By the way ... Red tape HASN’T improved hospital safety

STRICTLY speaking, the quality of care across hospitals should be improving — after all, doctors are now subject to annual appraisals aimed at ensuring high standards. On top of that, since 2009 we have had the Care Quality Commission (CQC), the inspectorate that takes great care to identify poor practice and poor systems in hospitals.

But I find myself asking whether these regulatory bodies are achieving anything — or have they failed in their task? For, when it comes to maternity care, things have not improved in a quarter of a century.

There are just as many babies being injured or permanently damaged now due to failings in maternity care as there were 25 years ago, according to a recent report from NHS Resolution, the litigation arm of the NHS.

The NHS paid out more than £800 million in compensation in the year 2016 to 2017. With payouts at that level clearly something is seriously wrong in the system somewhere.

Analysis of these claims found serious examples of failings: for example, midwives failing to understand the data from heart monitors and medics trying to deliver breech babies despite having had no training in how to do it.

When there are errors in medical care, safety and better outcomes will only result when these stimulate opportunities for learning and change. And yet it seems that what actually happens when problems are identified is that even more regulation is imposed. However, we practise evidencebased medicine these days: so is there any evidence that the vast burden of regulation has brought about any improvement in obstetric care?

Quite the reverse. Which begs the question: who, if anyone, is keeping an eye on the expensive regulatory framework? Last year the CQC’s budget was more than £230 million. I’d like to say those regulators are worth every penny. But I’m not convinced.