Tribalism in Midwifery and Obstetric services is dumbing down your local health service. Divisions between doctors and midwives…

Chris Smyth in The Times 10th May reports: NHS errors leave 1,300 babies dead or maimed and the key sentence in his report is “They blamed divisions between midwives and doctors, saying that the desire for “natural” births — without interventions — sometimes went too far. ” When I was training I was meant to get 25 deliveries and with the help and facilitation of the midwifery team this target was reached. In my elective I did a lot more obstetrics (In Canada) and really enjoyed the experience – so much that I did GP obstetrics for 15 years.. Contrast this experience with todays doctors. Males are lucky to get one delivery.. It is only the doctor who makes a complete diagnosis and a doctor has to be in charge, of both service delivery and training. Standards in specialist centres are the highest, and we need to puncture the balloon of midwifery led units being as safe as consultant led units… No fault compensation will help the financial disaster we are witnessing… and stopping the rationing of places in medical school will ensure sufficient manpower – in 10 years time!

The annual bill for NHS negligence in pregnancy has reached £1 billion 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 blamed 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 seen by The Times show that the NHS is spending ever bigger sums 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 just under £1 billion last year to settle 1,316 claims of negligence in maternity units, up from £488 million 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.

James Titcombe, who helped to expose the Morecambe Bay maternity scandal after the death of his son Joshua, said: “That we’re spending £1 billion is absolutely shocking. There should be no room for failing to learn, yet the system that we have at the moment is woefully inadequate.”

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 £268 million in claims, up from £154 million ten years ago.

“I think it’s a scandal, the lack of learning from mistakes,” Mr Titcombe said, arguing that other industries have systems to catch slip-ups before they become fatal. “Absolutely, people will make mistakes and nobody can blame staff but what is unacceptable is failure to learn.” He added: “Yes, we want to support women to have a normal birth, but we want to be very quick to recognise where normal becomes abnormal.”

Alan Cameron, of the Royal College of Obstetricians and Gynaecologists, said that babies being brain-damaged were “the real tragedies”, adding: “The average settlement for some cerebral palsy cases can be £5 million and beyond… 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.

Sara Burns, a specialist in negligence at the law firm Irwin Mitchell, said that some of the rise was down to a more litigious culture, but repetition of the same type of cases pointed to fundamental problems. “There is an inherent issue with the training of midwives,” she said.

Mervi Jokinen, of the Royal College of Midwives, 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. “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,” she said.

A spokesman for NHS England 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.”



This entry was posted in A Personal View, General Practitioners, Medical Education, Midwives, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

1 thought on “Tribalism in Midwifery and Obstetric services is dumbing down your local health service. Divisions between doctors and midwives…

  1. Pingback: Wales is an unsustainable state: another good reason not to leave the EU. Graphics in support… | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

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