The Department of Health has today published its Safer Maternity Care Action Plan.
The Plan aims to improve the quality of healthcare provision to mothers and babies to reduce the incidence of stillbirth, neonatal injuries and neonatal and maternal deaths.
However, much of the media coverage has been focussed on the proposed introduction of a new Rapid Resolution and Redress scheme. The effect of the scheme would be to provide compensation to families where a baby has suffered injuries around the time of delivery and where the delivery had been after 37 weeks’ gestation and that the baby had been entirely healthy at the onset of labour. The aim is to provide compensation simply on the basis that the treatment provided or not provided can be shown to have caused damage.
The policy does not require an investigation into whether the treatment provided was negligent or not.
It is said that doing so will foster a more open and transparent culture within the NHS so that, where mistakes are made, staff feel able to be open about those mistakes, learn from them and improve the quality of care to mothers and babies in the future.
Anything that will reduce the incidence of these catastrophic, and often avoidable, injuries must be welcomed. As a Solicitor dealing with these types of claims, I would much prefer to have a smaller caseload because these devastating injuries had not happened in the first place.
It is also anticipated that such a scheme would provide compensation to families rapidly to enable them to put in place without delay the key care packages and therapy regimes that brain injured children require on a day-to-day and often 24-hour basis.
It is essential that the primary focus of any action plan should be upon improving the provision of care at the frontline to prevent the injuries occurring rather than focussing on how to address the matter of compensation once the horse has bolted.
Perhaps Jeremy Hunt was alluding to difficulties with the provision of frontline care when he was quoted by the BBC today saying that the NHS maternity staff, “did a fantastic job under huge pressure”. Perhaps the huge pressure that our frontline staff are working under should be the focus of his campaign?
In my own experience of dealing with these types of claims and many others, there is already a culture of openness within the NHS. It is not uncommon to find that a Hospital Trust will have undertaken its own investigation into the circumstances surrounding a patient’s injury and, in the course of that investigation, it will have identified shortcomings. Unfortunately, it is also not uncommon to find that, when those shortcomings would be considered to represent negligent treatment, and they are brought to the attention of the Trust and their lawyers, liability is all too often denied only to be admitted at a later date once considerable additional and avoidable costs will have been incurred and precious time wasted that could have been spent reaching a sensible early resolution to the matter.
It should, however, be emphasised that if a family participates in the Rapid Resolution and Redress programme, it still has the option of resorting to the Courts to pursue a conventional claim if the outcome of the scheme is unsatisfactory.
I note that the proposal is that it will be an insurance based scheme with medical and legal experts considering whether compensation should be paid and an insurance assessor undertaking the process of assessing that payment. One hopes that the assessment process will be an impartial one.
However, the proposals do not address the very real problems of assessing compensation for neonatal brain injury at an early stage because the child has yet to develop. I hope that the scheme would at least allow for an early interim payment to set up initial care provision.
Finally, in its announcement today, the Department of Health makes reference to the Swedish Scheme which is considered to have been a success. In its Safer Maternity Care Action Plan, there is little detail on the Rapid Resolution and Redress Scheme and one has to look to the National Maternity Review Report for further information. I note, with some concern, the following:
“Successful insurance schemes, as in Sweden, offer a capped amount of damages and are therefore considered only to be fair and efficient models of compensation in countries who have generous social security provisions. We maintain that England has such a social security system and therefore a lower compensation payment combined with the additional benefits to learning, speed of redress, reduced harm and costs make the scheme a worthwhile option for families, clinicians and government to seriously consider.”
One wonders where the Government’s true intention lies…