Maternity Care In Crisis
The birth of a child is one of the most rewarding experiences we can have, and advances in medical technology and training should make it a safe one too. But recent studies point to an alarming rise in the number of birth-related accidents in the UK.
Injuries to mothers and babies caused by negligent maternity care account for 60% of the total sums paid in respect of clinical negligence claims. Over £1 billion has been paid by the NHS for maternity-related claims since 2001, and last year such claims accounted for six of the ten biggest payouts. The biggest claims are for the cost of maintaining birth-injured babies. A typical cerebral palsy claim will cost the NHS £2 to £5 million to settle.
“The human cost is immeasurable, and even the financial cost to the NHS should be ample incentive to make dramatic reductions in the number of errors resulting in injury,” says Peter Walsh of Action against Medical Accidents. “Sadly we continue to see familiar patterns in the kind of errors experienced, which it should be possible to address.”
A recent study by the National Patient Safety Agency investigated over 60,000 errors in maternity care between November 2003 and June 2006. Of those, 18,000 involved personal injury, with 246 patients dying during childbirth. A definitive study by the Confidential Enquiry into Maternal & Child Health, which investigates every case where a pregnant mother has died, shows that there has been a steady increase in maternal deaths since 1990. Nearly half of those deaths were the direct result of ‘major substandard care’. These findings have been supported by other organisations involved in monitoring or improving maternity care.
So what is going wrong? It seems that the main cause is a lack of trained staff. The Royal College of Midwives points to the fact that many health authorities have a freeze on recruitment although the birth rate is rising rapidly and two-thirds of hospital trusts have vacant posts. A survey by the National Perinatal & Epidemiology Unit found that a fifth of all mothers who have given birth recently in UK hospitals did not have a midwife or doctor with them, in breach of NHS guidelines. Experts say that 10,000 more midwives are needed just to halt the continued rise in birth-related accidents, but the growing pressures on midwives means that more and more are leaving the service.
According to the Royal College of Obstetricians & Gynaecologists there is an acute shortage of consultant obstetricians, “but there is no will at the moment to employ increased numbers because the service is not prepared to pay for it.” So it seems we have a vicious circle, with a cash-starved NHS employing fewer trained staff while the number of negligence claims increases, taking even more money from the health service. “The largest single problem is the lack of resources,” says Professor Jason Gardosi, Director of the NHS Perinatal Institute. “You would not allow an aeroplane to fly without a full crew, but [maternity units] have to make do without a full staff. It is little wonder that we see so many avoidable deaths.”
Of course, it is not only the monetary impact on the NHS which is of concern. Birth –related medical accidents have a huge impact on the families who have to look after a disabled child or to deal with the loss of a child, or of a wife and mother. Foot Anstey is handling a number of birth injury and stillbirth claims involving midwifery issues, but the compensation we can recover is small comfort for those involved.
Foot Anstey has four specialists in birth-related injury claims based at Plymouth and Taunton, and is working with Scope and other organisations dedicated to helping those disabled through birth injury.
Published 26/04/2007.
