As much spent on Maternity Compensation as Maternity Care

Another report from Baroness Amos

https://www.bbc.com/news/articles/cddlgqpg7mzo

Which Donna Ockendon says will make no difference

Times so paywalled

https://www.thetimes.com/uk/healthcare/article/donna-ockenden-baroness-amos-report-maternity-row-5kfhsm8p5

Archive ph doesn't seem to work anymore?

https://archive.ph/HB4JW

Just a note on the compensation figures - obviously there's a sum paid out (£1.1bn for maternity, or thereabouts) but there's also the total cost of dealing with negligence claims, which includes paying lawyers, staff time involved in doing paperwork and so on. It's not trivial.
https://www.theguardian.com/society/2025/oct/17/nhs-medical-negligence-liabilities-hit-60bn-amid-surge-in-maternity-payouts

This

Ok, I apologise, it was crossed wires. I thought you were challenging the whole premise of the thread, not that comment.

I was contradicting the disinformation posted that

Someone once told me the nhs budget is divided equally into 3

1. NHS pensions
2. Compensation
3. The actual cost of running it.

I think it's meant to be a joke as it's so ludicrously untrue. The annual NHS budget is about £200 billion Pensions paid out cost £17 billion (for 1.2 million pensioners). About £3 billion per year is paid out in compensation. Unsurprisingly for an organisation employing 1.9 million people the major cost for the NHS is £80 billion on wages.

For some reason you linked to an article in the Guardian which neither contradicted me nor supported the disinformation that I had highlighted.

Ok, that makes sense, thanks. Still not sure why you thought the comparison was totally made up, or a joke? I hold no brief for the Guardian but this does seem to stack up as a large amount.

Yes, I know. The pp says its comparing a figure across 7 years with an annual figure. Not according to the Guardian, both figures are based on the period 2019-2026.

The Guardian figure is comparing the cost of newborns with the total cost of maternity claims (which includes payments every year to the children damaged in childbirth and so adds up the total lifetime cost of those payments).

You cannot punish individuals financially. It would be grossly unfair. Medicine is a team sport. It's very rare that mistakes made only by one individual was to blame. It's always in the context of staff shortages, inadequate equipment etc etc just as there was at QMC.

The NHS spends about £5 billion per year on maternity & neonatal services with the latter accounting for a bit under a billion pounds annually.

www.england.nhs.uk/long-read/maternity-and-neonatal-infrastructure-review-findings/

NHS Resolution (the organisation that deals with compensation) paid out a bit over £3 billion last year. Matermity may be only 40% of claims but will be the majority of the damages paid out as individual cases will be awarded millions for lifelong care.

https://resolution.nhs.uk/2025/07/17/nhs-resolution-resolves-record-numbers-of-compensation-claims-through-collaboration/

You said this “compensation for clinical negligence” is 3 billion. Are you just referring to maternity here? Because that excludes 60% of claims which aren’t maternity related (I read somewhere, again correct with actual amount if wrong) so the full clinical negligence budget is surely going to be higher, no?

The article says the 18 billion in the comparison is the amount which would have been spent on newborns over the same time, not the annual budget. If that’s wrong, thats on the Guardian. Is it wrong? And you didn’t explain anything, you just handwaved it away.

You'd never get the well-performing trusts = better pay thing through because you'd just create silos of shit where only the people who can't get a job elsewhere go and things get worse and worse. Also, you get teams like mine - which are fantastic teams but within a really shit Trust - we work our arses off for our client group but the Trust ends up in the media for problems with another clinical area constantly - I'm not suffering (more than we all currently do) cos other services can't get their shit together.

I love my client group, love the area I serve - I could jump ship across a county border to an outstanding Trust (which has quadruple the waiting times for our equivalent service as we do) - that's not going to improve the service for my current patients.

There are issues with accountability, with how hard it is to get unsafe colleagues out of posts they've got into, with the "retired in post" skive mentality - but don't destroy the good along with it - we're the duct tape and optimism holding services together at all!

The NHS covering it gives them a reason to cover it up within the trust. Make the individuals get insurance - if they are aided costs go up which will act as a strong reminder to the individual how to behave.

In addition to the above any NHS trust covering up or ignoring issues along the lines of Nottingham - all senior staff should lose a years pay - without being released from their contract so they can’t just quit. Fuck them over make them pay for the mistakes for once.

Its probably not practical and there will be some legal bollocks as to why it won’t work but it is about time someone paid for the harm caused.

As I posted just above the NHS covers payment of damages for individual HCPs regardless. There was a time when doctors had their own professional indemnity insurance but that became so expensive for the individual it had to be covered by NHS Indemnity instead.

Yet time and time again staff get away scot free with no consequences for their actions. That needs to change. The behaviour described here isn’t accidental errors. It is consistent bad care, gaslighting and abuse.

Staff would have to have individual insurances to be allowed to practice - the insurance would have to pay - and there should be financial penalties for trusts that under perform and cover up this stuff - loss of pay to individuals including the head of trust.

Well performing trusts should get better pay - with patient outcomes assessed and patients able to contribute to the outcome.

