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Clinical Negligence Associate asks if NHS maternity services have a crisis on the horizon

On 8 November, the National Audit Office (NAO) published its long awaited review of maternity services in the UK (click here to view the report).

The headline that a fifth of all maternity funding in the UK was spent last year on Clinical & Medical Negligence litigation at a cost of £700.00 for every child born makes shocking reading. However, if we look beyond the immediate headlines, there are wider reasons for worrying over the current state of maternity services in the UK explains Clinical Negligence Associate Christian Beadell..........

In 2007 the Government produced a strategy document – Maternity Matters which was intended to provide a root and branch overhaul of maternity care and ensure long term sustainability and improvement.

The NAO’s report (which is primarily a costs and efficiency report) indicates that the government has failed to put in adequate systems to both monitor compliance with that strategy and ensure effective implementation.

As a consequence, the NAO conclude that the quality and safety of services fluctuate throughout the UK. Whilst overall, the number of still births has fallen; there has been a dramatic increase in the number of claims being made. The number of midwives is not keeping up with the increasing rate of births and senior consultant involvement in medical care is not at the benchmark level proposed by the Department of Health. At present there is a need for 2300 new midwives, just to hit the government’s own minimum target.

With increasing numbers of complex births i.e. twin pregnancies, there has never been a more demanding time for the maternity services in the NHS and it is no surprise to see claims rising if the proportion of qualified staff is reducing. When units are fire-fighting to cope with demand, it is inevitable that patient care will suffer.

The headlines regarding litigation can easily be a distraction from the reality that a hard pressed maternity service is struggling to provide adequate levels of care.

It would be a mistake for the Government to take the view that the increase in Clinical Negligence Claims is solely as a consequence of spurious claims being brought. In my experience, it is a complete fallacy to say that Clinical Negligence Solicitors make false claims, particularly when involving the highly emotive issue of child birth. Usually a claim is raised only as a consequence of a detailed and careful expert led review.

It’s also important to note that Birth Injury Claims are rarely, if ever, settled unless there is reasonable evidence of substandard care. It is only right and just that an individual who suffers lifelong injuries as a consequence of negligent treatment should be compensated for those injuries. Improving patient care is the most cost effective long term way of managing litigation.

Put simply, if the NHS improves it’s standards then the lawyers will be put out of a job tomorrow and litigation costs would fall.

Therefore the real concern raised by this report shouldn’t be what the costs consequences of poor treatment are, but rather what action the Government must now take to ensure that the current maternity crisis is averted.