Maternity services in England are so inadequate that cases of women receiving poor care and being harmed in childbirth are in danger of becoming “normalised”, the NHS regulator has said.
A Care Quality Commission (CQC) report based on inspections of 131 maternity units sets out an array of problems, adding to the sense of crisis that has enveloped an NHS service that cares for the 600,000 women a year who give birth and their babies.
The watchdog’s grim findings came as Wes Streeting, the health secretary, admitted he felt acute anxiety about “the risk of disaster greeting women in labour tomorrow”.
In its report, the CQC says problems in maternity care are so ingrained that:
Some women, frustrated at facing such long delays in being assessed at triage, discharge themselves before they are seen.
65% of units are not safe for women to give birth in, 47% of trusts are rated as requiring improvement on safety and another 18% are rated as inadequate.
Some hospitals do not record incidents that have resulted in serious harm.
There is a widespread lack of staff and in some places a lack of potentially life-saving equipment.
Hospitals do not always consider women’s suffering after receiving poor care.
Nicola Wise, the CQC’s director of secondary and specialist care, said: “We cannot allow an acceptance of shortfalls that are not tolerated in other services.”
She said it was vital that the NHS ensures “that poor care and preventable harm do not become normalised, and that staff are supported to deliver the high-quality care they want to provide for mothers and babies today and in the future”.
Streeting underlined the seriousness of what he called the crisis in maternity care at an event on Wednesday to launch a report by the IPPR thinktank on improving health in the UK.
“When it comes to the crisis in our maternity services across the country, it is one of the biggest issues that keeps me awake at night, worrying about the quality of care being delivered today [and] at the risk of disaster greeting women in labour tomorrow,” he said. “I think that what we have seen, in the case of specific trusts, are problems and risk factors that exist right across maternity services across the country.”
He also said the dire state of the public finances that the Labour government had inherited meant it could not extend free school meals to every primary school child in England. Last week the Child Poverty Action Group, the Royal College of Paediatrics and Child Health and the National Education Union urged ministers to take that step in order to reduce the number of children who do not have enough to eat and also the rising numbers who are overweight.
Streeting emphasised Labour’s determination to address the UK’s status as “the sick man of Europe” through concerted action on public heath.
“I think we are in this appalling situation when we are living longer but becoming sick sooner. That’s terrible for the quality of life, it’s also terrible for the country, for the labour market and for the financial sustainability of our health and care services,” he said.
However, he added that despite Labour’s plans to reduce the burden of killer diseases, he would not become “the fun police” and start checking what people were eating and drinking.
In better news for the NHS, it has won praise from the Commonwealth Fund, a US-based global health thinktank. It judged that despite its woes it was the third best system out of 10 it analysed, especially because it provides care that is universal and free to obtain at the point of need.
“The NHS may be in deep trouble right now from a UK perspective, but it is all relative. The US is worse on nearly all accounts,” said the report’s co-author Reginald Williams II. “While waitlists may be an issue and facilities need upgrades, the cost of health is not bankrupting individuals [as it is in the US].”