As much spent on Maternity Compensation as Maternity Care

[RedToothBrush]

Ockenden also highlights a "startling statistic", that says clinical negligence is costing the NHS almost the same in legal compensation - as it spends on the delivery of maternity care itself.

This is how little women matter in political terms.

This isn't just a reflection of the NHS. It's in terms of how our society values having children.

It says everything.

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

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

And that is with huge social pressure not to sue. Imagine how big the bill would be if more people took action.

I've shared my birth story multiple times on here - QMC 2012. They gave me an amazing child, but they destroyed my physical mobility and mental health.

Apparently I should have pressed legal charges for assault for stuff that was done to me explicitly against my consent - but they just normalised it at the time - they said openly "we're not all that bothered about the mothers in here - we just care about the babies" - it's fucking Nottingham, not fucking Gilead.

And people knew, people knew back in 2012 - people knew they would use the threat of social services to terrify mothers into not rocking the boat, my community midwife knew when she was so horrified by my maternity notes she told me to photocopy them before they were archived.

And to the fuckwits on here who minimised what had happened, claimed it was OK and normal and that the healthy baby was the only thing at the end of it - it was fucking institutional abuse of women on a massive scale and it was most definitely NOT OK.

I got off lightly - but I still have heavy trauma all these years later.

Oh yeah and I'll add in the appointment I had with the "specialist birth trauma midwife" when I was pregnant with number 2... "if you've come in here to demand a cesarian because of how it was last time - you've got no chance".

Interesting opening gambit for a conversation that basically consisted of telling me I'd done childbirth wrong and they were right for 30 minutes.

I have a story about a family member and their family. They work at the Trust. They spotted a huge clinical error and were treated appallingly. Senior job. The Trust absolutely knew. Timescale is in keeping.

And women are berated for making a choice to have an ELCS because of the cost.

This is totally made up disinformation. The NHS budget is almost £200 billion annually. Pensions cost £17 billion Compensation for clinical negligence is around £3 billion. Unsurprisingly for an organisation employing about 1.8 million people the major cost for the NHS is wages of employees at over £80 billion.

Looking at the report is horrible. Can’t even imagine living it.

It’s so widespread, systemic. I remember when Friends and Family came in there was a London trust - so not Nottingham and not one of the other Trusts recently under the spotlight for diabolically dangerous maternity care - the F&F score for maternity services was 22%. In the department I worked in we regarded anything below 95% as unacceptable. I’m not going to say that the department was even particularly good, I don’t feel like defending anything at the moment. Just that that maternity dept must have been a complete shitshow.

Im glad this is on FWR. The compensation bill for injuries to mothers and babies should have an impact. I don’t understand why it hasn’t already. Same for mental health services. In Nottingham.

500 women and babies died under this trust

I mean ffs 500 women and babies or suffered avoidable harm

the additional details in the news today is just heartbreaking.
nhs seems to be too big for accountability

Awful. I’m so sorry that happened to you

And also even if a woman is inclined to sue how many will have the energy (mental and physical) and be well enough to after a traumatic birth? Many will just want to try and put it behind them and will stay in denial or be told something along the lines of “well what did you expect when you gave birth?”

I wouldn’t be surprised if the true compensation due wasn’t at least double what has actually been paid.

It’s important to note that the perinatal mortality rate for Nottingnam hospitals is comparable to any unit its size and population in the UK . I gave birth there and whilst the postnatal ward care was very patchy my consultant and midwife care was good .

And I’m not minimising the harm or poor culture that is shocking , just that in general childbirth is dangerous and risky and NUH no worse than anywhere .

I turned down the offer of a birth debrief because I just couldn't deal with revisiting any of it, and no chance I would have been strong enough to complain - let alone sue (I've got permanent pelvic problems from how they mishandled my SPD pelvis under spinal block). I'm only realising now, just how much I blanked out of the whole experience trying to get on with life, as the media coverage runs on and I suddenly remember another bit.

The other thing they did with me - I had horrific SPD pain, was on crutches and housebound from about 18 weeks so I was terrified of permanent damage, and when they told me they WERE going to do a spinal and I asked them to note the safe gap to move my legs so I didn't have permanent damage - they wafted a tape measure at me petulantly and said "THERE - DONE IT" (and then ignored it completely) - and they referred me to social services as a "resistant patient".
Then they ignored the pain free gap - hoiked my knees up around my earlobes (I was impressed - never knew I could be that bendy - sorry I have a dark sense of humour) and I'm left with a pelvis that still is fucking agony and misaligned to fuck so I've got a permanently painful pelvis and hip over 14 years later.

