Sanja Strkljevic, a solicitor at Leigh Day, who specialises in cases arising from maternity care welcomes the independent review of maternity services in England, but with some caution.
It is reassuring that the National Maternity Review, published by NHS England earlier this month, found that the quality of maternity services has improved significantly over the last decade with a 20% fall in stillbirth and neonatal mortality rate between 2003 and 2013 and a reduction in maternal death rate.
The report called Better Births - improving outcomes of maternity services in England - aiming to improve care for women and their babies.
The Vision in the report states:
"Our vision for maternity services across England is for them to become safer, more personalised, kinder, professional and more family friendly; where every woman has access to information to enable her to make decisions about her care; and where she and her baby can access support that is centred around their individual needs and circumstances.
"And for all staff to be supported to deliver care which is women centred, working in high performing teams, in organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries."
The report recommends a personalised care centred on the woman, her baby and her family based around their needs and decisions, with a personalised care plan.
It suggests a personalised care budget providing women with more control over their care, be it through an existing NHS Trust or a fully accredited midwifery practice in the community.
The continuity of carer is another recommendation made, providing every woman with a midwife who is a part of a small team of 4 or 6 midwifes based in the community who know the women and their families and can provide continuity of support antenatally and postnatally.
The proposal for better postnatal and perinatal mental health care with calls for better resourcing are to be welcomed.
In terms of safer care; the report suggests that there should be rapid referral protocols in place for referrals between professionals and across organisations to ensure access to specialist care and that data should be collected routinely on quality and outcomes of services as performance measures.
The recommendation for a nationalised standardised investigation process for when things go wrong, ensuring honestly and learning, resulting in improvements in care is a leap forwards but it must ensure that the process of investigation should be thorough and open.
Baroness Cumberledge who drafted the report has suggested that there should be a system of “rapid resolution and redress” with a “no fault” compensation system in place.
It will mean that neither the hospital nor the doctors or midwives involved would have to admit any wrongdoing.
However, how such a scheme would be implemented, with a proper and detailed investigation into the circumstances of the birth, needs to be established before a person’s right to litigate is taken away from them.
Every legal case is a chance for the truth to surface followed by appropriate training or disciplinary repercussions. It also ensures appropriate compensation is provided on a needs basis after a proper assessment of the value of a claim.
Parents whose child was stillborn or died very early on in their life, are seeking answers for the tragedy.
Unfortunately, on too many occasions the internal investigation does not shed light on what actually happened and in most cases, parents have no choice but to instruct lawyers to get to the bottom of why their baby has died.
A scheme that lessens the ordeal of a protracted litigation process is to be welcomed but it should not take away a person’s right to litigate.