Mothers at risk in care crisis

Shock report attacks lack of maternity beds and midwife shortage

A devastating report on the state of Britain's maternity services has concluded that they put the lives of women and their babies at risk.

The first national inquiry into maternity care by the Healthcare Commission, the NHS watchdog, has revealed a critical shortage of midwives, obstetricians absent from wards, a lack of beds and poor continuity of care. These have contributed to high death rates in some units and threaten the long-term health of mothers and their babies in others.

The inquiry, which is the largest ever carried out, involved all 150 NHS maternity units in England. It was triggered by separate full-scale investigations conducted at three trusts where mothers and babies died, which revealed failings indicative of a national pattern.

The three trusts were Northwick Park Hospital in Harrow, where 10 mothers died between 2002 and 2005, New Cross in Wolverhampton, where three babies died in two months in 2003, and Ashford & St Peters in Surrey, where there was a series of serious incidents in 2000 and 2001.

The Healthcare Commission said the root cause of poor performance was weak leadership by managers and medical staff. Many trusts were critically short of midwives, with numbers ranging from 40 per 1,000 births in the best-staffed trusts to 25 per 1,000 in the worst.

Only two-thirds of trusts had a consultant present on their wards for 40 hours a week – the basic safety standard laid down by the Royal College of Obstetricians. The study also revealed a five-fold variation in the number of consultants among trusts, from 3.3 to 0.6 per 1,000 births. In some trusts this meant consultants were present on the wards for just 10 hours a week.

More than £660m was paid out by NHS trusts in the three years to 2007 in negligence cases for obstetric claims – enough to hire 1,000 extra consultant obstetricians. Maternity services account for one in 10 requests to the Healthcare Commission to investigate particular trusts. Today's report, which included surveys of 5,000 staff and 26,000 mothers, says nine out of 10 mothers rated their care as good. But it said there were "significant weaknesses", with wide variations in standards between trusts. Many of the problems identified in earlier investigations were widespread, suggesting that NHS trusts are not giving maternity services priority. Sir Ian Kennedy, chairman of the commission, said: "I don't ever again want to be reading another report into high death rates at a maternity unit."

Maternal and infant deaths in Britain are at record lows, but the consequences of errors can be catastrophic. A tiny mistake can result in oxygen deprivation and brain damage to the baby, resulting in life-long disability and huge compensation payouts.

In January, ministers announced £330m of funding over three years for maternity services, including a commitment to recruit 4,000 midwives by 2012 and to give all women a choice of where to have their baby by the end of 2009. But the Royal College of Midwives claims these targets are a long way from being hit.

A key finding of the 2006 study into the maternal deaths at Northwick Park was that consultants were spending insufficient time on labour wards. Research shows that the presence of consultants can improve care and reduce the number of Caesareans. Dangerous levels of overcrowding were revealed. Some trusts had as few as two beds per 1,000 births, meaning that each had to accommodate more than one woman a day. The pressure on obstetric units meant that staff tended to intervene medically rather than let nature take its course. Research shows that 60 per cent of births should be "normal", but fewer than half of women achieve a normal birth and in a quarter of trusts it is less than a third.

Anne Milton, a Conservative health spokesman, said: "This report exposes Labour's neglect. Doctors and midwives are working hard to give women the best care, but the Government isn't giving them the support." The Government's chief nursing officer, Christine Beasley, said: "We welcome the report which acknowledges that most women have a positive experience of pregnancy and childbirth. Some trusts are doing well and we will work with others that need support."

Click here to have your say

general electionThis quiz matches undecided voters with the best party for them
Life and Style
Men with beards rejoice: Your beard probably doesn't harbour faeces-like bacteria
Arts and Entertainment
Keira Knightley and Matthew Macfadyen starred in the big screen adaptation of Austen's novel in 2005
tvStar says studios are forcing actors to get buff for period roles
Life and Style
ebookNow available in paperback
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Ashdown Group: Trainee Consultant - Surrey/ South West London

    £22000 per annum + pension,bonus,career progression: Ashdown Group: An establi...

    Ashdown Group: Trainee Consultant - Surrey / South West London

    £22000 per annum + pension,bonus,career progression: Ashdown Group: An establi...

    Ashdown Group: Recruitment Consultant / Account Manager - Surrey / SW London

    £40000 per annum + realistic targets: Ashdown Group: A thriving recruitment co...

    Ashdown Group: Part-time Payroll Officer - Yorkshire - Professional Services

    £25000 per annum: Ashdown Group: A successful professional services firm is lo...

    Day In a Page

    Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

    Fishing is on Nigel Farage's mind

    Ukip leader casts a line to the disaffected
    Who is bombing whom in the Middle East? It's amazing they don't all hit each other

    Who is bombing whom in the Middle East?

    Robert Fisk untangles the countries and factions
    China's influence on fashion: At the top of the game both creatively and commercially

    China's influence on fashion

    At the top of the game both creatively and commercially
    Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

    The man known as GOD has a reputation for getting the job done

    Lord O'Donnell's three principles of rule
    Rainbow shades: It's all bright on the night

    Rainbow shades

    It's all bright on the night
    'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

    Bread from heaven

    Dutch survivors thank RAF for World War II drop that saved millions
    Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

    How 'the Axe' helped Labour

    UK will be 'run for the wealthy and powerful' if Tories retain power
    Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

    The price to be paid for challenging the rule of extremists

    A revolution now 'consuming its own children'
    Welcome to the world of Megagames

    Welcome to the world of Megagames

    300 players take part in Watch the Skies! board game in London
    'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

    Charlotte Gainsbourg on 'Nymphomaniac'

    Starring in one of the most explicit films ever
    Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

    Robert Fisk in Abu Dhabi

    The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
    Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

    Vince Cable exclusive interview

    Charging fees for employment tribunals was 'a very bad move'
    Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

    Iwan Rheon is returning to his Welsh roots

    Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
    Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

    It's time for my close-up

    Meet the man who films great whites for a living
    Increasing numbers of homeless people in America keep their mobile phones on the streets

    Homeless people keep mobile phones

    A homeless person with a smartphone is a common sight in the US. And that's creating a network where the 'hobo' community can share information - and fight stigma - like never before