A catalogue of poor care led to criticism of the health watchdogs set up to protect NHS patients when things don’t go according to plan. A report on the scandal of mother and baby deaths which occurred at the hospital was released last week and found that at least 11 babies and 1 mother died at University Hospitals of Morecambe Bay NHS Foundation Trust as a result of below par care made worse by professional competitiveness.
Six midwives faced disciplinary hearings in front of the Nursing and Midwifery Council later in the year, but to date no nurses, midwives or doctors have been permanently let go. The investigation found that the midwives chose not to alert doctors about patient complications in time because of a so-called ‘turf war’ between the two professions. It appeared that midwives had not been on speaking terms with doctors, and claimed they were made to feel useless when doctors were called in to help with more delicate cases.
The report, commissioned by Jeremy Hunt, the health secretary, came down heavily on the Care Quality Commission, along with the Parliamentary and Health Service Ombudsman. It also said that the watchdogs have let the public down by covering up some of their own faults and, by not investigating the risks to patients.
The investigation interviewed over 100 members of staff and NHS officials, including Sir David Nicholson, former chief executive of the NHS and Cynthia Bower, former chief executive of the Care Quality Commission (CQC), and officials from NHS England and Monitor, the health service regulator – in a bid to get to the truth.
A separate investigation in 2014 was launched and accused CQC’s former senior officials of attempting to delete reports which highlighted their failure to act accordingly on the concerns of the trust.
In an official document from the investigation, more than 200 deaths of mothers and babies between 2004 and 2013 have been reviewed. There are around 50 deaths which raised a huge amount of concern, that they were examined in more depth, with as many as 30 now confirmed to have died as a result of below standard care. Cases reviewed included deaths of mothers in or after labour, stillbirths, and deaths of newborn babies.
It’s already facing at least 30 civil negligence claims from bereaved parents and those who say they’ve been a victim of poor care at the trust. The investigation was ordered by ministers after a long campaign by a bereaved father, James Titcombe, whose newborn son died in October 2008 from a simple infection which could have been treated with antibiotics at Furness General Hospital,
In a statement, UHMBT said it had apologised unreservedly to the families. Pearse Butler, the chair of the trust’s board said: “This trust made some very serious mistakes in the way it cared for mothers and their babies. More than that, the same mistakes were repeated. And after making those mistakes, there was a lack of openness from the trust in acknowledging to families what had happened. This report vindicates these families.
“For these reasons, on behalf of the trust, I apologise unreservedly to the families concerned. I’m deeply sorry that so many people have suffered as a result of these mistakes. As the chair of the trust board, it’s my duty to ensure that lessons are learned and that we do everything we possibly can to make sure nothing like this happens again.”
The trust added that the entire composition of its board had changed near the end of the period covered by the report and it recognised the need for improvement in its maternity and neonatal service. It also said it now had 50 more midwives and doctors, and had also improved its culture and team-working.