MPs say 1,000 babies die preventable deaths in England each year
Commons health committee says NHS has reduced baby deaths significantly but could do more to improve safety
A thousand babies die preventable deaths every year in England because a culture of shifting blame and keeping tight-lipped means lessons are not learned after mistakes happen on NHS maternity wards, a report by MPs has said.
Almost two in five childbirth units still provide care that is unsafe to some extent, despite maternity care improving in recent years after a series of scandals, the health select committee said in a hard-hitting report published on Tuesday.
The cross-party group praises the NHS for the “impressive” 30% fall in neonatal deaths and 25% drop in stillbirths over the last decade. But the MPs said in the report: “The improvement has come from a low base and if we had the same rate as Sweden approximately 1,000 more babies would survive every year.”
Jeremy Hunt, who chairs the committee, stressed that most births in the NHS were safe, but some families experience “a devastating outcome” when errors occur.
The ex-health secretary said: “Despite a number of high-profile incidents, improvements in maternity safety are still not happening quickly enough. Although the NHS deserved credit for reducing baby deaths and stillbirths significantly, around 1,000 more babies would live every year if our maternity services were as safe as Sweden.”
It highlights how Sweden halved the number of avoidable birth injuries in its hospitals after it introduced a no-blame compensation scheme for injuries sustained as a result of medical treatment. It involves maternity staff speaking openly and honestly about why things went wrong that led to a baby, its mother or both suffering serious injury or dying.
In Sweden, compensation is paid to those who have suffered as a result of maternity failings purely on the basis that care was not good enough, unlike in the NHS, when negligence has to be proved. This contributes to what MPs describe as a damaging and persistent “blame game”. Experts credit the Swedish approach with encouraging health professionals to be upfront when mistakes happen, which in turn leads to a greater willingness to learn from failings.
Failings in maternity care cost the NHS in England £2.3bn a year, the report says. They are enduring despite a series of initiatives by the government, NHS England and professional bodies, MPs found.
Dr Edward Morris, the president of the Royal College of Obstetricians and Gynaecologists, which represents maternity doctors, said: “We acknowledge that stillbirth rates are still higher in the UK than many other high-income countries, with Sweden leading the way. While huge amounts of progress have been made and the number of stillbirths is going down, the death of any baby is a tragedy.”
Prof Ted Baker, the Care Quality Commission’s chief inspector of hospitals, told the committee’s inquiry into the safety of childbirth care that its inspections had found that 38% of NHS maternity services “require improvement for safety” – more than in any other medical speciality.
Baker also said hospitals “still had not learned all the lessons” from maternity care scandals at the Morecambe Bay, East Kent, and Shrewsbury and Telford NHS trusts, in which scores of babies and mothers sustained serious injuries or died. Enduring problems included “a defensive culture, dysfunctional teams and poor quality investigations without learning taking place”.
Lack of staff is the main reason maternity care can prove unsafe, the MPs say. Units are short of 1,932 midwives and also need 496 more senior doctors, while in a recent survey 80% of midwives told the Royal College of Midwives that they believed there were too few staff to ensure safe care.
Dr Bill Kirkup’s report in 2015 into the “serious and shocking” problems he uncovered in Morecambe Bay led ministers to pledge major improvements in maternity care. They included halving the number of stillbirths, neonatal deaths, brain injuries and maternal deaths by 2025.
But a panel of experts the MPs asked to assess the government’s progress to date said the speed of implementation of key changes “requires improvement” – a rating the CQC can award to hospitals found to be offering poor or unsafe care. They gave that rating to the government’s progress on maternity safety, safe staffing and women having the same midwife throughout their pregnancy and labour.
The MPs also found that, while stillbirths and neonatal deaths were falling, women from black, Asian and minority ethnic and poorer backgrounds were still more likely to experience either outcome.
“Babies should not be at a higher risk of death simply because of their parents’ postcode, ethnicity or income,” said Clea Harmer, chief executive of the stillbirth and neonatal death charity Sands.
The Guardian approached the Department of Health and Social Care for its response.
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