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The NHS is facing an “absolutely shocking” £27bn bill for maternity failings in England, the Guardian can reveal, after a series of hospital scandals triggered a record level of legal claims.
Hundreds of babies and women have died or suffered life-altering conditions as a result of botched care in NHS trusts across the country in recent years, prompting the government to launch a “rapid” national inquiry.
Analysis of NHS figures shows the potential bill for maternity negligence in England since 2019 has reached £27.4bn – far more than the health service’s roughly £18bn budget for newborns in that time.
The number of families taking legal action against the NHS for obstetrics errors rose to a record of nearly 1,400 a year in 2023, double the number in 2007, according to figures released under the Freedom of Information (FoI) Act.
Labour MP Paulette Hamilton, the acting chair of the Commons health and social care select committee, said the figures were “absolutely shocking” and represented a “devastatingly high number of deaths and injuries of mothers and babies”.
She added: “The words ‘eye-watering’ come nowhere near to describing the enormous financial cost of these cases to the NHS, arising from failings within its own provision of care.”
An NHS source said about half of the 1,400 claims a year may not result in compensation payouts, so the amount paid out would be lower. However, compensation only accounts for part of the total 27bn figure, a larger share being legal costs. In the past six years, the NHS has spent £24.6m on legal fees for claims that did not result in damages.
NHS Resolution, the organisation that handles negligence claims for the NHS trusts in England, recorded in its most recent annual report, published on Thursday, that the cost of settling all maternity-related claims was £37.5bn. This amounts to nearly two-thirds of its total £60bn clinical negligence liabilities bill, a sum described by senior MPs as “jaw-dropping”.
Jeremy Hunt, the former Conservative health secretary, said: “It should be a matter of national shame that we now spend more on maternity litigation than the total cost of running maternity services.”
Hunt said the NHS was still not doing enough to learn from mistakes and the biggest problem was that clinicians fear being sacked for admitting errors.
Jess Brown-Fuller, the Liberal Democrat hospitals spokesperson, accused the Conservatives of a “scandalous” neglect of maternity services.
She added: “The crisis in our maternity services is being laid bare through the trauma that so many families have to deal with. Now these figures are showing just how much damage it is causing to our health service.”
The £27.4bn figure is the estimated value of maternity claims arising out of incidents since April 2019. NHS Resolution said the figure could change as there is an average three-year gap between an incident and a legal claim, the most serious birth injuries resulting in payments made over several years – and sometimes for the duration of the child’s life.
The figures have been revealed amid growing alarm about the state of maternity care in NHS hospitals across England. Wes Streeting, the health secretary, last month ordered a national investigation into “failing” services for women and babies, following a series of scandals in Shrewsbury and Telford, Nottingham, Barrow-in-Furness, Leeds and elsewhere.
Inspections of 131 NHS maternity units across England classed as many as two-thirds as “inadequate” or “requires improvement” for safety between 2022 and 2024.
The Care Quality Commission, the healthcare regulator, said issues including staff shortages were “systemic” and “widespread”, with almost half of the 131 maternity units it reviewed performing below standard.
Hamilton said the state of maternity care in the UK was “completely unacceptable”.
Previously unreported FoI figures show the NHS paid out £134m in the nine years to March 2023 to the families of nearly 300 women and about 400 babies who died in NHS settings.
However, the biggest settlements were for clinical errors that resulted in severe long-term disabilities, for which the NHS is liable for the lifetime costs of the child’s care.
As much as £1.7bn was paid out over failures to respond to abnormal foetal heart rates and £1.55bn for failing to properly monitor second-stage labour between 2006 and 2024. A further £247m was paid out over birth defects owing to clinical negligence.
Natalie Richardson, a medical negligence solicitor for Patient Claim Line, said there had been a 79% increase in the number of birth and pregnancy cases the firm had taken on this year.
Leeds teaching hospitals NHS trust, whose maternity units were last month downgraded to inadequate over safety concerns, paid out nearly £72m in compensation due to 107 obstetrics failings in the nine years to March 2024 – including 13 fatalities and 14 stillbirths.
In the same period, Nottingham University hospitals NHS trust was ordered to pay nearly £60m for 80 clinical damages claims related to pregnancies – including seven deaths.
That trust is at the centre of a vast criminal investigation into suspected corporate manslaughter over the severe harm of potentially more than 2,000 babies and women.
The Department of Health and Social Care said it had inherited “an unacceptable situation where too many families are suffering from botched care” and the NHS is “paying billions for its mistakes, rather than fixing them”.
It added: “We are committed to breaking that cycle and providing mothers and babies with safe, compassionate care once and for all.”
NHS England said it was taking immediate steps to strengthen maternity services, including closer oversight of underperforming trusts. It added: “We recognise that too many women and families are not receiving the high-quality maternity care they deserve, and we are committed to changing this.”
NHS Resolution said: “The high cost of compensation arising in maternity comes from a small number of very serious incidents resulting in brain injury to a baby at birth. These incidents are devastating for families and reflect the need to make provision for lifelong and complex care needs.”
