Advising with empathy and experience

The financial cost of childbirth negligence.

The annual bill for NHS negligence in pregnancy has reached £1bn after more than 1,300 babies were killed or maimed last year.

One basic error accounts for a quarter of payouts, with campaigners saying it was a “scandal” that the health service was failing to learn from its mistakes. They blame divisions between midwives and doctors, saying that the desire for “natural” births — without interventions — sometimes went too far.

Health chiefs are understood to be planning a drive for more consistent care and independent investigation of deaths, as figures show that the NHS is spending growing amounts of money on compensating families for dead and brain-damaged children.

Claims for stillborn babies are also rising, with experts warning of an “explosion” in payouts as parents realise that their child’s death should have been prevented.

The NHS paid, or set aside, almost £1bn last year to settle 1,316 claims of negligence in maternity units, up from £488m a decade ago, data from the NHS Litigation Authority show. The most costly claims involve babies brain-damaged during labour, who will require constant care for the rest of their lives.

The most expensive claims consistently relate to the failure of midwives and doctors to monitor babies’ heart rate properly, which can lead to their brains being starved of oxygen if action is not taken to hasten birth. Last year this accounted for £268m in claims, up from £154m 10 years ago.

Vice president of clinical quality at the Royal College of Obstetricians and Gynaecologists, Alan Cameron, said that babies being brain-damaged were “the real tragedies”, adding: “The average settlement for some cerebral palsy cases can be £5m. If we could show some improvements in that then we could maybe direct some funds back into improving the service.”

He is urging hospitals to improve investigations, saying that it was “not good enough” to assume that little could have been done.

Practice development advisor in the learning, research and professional development department of the Royal College of Midwives, Mervi Jokinen, said that heart rate monitors were “a very good instrument for claimants” because there was room for doubt over danger zones.

She insisted that midwives were making efforts to improve training and systems and said: “We need to look at how the service is delivered and how we’re going to recognise women and babies at risk and we need to make sure we work within teams with good communication.”

An NHS England spokesman said: “We expect all mothers and their babies to receive excellent care. At a time when we need to get the best possible value within the NHS, the need to ensure the highest standards of safety becomes more urgent, not less.”