Catherine McKinnell (Newcastle upon Tyne North) (Lab)
I beg to move,
That leave be given to bring in a Bill to make provision for a fixed recoverable costs scheme to limit the costs that may be recovered in respect of certain cases of clinical negligence; to provide for regular review of the limits set by such a scheme; to amend the Law Reform (Personal Injuries) Act 1948; to require the Secretary to State to report on options for reform of clinical negligence compensation relating to obstetrics; and for connected purposes.
Horrified by the money spent on paying out for failure rather than on improving care, I was already set on bringing forward a Bill to implement some of the findings of our recent Public Accounts Committee “Costs of clinical negligence” report when Amie Evans from Forest Hall walked into my constituency surgery. Her story confirmed the urgency of the issue and the desperate need for change.
Amie, a teaching assistant, is a truly inspirational young woman. With unimaginable grace, she told me about the heartbreaking loss of her daughter Seren, stillborn last year, and its ongoing impact. She told me how the concerns she raised about reduced movements in the days leading up to her due date were simply not listened to. The fourth time she raised it, after her due date had passed, it was already too late.
On top of being utterly devastated, Amie feels completely failed by the medical professionals who were supposed to be taking care of her and Seren. Yet despite their grief, Amie and her partner Lewis have shown remarkable courage in campaigning to raise awareness and encouraging pregnant mothers to trust their instincts. She has succeeded in getting the hospital to review and change procedures in the hope that no other mother will ever have to experience such heartbreak.
Yet sadly, Amie is far from alone. Failures at maternity units across the country have sadly returned to the spotlight in recent years. The Secretary of State was right to commission a national review, led by Baroness Amos. Her interim report, published last month, sets out a horrifying catalogue of failings: culture issues, weak leadership, discrimination, and a lack of transparency and accountability when things go wrong. That lack of accountability is at the heart of the problem. Review after review have found families who feel ignored by hospitals, left desperately seeking answers and concerned that the same errors will happen again.
Rhiannon Davies and her husband Richard spent years calling for a review at Shrewsbury and Telford hospital following the death of their daughter, Kate, at just six hours old. Their steadfast commitment to ensuring that could never happen again led to the Ockenden review, which concluded that failures had led to the death of over 200 babies at the trust. Rhiannon said:
“All we wanted was the truth about why our daughter died. Instead, we faced years of denial.”
This theme of denial was front and centre of the Kirkup review into the Morecambe Bay NHS trust. One member of staff who was interviewed said as she left the room:
“Sometimes bad things happen in maternity—people just have to accept it.”
How can any parent have faith that lessons will be learned with attitudes like that? In Dr Kirkup’s next review into failings at East Kent, one parent said:
“Every time at the hospital, it always seems like one person is covering up for the next; they are a team and they work together, but they shouldn’t cover up when children are dying.”
As Chair of the Petitions Committee in 2021, I led a debate on black maternal healthcare, backed by 170,000 people calling for better care for black women, who continue to receive disproportionately poor outcomes in maternity care. I recounted the story of a woman who had said:
“As soon as the second midwife was on shift, she just seemed to have one goal in mind and that was delivering my baby as soon as possible. She didn’t seem to care about easing any part of my pain or reassuring me for the many worries I had at the time—she rushed my labour along and as a result almost cost me my son’s life.”
This is also personal for me. I had my own experience of poor care when in labour with my first child. Despite being in significant pain, nauseous and vomiting, and waters broken, I was sent away from the hospital numerous times. I was finally admitted as a full emergency, my unborn baby with a falling heart rate and in clear distress, both of us having endured 24 hours of unproductive, painful and dangerous back-to-back labour. I recalled afterwards that the midwives behaved more like nightclub bouncers than carers.
One even said to me, I think on the third time of being sent away:
“I know it’s exciting having your first baby”.
She clearly had never given birth. Fortunately both my daughter and I came through the experience without lasting damage, but when I read the stories of parents who have experienced the worst, I can see how close we came.
It is no surprise, then, faced with issues around accountability, denial and a lack of trust, that so many parents have to pursue legal avenues to get their answers. When mothers feel they haven’t been listened to and they hit the brick wall of NHS defensive culture, they have nowhere else to turn. Maternity claims are the highest-value negligence claims and can often involve babies born with catastrophic, lifelong injuries, yet the average birth injury claim in England takes six and a half years to conclude, during which time parents are trapped, having to fight for the support their child needs.
As the Public Accounts Committee’s extensive inquiry found, other countries have shown that a better, safer and more compassionate system is possible. New Zealand’s automatic no-fault scheme costs roughly half what England spends per capita. Japan’s cerebral palsy scheme combines compensation with a robust investigation and prevention programme, improving care while reducing claims. Sweden has a long-standing no-blame compensation scheme, where cases are assessed on whether it was avoidable, rather than proving negligence. This encourages transparency from clinicians and has contributed to a reduction in avoidable birth injuries. In Sweden, one baby fewer dies each day than in the UK. In Japan, that figure is two.
At the heart of this must be a willingness and openness to seek answers and learn lessons, so that healing can begin and care can improve. That is why this Bill calls for the incorporation of the lessons of existing maternity reviews and asks the Government to draw on international best practice, so that we can build a fairer, safer and more effective system in our NHS. The Bill also reflects the further findings in the Public Accounts Committee report. The Government’s liability for clinical negligence claims has quadrupled over the last two decades and now stands at £60 billion. When it comes to maternity, it is truly shocking that we spend more on failure than we do on the care itself.
NHS Resolution is working to resolve more claims without litigation, and that is welcome but it is far from enough. In 2024-25, claims under £25,000 in value cost the NHS £183 million, yet only £39 million—just £1 in every £5—went to patients in damages. The rest was absorbed by legal and defence costs. It is staggering that so much public money goes to lawyers, not to those patients who have been harmed or to improve care. The previous Government consulted on introducing a fixed recoverable costs scheme, mirroring the approach already used in many personal injury cases, and while it was agreed to three years ago, it remains under review. The Bill will put in place a system that will improve this, and I am grateful to the former Chancellor and Health Secretary, the right hon. Member for Godalming and Ash (Sir Jeremy Hunt), for supporting the Bill.
There is also a long-standing anomaly in how compensation is calculated, dictated by a law predating the NHS that prevents consideration that the NHS may be the best place for claimants to access ongoing care. As it stands, it can lead to the state effectively being double-charged. To ensure that every pound is focused on improving care and preventing harm, we must finally amend and update this law—this 1948 relic—to reflect modern-day reality.
Fundamentally, the Bill is not about numbers on a balance sheet, nor about restricting compensation for those who have experienced harms. It is about the mothers, patients and families who live every day with the consequences of failure, and who are crying out for a system that listens, learns and acts to reduce harm. We have to restore trust and have an NHS built on compassion, not defensiveness, when things go wrong. We must ensure that lessons are learned quickly and openly, so patients get the answers they need and a reassurance that the same mistakes will not happen again. The vast sums of money we currently spend on legal costs must instead go to improving the system, rather than forcing families into years of litigation just to get the answers they deserve.
For Amie, Lewis and baby Seren, and for all parents and babies who have suffered the most unimaginable harm, I commend this Bill to the House.
Question put and agreed to.
Ordered,
That Catherine McKinnell, Sir Jeremy Hunt, Marsha De Cordova, Mr Tanmanjeet Singh Dhesi, David Smith, Peter Prinsley, Rachel Gilmour, Mary Glindon, Jen Craft, Paulette Hamilton, Anna Dixon and Josh Fenton-Glynn present the Bill.
Catherine McKinnell accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 17 April, and to be printed (Bill 407).