Independent midwives are self-employed providers of maternity care who work outside the NHS, although they will inevitably have been trained by the NHS and are likely to be highly experienced. They are fairly rare although quite a number do practice in London and other major cities in the UK.
Are they insured?
As a result of this Directive the UK introduced The Health Care and Associated Professions (Indemnity Arrangements) Order 2014.
The legislation requires that all health professionals carry medical malpractice insurance.
The EU Directive states that EU Member States ensure that all healthcare professionals have cover that is “appropriate to the nature and the extent of the risk”.
What level of insurance should UK independent midwives have?
The Health Care and Associated Professions (Indemnity Arrangements) Order 2014 says that midwives must have ‘appropriate cover under an indemnity arrangement’.
What is ‘appropriate’ cover exactly?
Well, the legislation does not actually define this. A group of London based independent midwives are advertising on the internet at present stating that their company has a £10 million indemnity insurance policy in place.
Is a £10 million insurance policy sufficient cover?
In an era of a minus 0.75% discount rate, I would say that it is not.
When the 2014 legislation was introduced compensation payments in cases of cerebral palsy caused due to negligence during the pregnancy or at the time of birth were in the order of between £6-10m.
However, in an era of the new discount rate of -0.75% the likely payments for a severely disabled child will be far higher.
The High Court dealt with one case in March 2017 under the new discount rate of minus 0.75%.
The claimant, aged 10, was left with cerebral palsy following complications at birth, was awarded a capitalised settlement of around £9.3m, up from a previously agreed figure of £3.8m.
The court approved the agreed quantum settlement in LMS v East Lancashire Hospitals NHS Trust on the basis that she was to recover 50% of the full value of her claims calculated at the minus 0.75% rate. Her lawyers agreed to settle for 50% of the value of the claim as it was a high risk case that might not succeed at trial.
At a joint settlement meeting in January 2017, it was agreed the claimant would receive a lump sum of around £1.3m. She would also receive periodical payments of £50,000 per year to age 19 and thereafter for life £73,500 per year, subject to court approval.
On a full valuation of this case of course, the value of the claim was close to £20 million.
Independent midwifes under insured?
Even if the discount rate is changed to 0% or so within the next 12 months I would still argue that an insurance indemnity limit of £10 million is not sufficient for an independent midwife.
Prospective mothers should think very carefully as to whether their chosen independent midwife carries sufficient cover in the unlikely event that an adverse event occurred at birth.