Baby death report fuels call for review

Health and Disability Commissioner Ron Paterson

A damning report into the death of a baby at Auckland's North Shore Hospital following a communication breakdown between a midwife and a senior hospital registrar has fuelled calls for a national review of maternity services.

The report, released today by the Health and Disability Commissioner Ron Paterson, has highlighted a lack of accountability for private maternity providers using public hospitals.

Mr Paterson found that both the private midwife and a senior registrar made mistakes in their management of the labour. The newborn baby died due to the delay of an emergency caesarean operation.

The baby -- the first child of a 37-year-old woman -- died at North Shore Hospital in 2004, two days after being born by emergency caesarean.

In his report, the commissioner said the "confusion" over who was responsible for the mother during labour was not confined to Waitemata District Health Board (DHB) and the issue was relevant to maternity to maternity services throughout New Zealand.

He said he was concerned that under the access agreement -- a government document governing the access of private midwives, obstetricians and GPs to maternity hospitals -- there was no obligation on the part of the practitioner to comply with the safety policies of the facility.

"Indeed, the only 'safety' obligation imposed on the practitioner by the access agreement is to ensure the 'cultural safety' of the woman," Mr Paterson said.

The parents of the dead baby told the Sunday Star-Times that staff at National Women's Hospital told them their son should never have died.

"Had we known a balls-up like this could happen in a hospital in New Zealand, we would have gone private," the father said.

Mr Paterson called on the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the New Zealand College of Midwives to develop a joint statement on primary, secondary and shared maternity care responsibilities.

National's health spokesman Tony Ryall said the Government's refusal to authorise a nationwide review of maternity services was putting mothers and babies' lives at risk.

"There are more and more frightening incidents coming to light, and more and more professional groups calling for change," he said.

"How many more babies will die before the Government realises that the current system is flawed?"

Last month Health Minister Pete Hodgson announced the Government would not be following a recommendation by Wellington coroner Garry Evans for an independent review of maternity services after investigating the deaths of two babies.

The New Zealand chairman of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), Dr Bill Ridley, said there needed to be "better definition of boundaries" when it came to transferring care of women in labour.

Midwives' "fear of medical intervention" led to access problems in hospitals, he told NZPA.

"We don't want to intrude into their domain of normalcy, but they should understand that when their patients need help, it should happen in as controlled a fashion as possible."

- NZPA