The NHS has spent £4.1bn over the last 11 years settling lawsuits involving babies who suffered brain damage when being born, amid claims that maternity units are not learning from mistakes. It paid out just under £3.6bn in damages in 1,307 cases in which parents were left to care for a baby with cerebral palsy or other forms of brain injury, NHS figures reveal. NHS Resolution, which defends hospitals in England accused of medical negligence, spent another £490m on legal fees, taking the total cost of dealing with the legal actions to £4.1bn. “These figures are shocking and also a tragedy. They should set alarm bells ringing across the NHS,” said Robert Rose of Lime Solicitors, which obtained the data under freedom of information laws. “These mistakes in maternity care just keep happening. We’re stuck in a cycle of repetition of these sorts of mistakes – a continuing circle of negligence. It is a scandal that lessons are not being learned [by hospitals],” he added. A single case in which a baby is brain-damaged, often because they were deprived of oxygen during labour, can cost the NHS up to £20m to settle because of the high costs of caring for a child with particularly significant needs over their lifetime. In such cases, newborns often end up with serious cognitive and physical disabilities, including jerky movements and an inability to see, speak and learn normally. The £4.1bn bill for the 1,307 brain-damaged babies is further evidence of the growing crisis of poor care being provided across many NHS childbirth services. Almost two-thirds of maternity units in England are unsafe, according to the Care Quality Commission, the independent health regulator. Maternity care overall is getting worse, the CQC has warned. A hard-hitting parliamentary report earlier this month laid bare the scale of birth trauma that mothers suffer when things go wrong and they, their baby or both end up damaged. MPs demanded urgent measures to make care safer, including an end to staff shortages. The data shows that between 2012-13 and 2022-23, 10 NHS trusts, mainly those that run one or more large acute hospitals, each settled at least 20 negligence cases involving cerebral palsy or brain damage. Barts Health trust in London settled 36 – the most – at a cost of £32.6m. Many of the births happened years before they were settled, as it can take years for NHS Resolution and families to reach an agreement. The number of claims settled by a trust is not necessarily a reflection of the quality of the care it provides, as trusts serve populations of different sizes and demographic profile. Nottingham University hospitals NHS trust, which is at the centre of an inquiry into alleged mistakes in maternity care harming mothers and babies, settled 16 cases at a cost of £44.8m. Three other trusts that have also been at the centre of maternity scandals in recent years – Morecambe Bay, East Kent and Shrewsbury and Telford – settled 14, 12 and 11 cases at a cost of £36.3m, £27.4m and £16.7m respectively. Rose, Lime Solicitors’ head of clinical negligence, said common mistakes made by maternity staff included a failure to properly monitor the baby’s growth during pregnancy and inadequate monitoring of the baby’s heartbeat during labour. The NHS appears to have abandoned an initiative it launched years ago to investigate problem births immediately and then tell the parents, he said. Instead, legal action can take as long as nine years to reach a conclusion, despite the evidence of errors, he added. NHS Resolution also settled 933 legal actions involving a stillbirth at a cost of £93m, it disclosed in its freedom of information response. Last month, three out of four midwives who responded to a survey by the Royal College of Midwives said their workplace was not safely staffed during a week in early March. Paul Whiteing, the chief executive of patient safety charity Action against Medical Accidents, said: “The volume of harm and associated costs is appalling and confirms what we are seeing and hearing from distressed parents who are dealing with the consequences of having a brain-damaged baby and want answers from the NHS about how that tragedy occurred. “Maternity services are in a poor state, as is shown by the overall number of maternity services that are rated as inadequate by the CQC through their programme of inspections.” The Department of Health and Social Care said it could not comment because of the general election campaign. However, the health secretary, Victoria Atkins, gave a speech at the launch of the birth trauma report in which she acknowledged that too many women were having a bad experience when they give birth in the NHS. “There is far too much unacceptable variation across the country in the service that women receive. Some mums endure simply unacceptable care and live with the consequences of that trauma for the rest of their lives,” she said. NHS Resolution declined to comment.