Better births

ARAGBy Legal Futures Associate ARAG

Reports from the first national inquiry into traumatic births revealed testimony from mothers that was harrowing and often shocking, but probably unsurprising for anyone with even the remotest experience of clinical negligence cases. Mike Knight, UK Sales Manager for ARAG’s after-the-event insurance business considers what the next government might do with the report.

The publication of “Listen to Mums”, a report produced by the All-Party Parliamentary Group (APPG) on Birth Trauma, briefly captured the public attention last month, as numerous mothers retold their distressing birth stories in newspapers, on the radio and TV.

Released between the latest revelations from the Post Office inquiry and the belated acknowledgement of another national scandal involving thousands of victims treated with infected blood, the Birth Trauma Report’s moment in the spotlight was all too brief.

While the individual stories are alarming and often tragic, the broader picture the report paints of national systemic failure shouldn’t come as a surprise.

The roll call of NHS Trusts with failings so great and so widespread that they have come to national attention over the past 20 years, is as long as it is geographically spread: East Kent, Cwm Taf, Nottingham, Morecambe Bay, Shrewsbury and Telford…

The experiences detailed in the report suggest that, far from being a few bad apples in the barrel, these trusts were far more representative than the public realised. Perhaps the fragmentation of more than 200 NHS trusts, over half of which provide maternity services, helped to obscure the bigger picture of failure on a national scale.

Sadly, the recurring themes are all too common. Understaffing, equipment shortages, inadequate training budgets, cultures of bullying, secrecy and denial have pervaded at the cost of thousands of infant lives.

The financial cost of the babies who die as a result of a traumatic birth is, of course, tiny in comparison to the many thousands more who are injured and left needing life-long care. Care that will cost billions of pounds a year, for at least the foreseeable future.

The improvements needed are clear and achievable, but delivering them will be complex, often expensive and results won’t be seen overnight. The balance between cost and benefit, however, is about as certain as any in public spending, even without taking the terrible human cost into account.

What has consistently failed to move the needle is the delusion and often the distraction that claimants’ legal costs are the cause rather than a symptom of the financial burden that maternity care failures put on the public purse. The surest way to reduce costs is to reduce the number of claims.

The most recent proposals for fixed recoverable costs in lower value clinical negligence cases had already been adopted by the government and were due for implementation in October but, with work still to be done, any progress appears to have been at least deferred until after the election.

Apparently longer forgotten is the national ambition to halve the rates of stillbirth, neonatal mortality, maternal mortality and brain injury in England, by 2025. If such a reduction is still achievable, even within the next parliament, it would have a profound impact.

I’ve worked with hundreds of clinical negligence lawyers over many years. The idea that any of them is riding a gravy train fueled by public money is a myth that is as pernicious as it’s wrong. They work in a practice area that they wish didn’t need to exist.

Any of them might easily have worked in a different area of law and many might be better compensated if they did. Instead, they use their skills and experience to help pick up the pieces of lives shattered by the worst, too often avoidable, trauma.

Whether this latest, national report will provide the impetus needed to reverse the decline is impossible to say. Whoever the next Health Secretary may be, it should certainly be close to the top of their in-tray, and the prospect of making a huge difference, not just to NHS finances but also to thousands of lives, should make it an appealing project for any government.


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