Maternity Negligence Cover: NHS Spends £482m

A fifth of maternity services funding is spent on insurance against malpractice, according to a review by the National Audit Office (NAO).

The report found the NHS in England spent £482m on clinical negligence cover in the last year - the equivalent of £700 per birth.

The most common reasons for maternity claims are mistakes during labour or caesarean sections and errors resulting in cerebral palsy, the review said.

Public Accounts Committee chairwoman Margaret Hodge said the figures were "absolutely scandalous"

"The current system is not working as it should," she said.

"The Department of Health needs to buck up and take responsibility for this.

"It needs to review its monitoring and reporting process to ensure that all relevant bodies can work effectively together to deliver maternity services that are value for money and fit for purpose."

The report also highlights a shortage of midwives and consultants on labour wards.

The equivalent of £700 per birth is spent on insurance, the report said

During 2012 there was a shortfall of around 2,300 midwives, the authors said.

More than half of units were not meeting the levels of consultant presence recommended by the Royal College of Obstetricians and Gynaecologists.

Between April and September 2012, more than a quarter (28%) of maternity units were forced to close their doors to patients for at least half a day because of a lack of space or a shortage of midwives.

Of these units, 11% closed for the equivalent of a fortnight or more, the report found.

Cathy Warwick, chief executive of the Royal College of Midwives, said: "We are many thousands of midwives short of the number needed to deliver safe, high-quality care.

"Births are at a 40-year high and other figures out this week show that this is set to continue.

"As the report states, births are also becoming increasingly complex putting even more demands on midwives and maternity services."

The report found a "wide variation" in complication rates between hospitals

She added: "The cost of litigation payments in maternity can be enormous.

"What this shows is that you cannot get safe, high-quality maternity services on the cheap because it will cost much more in the long run."

Minister for Health and Maternity Dr Dan Poulter said: "We have always recognised the need for greater investment in midwives and maternity units.

"The NHS now has over 1,300 more midwives since May 2010 and there are a record 5,000 more in training."

But Labour's shadow health secretary Andy Burnham said: "David Cameron promised thousands more midwives, but he's failing to deliver them.

"Across England, too many maternity units are operating without enough staff - unable to keep up with demand - whilst others are facing closure or downgrading."

The NAO report also highlights a "wide unexplained variation" in complication rates between hospitals.

In some hospitals up to 1.6% of women are readmitted as an emergency after having a baby, compared to 0.5% in others.

Infection rates in newborns range from 0.6% of babies born in some hospitals, while the figure is as high as 4.2% of babies born in others.

The authors also said more needs to be done to address the number of stillbirths in England.

The report points out that in 2011, one in 133 babies was stillborn or died within several days of birth.

The mortality rate has fallen over time, but comparisons with the other UK nations suggest scope for further improvement.

On the number of stillbirths in England, the minister said: "The death of a child is always a tragedy and has a devastating impact on the whole family.

"We are working closely with the charity Sands and the NHS on ways to raise awareness about stillbirth with women and NHS staff."

Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists, said: "Although the UK is generally a safe place for women to give birth, we have known for some time that pressure on maternity services is growing in some areas particularly inner city conurbations placing stress on clinicians, managers and patients alike.

"More consultants are needed to deal with not only the rapidly increasing birth rate but the rise in complex pregnancies, with older mothers, maternal obesity and multiple pregnancies at the fore."

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