Any damages awarded against an individual doctor, nurse or midwife will be paid by the NHS. Doctors used to pay for their own indemnity insurance with MDU or similar but it got so expensive that the government agreed the NHS would pay for all damages instead. This is regardless of how blameworthy the HCP may be.

from a compensation pov there’s no point suing an individual who lets face it as a nurse, midwife or doctor is not going to be able to pay much.

you could argue well it’s a deterrent for poor practice but how can you prove what caused an individual’s poor practice? Were they lazy, negligent or did they have an unmanageable workload? What contributed to the error.

As a midwife I once made a medication error. I gave a woman propess for an induction who’d had a previous lscs. Which is a contradiction. She had been seen in clinic, booked for induction and the medication prescribed. Induction women came in every morning and one midwife looked after them all (5 women), their arrival times were staggered 15 mins apart. Previously it had been an hour gap. When it moved to 15 mins I flagged it as a risk and was told to stop moaning. There is so much to do, show the women where stuff is on the ward, answer questions, explain the process, do a full antenatal check, start a ctg, check the ctg, 30 mins later give propess, then start the post propess ctg, check that ctg, document. The idea was to keep the ward running smoothly you’d run from one to the next, you couldn’t finish one woman completely before starting the next. By the time you’d done the antenatal check on the first woman, the second and maybe the third had turned up. I’d checked the drug was prescribed and gave it. I had no idea she’d previously had a lscs because I didn’t have time to go through her notes and to be honest it never crossed my mind to check for this anyway as a doctor surely wouldn’t have prescribed it if she shouldn’t have it!

I was newly qualified then and learnt a lesson for sure. But the pressure of that system was awful and made mistakes more likely. Luckily everything was fine but if it hadn’t been should I have been sued? When the position I was put in contributed to it?

I think a lot of staff would leave if it was thought that individual employees could be sued. We could as things stand be charged with manslaughter if things go really wrong. I’ve heard of this happening with some nurses who didn’t check a patients glucose levels frequently enough.

Actually - even if I had been "allowed" (god it sounds like we're naughty schoolgirls) an elective section with DD2 on the grounds of birth trauma after what QMC did to me - I wouldn't have taken it because no way was I prepared to risk being even MORE vulnerable post-op on the same type of ward that I'd gone through hell in previously.

What I needed, and what I did as much pushing for as I could, was a reassurance that I'd be prioritised NOT to be sent over to QMC for DD2 - at the time I was pregnant with both of them (2012/2013 ish) there was quite a number of situations where one labour ward or the other would be closed due to being overcapacity and women would be sent running around Nottingham to the other site despite birth plans and ante natal care and everything else having been carried out at the other hospital. It was so frequent it had almost become accepted and normalised.

The HUGE RED capital letters over my maternity notes I'd written begging them not to send me over to QMC might have offered some leverage as well - the midwives at the City hospital were actually fuming when they heard some of what had gone on and saw how traumatised and terrified I was.

The single biggest issue with maternity care is that they do not listen to mothers either way.

Time after time in all the literature you are given by midwives you are told "listen to your body" "go with your gut" but when you try to do that they bully and pressure you into choices you don't want to make.

I had a home birth with my second that I had to fight for so hard. They pushed and pushed me to be induced. They scheduled induction without my consent and they did not listen to me and tried to push me down the "Saving babies lives" care package route with pathetic and unrelated "horror stories". It was awful and that level of intervention could have gone to someone who actually needed it.

They thought my daughter was SGA but they measured me incorrectly at booking and so all my measurements and charts were off and they would not amend them later on - my daughter was born a bang average 7lb7oz.

Tbh I think individuals who provide poor care need to be held accountable- at the moment it’s very rare for anything to be done and difficult to sue an individual (I don’t know if it’s possible at all).

If these people knew they could loose their job, their licence and their home from being sued they might have an incentive to not provide such shit care.

And then the trust might stop covering it up on their behalf as it won’t be the trust being taken to court - it would be the person.

RedToothbrush is right about the lack of data. And we need to distinguish between research (where you take a sample of, say, 1,000 women and extrapolate from that) and hard statistics. The NHS records the number of caesareans, but the only distinction it makes is between emergency and planned/elective.

So we don't know the reasons why women are having planned caesareans. Is it because of personal preference? Is it because they had a caesarean with their first birth, and therefore have been advised a caesarean is safer for their second birth? Is it because their baby is breech, or because they have a condition such as placenta praevia or placenta accreta that would make a vaginal birth dangerous or impossible? We don't know.

Neither do we know the reasons for the increase in emergency caesareans.

The disinformation is in quoting a figure for claims over seven years & then comparing it to an annual budget. £27.4 billion over seven years is about £3.19 billion per year very near to the figure I gave of £3 billion for compensation paid out annually.

The £27.4bn figure is the estimated value of maternity claims arising out of incidents since April 2019.

If maternity claims over the last seven years amount to £27.4 billion then the annual average would be £3.19 billion for claims compared to the £3 billion paid out that I gave in my post.