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Botched maternity care hurts budgets and lives

Giving birth is for many women a yearned-for experience, yet it is also a daunting one.

While the majority of deliveries are relatively free of trouble, all have an element of drama, especially for first timers, and when things do go wrong, it can be very frightening for those concerned.

So news that botched maternity care has landed the Scottish NHS with a bill for £108 million for negligence payouts over the last decade, and that complaints by patients are up by a quarter in four years, will do nothing to reassure mothers-to-be.

For the NHS to be doling out such sums in compensation when frontline care budgets are under such pressure, is hugely regrettable. That money could pay for a year's treatment for 3600 cancer patients. It is money that ought to be spent, as intended, on care.

The NHS, given the pressure it is under 24 hours a day, seven days a week, cannot be expected to operate flawlessly, but unfortunately, money spent on compensation payouts when shortcomings in medical care result in injury or trauma is always wasted money.

And to make matters worse, the sum of £108m does not even represent the full cost - the true figure will be higher still, since a number of health boards have, oddly, destroyed some of their older compensation records.

But this is not primarily about money. It is about trauma and hardship to parents, particularly mothers, and injury to babies. The good news is that after a surge in complaints four years ago the figures appear to have come down again, but levels are still 26% higher than they were, with one NHS board, Grampian, performing particularly badly.

Why should this be happening? It is not altogether clear, but if understaffing is in any way implicated in higher levels of complaints about unsatisfactory births, then that must be carefully monitored and addressed. The Royal College of Midwives reports that a baby boom three years ago was unexpected for maternity units all over the UK and did result in delays for women being transferred to settings where they could receive one-to-one care, but in Scotland the NHS is now said to be on track to meet a target number of midwives.

This is heartening news, as is evidence that staffing levels in Scotland's maternity units are better than in England, but it is also clear that maternity units face an ongoing increase in the number of women with complex needs and complex pregnancies, due to their age or weight, potentially requiring a higher level of midwife and obstetric care.

Staffing levels have to adapt to this change. It can be difficult to anticipate the number of health professionals a given population will need at any one time, but it seems unlikely that the work of Scotland's midwives is going to get simpler any time soon.

The aim must now be to drive down the number of complaints, so that ever fewer women leave hospital feeling upset or traumatised about the care they and their babies have received.

Too many are still finding that Scotland's maternity units fall well short of their hopes and expectations.

Contextual targeting label: 
Health

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