New NHS Report Reveals a Rapid Rise in Obstetric Claims
The 2017 NHS Annual Report has highlighted a number of trends in the type of claims that they are receiving. Negligence claims are overall reducing (by 2%), but the total costs to the NHS are increasing (by 14%). One of the biggest costs is in the area of obstetric negligence. The NHS has put forward several different plans, with the aim of reducing these costs to the NHS, and reducing the occurrence of obstetric negligence overall.
Why are Obstetric Negligence Claims so Costly?
The injuries that result from obstetric negligence can be life-altering for the affected baby. In many cases, the child is left with irreversible brain damage or physical injuries, and in some cases the individual’s life expectancy is shortened. As a result, when the NHS pays out for these claims, the amount will cover the child for the entirety of its lifetime. This can be, in some cases, up to $5 million. To tackle these costs, the NHS has proposed a Safer Maternity Care plan, as well as a rapid resolution and redress (RRR) scheme.
Safer Maternity Action Plan
The Safer Maternity Care plan put forward by the NHS has the goal of reducing obstetric negligence claims, in addition to providing safer and more effective care for mothers and babies. There are a number of proposals that the plan suggests, with the primary aims of increasing staff education and training, providing greater transparency within hospitals and for consumers, and to increase staff communication.
The first part of the plan proposes that a £250,000 maternity safety innovation fund should be set up. Its purpose is to design and push new ideas that could improve maternity care, with the aim of improving babies’ care at birth. This fund follows the lead of another successful scheme known as PROMPT; this scheme has reduced the number of babies born with low oxygen (by 50%) and reduced the number of babies born with a paralysed arm by 70%.
Next, the plan suggests that maternity care ratings should be established, which will allow patients to more accurately assess the quality of their local maternity care facility. A secondary aim is that each clinical commissioning group will try to improve its rating, driving better care.
Finally, the plan also proposes that a Maternal and Neonatal Health Quality Improvement Programme should be established. The primary aim is for information-sharing to increase, to allow best-practice ideas to spread more easily. In Scotland, a similar scheme resulted in a 19% decrease in stillbirths over a period of 3 years.
Another approach has also been proposed: the RRR scheme. The purpose of the RRR scheme is to provide financial support to victims of an incident of medical negligence. This allows the family to access an “alternative system of compensation”, and families would avoid needing to bring legal proceedings. A number of criticisms of the RRR scheme have been raised, however, as detractors believe that legal proceedings can play a valuable role in getting families more than just compensation.
What Benefit do Legal Proceedings Provide?
The primary critique of the RRR scheme is that the issue of medical negligence should not be focused on cost. Instead, the focus should be on the victims and their families. The RRR scheme focuses too much on compensation as a solution to the problem of medical negligence, without recognising that the main benefit of legal proceedings for many families is that they get answers. The financial issue, while important, is a secondary one for most families. In saying that, if the RRR scheme does not compensate families sufficiently, they may be out of pocket when caring for a child with a lifelong disability.
A representative from Patient Claim Line, a medical negligence specialist firm that handles medical negligence lawsuits, notes that “these types of cases must be properly investigated, due to the large burden of care that falls upon the family of a severely disabled child. Without this thorough investigation, negligence can be missed, and the family ends up facing a huge cost without the financial means to support their child.”
In a court case, the biggest issue is proving that medical negligence has occurred. With the NHS keen to avoid paying out, cases usually become extremely complex with numerous experts being brought in to “determine whether negligence took place, and whether it caused brain damage.”
Both of the NHS proposals (the Safer Maternity Care Plan and the RRR scheme) have the important and admirable goals of providing safer maternity outcomes for mothers and babies. However, the secondary driving goal of reducing costs to the NHS may mean that the real issue is pushed aside: the first step should always be preventing negligence in the first place.