As deaths and financial costs rise, Karen Constantine says it’s time for a nationwide public inquiry
A recent Telegraph report revealed the scale and cost of maternity care problems in the UK when it published details of a medical negligence scheme costing the NHS £90 billion. This is money set aside to meet the costs of the rising tide of claims. The figure is all the more staggering when you consider this sum is 70% of the total liability for negligence claims across the NHS.
How can these costs be so high? Birth can be dangerous (which is why Bevan and successive Labour governments have always invested in maternity services). Errors in childbirth can result in such severe brain injuries that settlements have to fund a lifetime of 24/7 care.
The Tories have not only failed to deal with the crisis in maternity care, but have actively stoked chronic staff shortages. The historic midwives’ strike in 2014, the first in the Royal College of Midwives’ 120-year existence, was provoked in part by the Government’s proposals to terminate nursing and midwifery bursaries. The RCM warned the Government that this was a fundamental mistake which would worsen significant staffing shortages evident at that time.
Staff shortages in midwifery are now so acute that delivery suites are all too often unsafe and women and babies are receiving substandard care. Eighty of the NHS’s 193 maternity services are rated as inadequate or requiring improvement. This means they are not meeting basic safety standards.
Staffing levels are so low that they even mitigate against the training of vitally needed trainee midwifes, as there is reduced capacity for critical clinical supervision. This has led to midwives’ training courses being abandoned halfway through.
A recent survey of midwives by the RCM paints a stark picture of chronic workforce shortages and challenges with maternity services often only functioning safely because of staff working long and additional hours, often unpaid. It also shows a service haemorrhaging midwives at an alarming rate. The cost of training has skyrocketed to £47,712 for a three-year course, plus a further preceptorship year to fully qualify. These costs are higher in cities such as London, reflecting the higher cost of living.
With staff clearly overworked and too few completing training, persistent maternity scandals are little surprise. The Kirkup Review, led by the expert Dr Bill Kirkup in East Kent, examined more than 200 cases. The recent report concluded that there were 45 avoidable baby deaths, plus injuries to babies and mothers. In 2015, the Morecambe Bay report into maternity care published the failures that led to the deaths of 11 babies. In 2022, the Shropshire maternity scandal detailed 300 babies dead or brain-damaged due to inadequate care. NHS England is now facing its largest investigation as more than 1,500 families have submitted their concerns after the deaths of dozens more babies at Nottingham University Hospital.
Maternity care in the UK is in decline. Babies born in the UK are twice as likely to die compared to babies born in Finland or Japan.
Whilst all NHS services are under pressure, no patients are more vulnerable – or voiceless – than newborn babies. With so many deaths and injuries and a maternity service that appears to be in terminal decline, a full public inquiry is warranted. The death toll is growing. The cost of litigation is heavy and cannot compensate for the loss and injury. It’s these most vulnerable babies and their families that are paying the highest price for Conservative failings.