Tuesday, November 18, 2008

NHS a huge flop at maternity care

One billion pounds in compensation payments!

Errors that caused serious harm to mothers and babies have accounted for nearly half of the 2.1 billion pounds paid out as a result of medical negligence since 1995, The Times has learnt. A total of 947 million has been spent on compensation relating directly to obstetrics, reflecting the increasing cost of lifetime care for children who have suffered brain damage, cerebral palsy or developmental delay. The scale of the cost — enough to hire thousands of consultants or midwives — reveals the growing burden of claims on the health service at a time when maternity wards are short-staffed and the birthrate is rising. Medical colleges say the chances of harm to mother or baby are lower than ever, but they remain concerned that shortages of consultants and midwives leave patients at risk.

Taking into account a backlog of cases from the 1990s, the cost of maternity-related claims has risen from 163million in 2003-04 to 288 million in 2007-08. The figures, revealed by the NHS Litigation Authority in answers to parliamentary questions by Harry Cohen, the Labour MP for Leyton & Wanstead, reflect the cost of settled claims awarded under the Clinical Negligence Scheme for Trusts. But this does not include cases that preceded the authority's creation in 1995, some of which have arisen from health problems diagnosed years after birth.

Medical colleges said that the total bill for litigation put the 330 million pledged by the Government to improve maternity services into sharp relief. As The Times reported in September, trusts have had trouble identifying specific funding promised over three years to help to implement a policy document, Maternity Matters, that promised all women dedicated care from a midwife by the end of next year.

Louise Silverton, the deputy general secretary of the Royal College of Midwives, said that the cost of claims “underlines what a false economy it is to cut back on maternity care”. “Women keep hearing about these excellent government policy statements such as one-to-one care in labour from a midwife,” she said, “but they are not getting that sort of treatment in many areas such as the East of England, the South West and London. Our members are telling us that they are overworked and overstretched and are running between beds dealing with, in some cases, three women at once.” Overall NHS spending on maternity in England was cut by £55million in 2006-07, while the birthrate has risen by 16 per cent — equivalent to 90,000 extra births — since 2001, Ms Silverton added.

Tristian Blomfield, 8, from Watford, Hertfordshire, received a compensation package of just over 8.26 million after suffering permanent brain damage at birth. He has cerebral palsy in all four limbs and requires constant care. West Hertfordshire Hospitals NHS Trust, which manages Watford General Hospital where Tristian was born, offered his family an unreserved apology and expressed hope that the agreed settlement would provide them with security for the future.

Sabaratnam Arulkumaran, the president of the Royal College of Obstetricians and Gynaecologists, said that only six in every 1,000 births resulted in a litigation claim. But at that rate trusts had to set aside 500 pounds for each birth as a form of insurance, he added. “In a busy maternity unit of 5,000 births or more, we believe there needs to be 24-hour consultant cover to deal with emergencies and prevent disasters better. Rather than have more negligence cases and pay out on more claims, we should spend on more consultants, better training and reduce the number of cases,” he said.

A spokesman for the Department of Health said: “The UK remains one of the safest countries in the world in which to have a baby.” [Compared with Africa, I guess]


Australia: The mayhem in North Queensland public hospitals continues

And all the managers and administrators have been no help at all. The cardiac unit at Townsville had to be closed because of infighting and now Cairns hospital seems to be going down the same road

QUEENSLAND Health faces unprecedented legal action after a report found a junior surgeon was harassed by senior Cairns Base Hospital doctors. The Royal Australasian College of Surgeons, in an independent review, cleared doctor Heng-chin Chiam, 39, of allegations of incompetence and botched surgery. The father of three, who has been off work on five months stress leave was a "cautious but safe surgeon" whose medical skill could not be faulted, the audit found. The University of Queensland-educated specialist was a victim of "harassment" allowed to "fester" by management, it said.

CBH director of surgery Christina Steffen, who stood down in defence of Dr Chiam, yesterday told The Courier-Mail the findings opened the way for legal action. She said it was a clear case of "workplace mobbing" by a group at the hospital. "This is a surgeon who has had his whole career destroyed where there is no basis and nothing proven," Dr Steffen said. She said they had both been the victims of the "virus" or "cancer" of malicious rumour and unfounded accusations.

Queensland Health did not respond to questions about the alleged workplace harassment, except to say "all appropriate action will be taken".

Dr Chiam said he had been hurt and demoralised by the claims, made in secrecy under the Whistleblowers Act, but still wanted to return to work. The medico had been investigated twice before for the same complaint but both internal inquiries found no evidence to support the allegations. Dr Chiam felt he had been denied natural justice.

Four surgical procedures a week had to be cancelled with the two full-time surgeons on stress leave. Two months ago, a separate inquiry was launched when Dr Steffen revealed concerns of a party culture at the hospital. She claims that a group of doctors held a booze-fuelled staff meeting and joked about a patient who bled to death on the operating table. "When there is a power vacuum such as at Cairns Base Hospital with a transient ... administration, it allows the formation of these powerful cliques," Dr Steffen said.


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