Doubts about safety of NHS maternity care as negligence payouts reach £1 billion
A total of £947 million has been spent on compensation relating directly to obstetrics, reflecting the increasing cost of lifetime care for children who have suffered brain damage, cerebral palsy or developmental delay.
The scale of the cost — enough to hire thousands of consultants or midwives — reveals the growing burden of claims on the health service at a time when maternity wards are short-staffed and the birthrate is rising.
Medical colleges say the chances of harm to mother or baby are lower than ever, but they remain concerned that shortages of consultants and midwives leave patients at risk.
Taking into account a backlog of cases from the 1990s, the cost of maternity-related claims has risen from £163million in 2003-04 to £288 million in 2007-08.
The figures, revealed by the NHS Litigation Authority in answers to parliamentary questions by Harry Cohen, the Labour MP for Leyton & Wanstead, reflect the cost of settled claims awarded under the Clinical Negligence Scheme for Trusts.
But this does not include cases that preceded the authority’s creation in 1995, some of which have arisen from health problems diagnosed years after birth.
Medical colleges said that the total bill for litigation put the £330 million pledged by the labour Government to improve maternity services into sharp relief.
As The Times reported in September, trusts have had trouble identifying specific funding promised over three years to help to implement a policy document, Maternity Matters, that promised all women dedicated care from a midwife by the end of next year.
Louise Silverton, the deputy general secretary of the Royal College of Midwives, said that the cost of claims “underlines what a false economy it is to cut back on maternity care”.
“Women keep hearing about these excellent government policy statements such as one-to-one care in labour from a midwife,” she said, “but they are not getting that sort of treatment in many areas such as the East of England, the South West and London.
Our members are telling us that they are overworked and overstretched and are running between beds dealing with, in some cases, three women at once.”
Overall NHS spending on maternity in England was cut by £55 million in 2006-07, while the birthrate has risen by 16 per cent — equivalent to 90,000 extra births — since 2001, Ms Silverton added.
Tristian Blomfield, 8, from Watford, Hertfordshire, received a compensation package of just over £8.26 million after suffering permanent brain damage at birth. He has cerebral palsy in all four limbs and requires constant care.
West Hertfordshire Hospitals NHS Trust, which manages Watford General Hospital where Tristian was born, offered his family an unreserved apology and expressed hope that the agreed settlement would provide them with security for the future.
Sabaratnam Arulkumaran, the president of the Royal College of Obstetricians and Gynaecologists, said that only one in every 6,000 births resulted in a litigation claim. But at that rate trusts had to set aside £500 for each birth as a form of insurance, he added.
“In a busy maternity unit of 5,000 births or more, we believe there needs to be 24-hour consultant cover to deal with emergencies and prevent disasters better. Rather than have more negligence cases and pay out on more claims, we should spend on more consultants, better training and reduce the number of cases,” he said.