Maternity Services Inquiry – Litigation as an Aid to Change

In November 2020, MPs held the second session of oral evidence as part of the Health and Social Care Committee’s Inquiry into the safety of maternity services in England.  The Inquiry was established following the recurrent failings in maternity services at, most notably, East Kent, Shrewsbury & Telford and Morecambe Bay Hospitals. 

Whilst the Government has introduced a number of initiatives to drive the improvement of maternity services, it is clear that further action still needs to be taken to improve safety for both mothers and babies.  Charities such as GBSS contribute a huge amount to improvements in the field of maternity services and the impact of their work helps to reduce the incidents of stillbirth, neonatal death and brain injury during delivery.  There are many initiatives that are progressed thanks to the hard work and dedication of these charities; the most recent example being the International Plan to defeat Group B Strep Meningitis which was endorsed by the World Health Assembly in the middle of November 2020.

Litigation as a way to change the provision of care

I was particularly interested in the most recent oral evidence heard by the Health and Social Care Committee’s Inquiry as this focused on the role of litigation in the improvement of maternity services.  I have long been a believer that litigation can be an aid to change.  The cases that my team and I deal with which involve failings in care at delivery, antenatal care and neonatal care all demonstrate lessons to be learned which can prevent similar incidents happening again in the future.  Whilst the litigation process cannot force a particular hospital to change practices, or for that matter the whole of the NHS, in every clinical negligence case which we deal with at Enable Law, we always work with the family to explore the changes they would like to see come out of the case.  It is a way to provide a lasting legacy for their child who has very tragically died.  We regularly ask for changes to protocols, the introduction of local guidelines and reassurance that training will be introduced and given on a regular basis.  We also routinely ask for a formal written apology to be provided to the family.  Often this is all the family really wants.

The importance of your hospital’s response to questions

The evidence given at the Inquiry on 3 November 2020 by two bereaved fathers, James Titcombe and Darren Smith, was really moving.  Their evidence highlighted that the response by a Hospital Trust when a baby has died is so important.  Most families I speak to simply want answers as to what happened, an explanation, an apology if things went wrong and reassurance that practices have been changed for the future so that no other family has to go through what they have endured.  The evidence of James and Darren showed that often the internal inquiry that the hospital conducts is lacking and produces more questions than answers.  Quite often the shutters come down and it is very difficult to obtain any more information.  There is a need for transparency and a need for a relationship of trust to be built up during the investigation stage when a baby dies.  More importantly, it is essential that there is a relationship of transparency and trust during the antenatal and obstetric care and treatment of pregnant mums to, hopefully, avoid some of the tragic outcomes in the first place.

Hospitals need to be honest

The evidence given to the Inquiry showed that if a Hospital Trust fails to be honest and open after a baby has died, the family have no option but to pursue a medical negligence claim.  Whilst this claim is ongoing, it is difficult for families to grieve.  Quite often parents are suffering from a psychiatric injury as a result of what has happened to them and their condition can be aggravated and prolonged by the response that they receive from the Trust.

I have been helping bereaved families find answers to their questions for over 20 years.  In nearly every case families seek mine and my team’s help because the hospital’s investigation has been lacking, they have not been listened to, there has been a lack of transparency and candour, they want to prevent this happening again and they want to receive an apology.   The strength of these families never ceases to amaze me.  The openness and bravery of James Titcombe and Darren Smith in giving their evidence to the Health and Social Care Committee was very humbling.  Nearly all of the charities that have been set up to drive change, improve care and reduce the number of baby deaths are set up by bereaved parents and bereaved families.  The work they do and the dedication and kindness they show is truly awesome.  Without these charities and the work that they do, I am sure the incidents of baby loss would be higher.  I only hope the Inquiry, once it has finished assessing all of the evidence, is able to reach some conclusions that lead to positive and effective change to improve safety in maternity services and to use the valuable learning points that litigation produces in every case to effect change and prevent more families having to go through such a tragic and life-changing event.

Support for dads after losing a baby

Losing a baby is extremely difficult for any parent, and the pain of loss can be overwhelming. Fathers may feel extra pressure after losing their baby, as they are often seen as the ‘strong’ one, in control of their emotions and the ‘breadwinner’ of the family. There is often an expectation that the father needs to stay strong for his partner and return to work (even if they aren’t ready) to ensure they have an income.

This extra burden means that support for fathers is often overlooked, when in reality, they need just as much support after the loss of a baby. Comforting a partner through their grief can result in feelings of isolation and loneliness for the father.

We work closely with many charities at Enable Law and have provided some brief information below on a few charities that offer support tailored to dads after baby loss:

• JOEL: The Complete Package
  • JOEL have a Facebook page dedicated for dads. They have various groups across the UK and aim to promote a positive mental wellbeing in men. The groups take part in a range of activities as opposed to a support group.
• Sands – Sands United FC
  • Sands provide bereavement support services following stillbirth or neonatal death. Sands United FC is a unique way for dads and other bereaved family members to come together through a shared love of football. The support network enables members to talk about their grief when they are ready.