If your arrival on the post-natal ward is greeted with a safeguarding interrogation and then phone interviews with social services you have to conduct on the phone at the nurses' station in the corridor, and you've spent the night listening to them slag off patients (especially yourself) in earshot... you're going to be surviving having a newborn - and not in challenging services mode. It took me YEARS to be able to stand my ground on anything child-related because they made me so scared of that.

The thing is you only have to go on the old Shredded Bits threads to see that this isn’t just one trust, this is NHS maternity care across the board. The last maternity scandal was ‘the biggest ever’ a couple of years ago, now this one is. Unless they systematically go through every single trust in the UK they are never going to find out the full scale and extent of this issue. There might be a handful of trusts out there that aren’t like this but from the deluge of awful birth injuries and trauma that women have reported on MN, that aren’t taken seriously by hospitals and GPs, I believe this is the standard in the NHS and they should all be investigated and forced to improve. We’ve stopped talking about it in recent years to the extent that we did 5 years ago.

😱

I strongly suspect it isn’t only maternity care and that neglect and bad behaviour is endemic in the NHS. After all if it’s so bad that 14 trusts are still under investigation for one dept why would it be only that dept ?

This would be alarming if true but I already posted up thread that this is total disinformation. Maybe it is supposed to be a joke but it’s complete lies.

The total NHS budget is about £200 million with £17 billion paid out as pensions & £3 billion paid in damages for clinical malpractice. The NHS employs nearly two million people so unsurprisingly the largest single expense annually is £80 billion in wages.

I had always assumed that compensation was paid by insurance and not from the NHS budget. Is that not the case? Or perhaps the £3 billion isthe cost of the insurance?

And the average NHS pension is 7.5k to 10
k per year for context

The trouble is Carrie that NUH was graded as significantly worse than other Trusts and this review has taken place. Either the really quite extreme issues in the report do indicate that NUH has specific issues, or NHS maternity care is in a truly appalling level of crisis throughout.

I personally think it’s a bit of both? NHs maternity care perhaps is in an extremely poor state throughout. Perhaps the philosophy of care is based on essentially a 1960s setup - high levels of very young, healthy multiparous mothers, extensive NHS antenatal care, in new hospital maternity services where they routinely stay in postnatal for 1-2 weeks, with a lot of historically experienced and obstetrically skilled GPs backing up the service in the community. And I’m going to say it I suppose, a patient and staff cohort that were culturally more similar. Now we have a much older and medically riskier maternal cohort, GPs who haven’t delivered a baby in years and who rarely see a home birth, midwives/doctors/mothers who may all be operating in English as a second language with different first languages, antenatal care reduced to below the minimum, phone labour triage on the phone becoming a danger due to increasing staff bullying around being the one who tells mothers to come in to an overloaded service and therefore a culture of approval if you tell them to stay at home.

But if some of these figures are unique to NUH, that’s another thing. There’s a mention of 120 whole time equivalent midwife vacancies. I mean, what the fuck? That’s actual funded posts.

And it’s important to note the the maternal mortality rate of the UK is pretty terrible overall, currently 12.8 per 100,000. This is awful.

I don’t mean to be argumentative, but wouldn’t the report’s finding mean that it is worse than other places? The 500 women and babies harmed need not have been harmed or they wouldn’t have been included.

The NHS (each individual trust) pays a premium to an entity called NHS Resolution each year. NHS Resolution is like an insurance company in that regard and the compensation is paid by them. The 3 billion is the cost of the premiums. So it’s true to say that compensation doesn’t come from NHS working budgets but it’s not free money from somewhere in the ether. And about 40% of the payouts are for maternity cases.

I heard an interesting point made yesterday (it may even have been by Jeremy Hunt…), that in countries like Japan, the culture of unchallenged apology and immediate payment of compensation in maternity cases without the need to bring a legal case and prove malpractice, actually reduces the instances of it happening in the first place.
This is largely because instead of a defence culture where everything is challenged and argued and denied - leading to cases that do succeed being dismissed as failures, from the perspective of defending a case and trying desperately to not pay out millions - they are actually free to accept the issues that went wrong, study them and genuinely understand how to improve. It’s a ‘Lessons will be learnt’ approach where they actually do learn lessons and act on them.