For far too long the focus of all Clinical Negligence reforms has been reducing the legal cost of the Negligence rather than concentrating on the root cause of the problem.

This year the Royal College of Obstetricians and Gynaecologists (RCOG) released their updated report Each Baby Counts, a national clinical improvement programme that aims to reduce the number of babies who die or are left severely disabled as a result of incidents during labour. Their evidence was that between 500 and 800 babies in the U.K. each year die or are left with severe brain injury because something went wrong during labour. Their commitment is to reduce this figure for unnecessary suffering and loss by 50% by 2020.

Without doubt RCOG’s position is commendable and if they get anywhere close to achieving their goals their efforts must be considered a success. Again this will have the undoubted effect of significantly reducing the legal costs associated with this type of incident. It may be argued that the unacceptable prevalence of such an injury has forced the hand of RCOG as costs and compensation in these areas could not be allowed to continue unchecked without tackling the cause. Perhaps the change in the discount rate increased the appetite for reform. I am sure that the pace of reform has been affected by patient advocates pushing for improvement.

What about the Royal College of Midwives (RCM)? We have all heard and some of us have sat in the antenatal classes where “breast is best” and unassisted midwifery led birth is claimed to be in the best interests of the baby and anything else will have a detrimental effect. Well the RCM now accept it was incorrect in portraying Caesarean section and epidural as abnormal.

Criticism in part arose from the Morecambe Bay NHS Trust investigation into avoidable deaths where it was admitted that Midwives desire for normal births at any cost had contributed to unsafe deliveries.

RCM have now accepted that “if you have a Caesarean section it does not mean that you're a failure. Something has happened in your birth that means you need some help and support…”

We have moved on from the early days of the NHS and “Call the Midwife”. We are somewhat more advanced in our understanding of medical science and while the NHS is very safe in many aspects it still could do better in others. If the RCM are going to adopt the proactive position similar to RCOG then this change of policy should be beneficial.

I am currently instructed in a number of birth injury cases and still births where the wait and see approach of Midwives contributed or caused the injury. Had communication been better or had they involved Obstetrics earlier I am confident that my clients would have had a better outcome. This is not a blame game. If these changes significantly reduce the prevalence of birth injury I will be overjoyed. After all as RCOG have said Each Baby Counts, let us hope that RCM also fully buy into this mantra and accept that the midwife does not always know best.

Jerard Knott, Curtis Law Solicitors LLP

The Medical and Serious Injury Team at Curtis Law is led by Jerard Knott, Associate Solicitor. We are committed to promoting Patient Safety. The team only acts for Claimants and is dedicated to providing a client care centered high level of service, providing the best possible advice and maximising damages. The department acts on a large number of fatal (including representation at Inquests) and high value cases. The department regularly advises on cases with valuation exceeding £1,000,000. We can be contacted on 01254 297130 or MedNeg@curtislaw.co.uk.