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The above, in the Scotsman, today, is an , by a journalist who has found evidence of missed shifts in maternity units, over three years, adding up to 39 978 and, then made that into a crisis otherwise completely imaginary based on the real evidence below.

In Scotland, there are around 45 000 live births every year, 135 000 in the Scotsman period of counting. There are 3 939 registered midwives doing a total of around 800 000 shifts annually, based on a conservative estimate of 200 working days per year, so the ‘missed’ shifts represents 5% of the total. This is below the ‘missed shift’, absence rate of nurses generally, 6%, and well below that of police officers, 7-8%.

However, the above is only circumstantial evidence at best. Here are the real forensic facts:

First, the Ockenden review into NHS England’s maternity services was built around detailed case reviews of families where mothers or babies had died or suffered severe injury. It concluded there were repeated instances where different care would reasonably have changed outcomes for thousands of babies and mothers, and described longstanding failures to investigate incidents properly and trust-board oversight failures.

By contrast, the Scottish inspections published so far are regulatory inspections, not retrospective reviews of hundreds or thousands of adverse clinical outcomes. They identify risks and weaknesses—for example, staffing shortages, delays in induction, governance problems and inconsistent escalation—but they do not conclude that Scotland has experienced an Ockenden-scale maternity scandal. The Scottish Government’s decision to commission an independent review is largely precautionary and aimed at understanding whether the recurring inspection findings indicate wider systemic problems.

Second, how we have known for at least a decade that Scotland’s maternity services were not troubled like those in NHS England – More than three times per head, the cost of settling negligence lawsuits in NHS England

In the Guardian 19 February 2026, the above and:

The NHS will have to spend more money settling lawsuits involving negligence during childbirth after a supreme court ruling that lawyers said puts right a “historic injustice”. The court ruled on Wednesday that children in England who suffer catastrophic injuries while they are being born can claim damages for future earnings they would otherwise have had.

The ruling on “lost years damages” means that children whose life expectancy is shortened can recover compensation for being unable to work. It comes amid mounting concern at the rising cost of medical negligence to the NHS in England – its liabilities have hit £60bn – much of which is due to errors made during childbirth. https://www.theguardian.com/society/2026/feb/18/nhs-spend-more-settle-lawsuits-negligence-childbirth-supreme-court

From 2015/16 to 2024/2025, NHS England paid out out £5.97bn for maternity negligence.⁴

With a tenth of the population but the same troubles in maternity services, Scotland would have paid out £597m.

For the, I appreciate slightly different ten year period, 2013/14 to 2022/23 (the only comparable study I can find), it was £177.89m⁵, less than one third.

Using two slightly varying (2 years-off) sets of data would be problematic if the difference was small but at more than 3 times higher we can be confident that the contrast is reliable.

Sources:

1. https://www.healthcareimprovementscotland.scot/publications/media-release-inspection-report-royal-infirmary-of-edinburgh-nhs-lothian/
2. https://x.com/i/grok?conversation=1983476698260623709
3. https://www.cwj.co.uk/site/newsandevents/legalnews/costs_of_NHS_maternity_care_claims_revealed.html
4. https://www.medrxiv.org/content/10.64898/2026.05.01.26352218v1.full.pdf
5. https://www.nss.nhs.scot/media/4788/cnoris-annual-report-2022-2023.pdf

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How bad are things in NHS England’s maternity units for such a difference in pay-outs to settle negligence.

Surely it cannot be any worse than the problems Anas Sarwar has found at the QEUH?

Just last week, on BBC Breakfast, we hear of a joint BBC News/New Statesman, external investigation into maternity care at University Hospitals Sussex NHS Foundation Trust (UH Sussex) which has found:

• At least 55 babies who died may have survived with better care between 2019 and 2023
• A review of nine stillbirths in 2021 and 2022 found missed opportunities in all cases
• External investigators warned that a “normal birth” culture (one that seeks to promote vaginal delivery with minimal medical intervention) was causing concern
• Payments for maternity errors at the trust were the highest in England last year

No government nor former government minister is associated, in the BBC Health report, with these horrific figures. https://www.bbc.co.uk/news/articles/ckg2n644l44o

Finally, years before Titchener was appointed, from 2022:

Dr Pelle Gustafson, chief medical officer, of Swedish patient insurer Löf, said he was “particularly impressed” by the work in Scotland over the past 10 years during a meeting of the House of Commons Health and Social Care Committee.

The Scottish Patient Safety Programme (SPSP), which has been in existence for around 13 years, was set up to make patient safety a priority in NHS Scotland, drawing on lessons from the airline industry such as introducing checklists. Gustafson was asked by Tory MP Dr Luke Evans which country he would hold at the “very top of the pillar” for preventative work during an evidence session on NHS litigation reform last week.

He responded: “If you take all preventive work as regards patient safety, I would say that I am personally very impressed by Scotland. “You have a system that is fairly equal all over the place and you also have improvement activities going on. I am very impressed by Scotland.”

He added: “I am particularly impressed by the Scottish work over the last 10 years. There are a lot of things that we, in the Nordic countries, can learn from Scotland too.”

Source: https://www.thenational.scot/news/19850998.swedish-expert-praises-leading-work-patient-safety-scotland/

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