Is It Actually That Safe to Have a Baby on the NHS?

03/10/2013 15:56 BST | Updated 23/01/2014 23:58 GMT

The recent inquest into the death of a baby girl born at Furness General Hospital in February 2004 has revealed the extent of failings in obstetric care at the unit, highlighting wider concerns around maternity care in the UK. Midwives at the hospital failed to monitor Elleanor Bennett's heartbeat for a period of over 40 minutes, ignoring the national requirement to do so at five minute intervals during labour. It was in this time that the child was likely deprived of oxygen, compromising her health.

When midwives finally attempted to record a heartbeat and failed to find one, not even the doctor on duty was sought to intervene. Elleanor fought for a day before she died, and it was almost eight years before her parents were given cause to suspect the hospital had acted negligently. Grieving for a child who died of natural causes is hard enough; to then learn of a cover-up surrounding the death is likely devastating.

The failure to accurately monitor infant heart rates during the birthing process is prevalent in lawsuits filed against the NHS. Maternity claims are in fact the second most common type of negligence claim for the NHS behind surgery. Earlier this year, the NHS Litigation Authority (NHS LA) published its analysis of ten years of maternity claims, reviewing incidents which occurred between 1 April 2000 and 31 March 2010. Along with errors managing labour, and births in which a baby suffers cerebral palsy, foetal heart monitoring mistakes accounted for 70 percent of claims.

Not only are maternity cases disproportionately common for the NHS, they also cost the service more money than any other type of claim. 5,087 claims were made within the decade, representing a total of £3.1 billion. With medical negligence claims at an all-time high, surely this should be the wake-up call the NHS needs to start lifting overall standards of care and therefore reducing the amount it is spending on drawn-out legal proceedings. It's this money that would be better spent on improving services for patients, as well as facilitating education and safe working conditions for staff.

Between 2000 and 2009, 5.5 million babies were born in England. 0.1 per cent of those births eventuated in a clinical negligence claim. Despite the NHS LA suggesting these figures indicate that having a baby within the NHS is 'very safe', the unsounded concern is that claims only represent people who have actually complained. What about the parents or practitioners who kept quiet when things went wrong, or as in the case of Elleanor Bennett, the families who were given no reason to even question the care received?

The challenge we face now is to disband the management ethos that sees clinical negligence buried, along with the ineffectual systems that mean practitioners either can't or won't fulfil their duty of care. Hospital managers will point to significant reforms which have taken place during the decade under review, as well as in the years since. Indeed, medicine and the technology used to deliver care is continually evolving, if not always for the better. However, there is nothing to show the culture of secrecy within the NHS has subsided, and little to encourage the belief it can do so independently.

In an effort to initiate change, the NHS LA has compiled the report using the decade of childbirth claims to identify common themes in maternity cases and create learnings which it says can be 'cascaded' through the organisation. The long-term goal is to reduce harm to both women and babies, with suggestions that clinicians be targeted with training and expert evaluation to ensure standards are raised and met. It's a positive step, but surely preventing harm and eradicating further secrecy can be an immediate aim.

When a mother-to-be presents to a maternity ward preparing for the birth of her child, she is admitted to the care of healthcare professionals and should be able to feel confident in their support. By reflecting on those occasions when services have failed, we can devise actionable improvements to better outcomes for patients and staff, and ensure our hospitals are safe.

This post was written by Ed Fletcher, the chief executive of Fletchers Solicitors. For more information visit