prejudice were major contributors to women's ability to access services.

Prejudice consisted not just of racism but was a particular factor experienced by teenage mums said Spires, which was being successfully tackled through the introduction of advocacy groups for teenage girls to help address the "difficult attitudes to that age group, not just race and class".

In response to a question from Sandra Gidley MP as to whether enough was being done to help women with postnatal depression, Diane Jones, research and development midwife at Newham General Hospital in Plaistow, said that mental health teams did not see this as "their area", and that mothers presenting with bizarre behaviour "can't go to the mother and baby unit, and will be separated [from their babies] and this will exacerbate her problems".

When Gidley asked if better liaison between maternity and mental health services was needed, all the witnesses present agreed with a resounding "absolutely".

Many maternity services provided outreach services for the groups most at risk of social exclusion, though Roth said that there were still "shortcomings" with 60 per cent of the women in her area still not getting the services they needed. "It is a challenge getting the service to women where they need it," she said. "Somehow what is being done is not working properly."

Many maternity departments employ midwives with second languages - Queen Charlotte's and Chelsea Hospital's maternity department, for instance, has the "most ethic mix in the Trust". However in communities as ethnically diverse as London's many midwives still depend on the family members of pregnant women who do not speak English to translate for them.

This can pose considerable problems if the pregnant woman in question has a violent partner - as Maggie Elliott (also a head midwife at Queen Charlotte's and Chelsea Hospital) pointed out, these women are "amongst the highest risk of maternal death".

When asked by Julia Drown MP what she would say to people who would maintain that it was "dangerous" ever to use family members to translate, Spires responded: "I would say that we don't have the resources."

Indeed Doug Naysmith MP commented that the fact that there were not enough resources in the maternity field "was a fairly clear conclusion to be drawn".

The extra cash for neo-natal intensive care cots is a certainly a welcome boost - but can the pledge to deliver an improved maternity service be achieved without extra cash? However it is clear that the government's commitment to modernise the maternity service as a part of its wider programme cannot come too soon.