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A £27 billion bill for NHS maternity failings is only the beginning. Across public services, the hidden cost of austerity now far exceeds any money it ever saved.
The Observer has revealed that the NHS in England is facing an “absolutely shocking” £27.4 billion bill for maternity failings since 2019.
These failings have resulted in hundreds of deaths and life-altering injuries to mothers and babies.
The scale of the harm is appalling.
So too is the cost: it is more than the entire NHS budget for newborn care over the same period.
According to NHS Resolution (the body that handles clinical negligence claims) maternity-related claims now account for nearly two-thirds of all NHS clinical negligence liabilities.
Former health secretary Jeremy Hunt has called it a “national shame” that the NHS spends more on maternity litigation than on running maternity services themselves.
It would be easy to treat this as a problem confined to the NHS.
But that would be a mistake.
The scale and scope of this disaster did not emerge in a vacuum.
It is the direct consequence of a decade of underfunding, understaffing, and erosion of public services under austerity.
And the NHS is far from the only casualty.
Austerity and its consequences
When the Conservative-led coalition came to power in 2010, it introduced sweeping cuts to public spending in the name of reducing the national deficit.
But austerity was not simply about trimming excess.
It meant pay freezes for NHS staff and local government workers.
It meant reductions in social care budgets, the dismantling of legal aid, and deep cuts to local councils.
It meant fewer doctors, fewer midwives, fewer housing officers, fewer inspectors, and fewer people keeping the system safe.
The effects of this hollowing-out are now impossible to ignore.
In maternity care, understaffing is systemic.
The Royal College of Midwives estimates that England is short of more than 2,000 midwives.
Units have been described as unsafe by the Care Quality Commission.
Staff report burnout, fear of blame, and being unable to provide safe care.
But this is just one part of a much larger picture. Across the justice system, courts have been overwhelmed and backlogged following legal aid cuts and court closures.
In social care, councils have been forced to ration services, with devastating effects on vulnerable families.
In housing, cuts to local authority budgets have led to a rise in temporary accommodation and homelessness.
Even the Ministry of Defence now faces a potential £1 billion compensation claim over a data leak affecting Afghan personnel.
Austerity has not saved the country money.
It has simply moved the costs elsewhere—and magnified them.
The Austerity Fund: a mirror to the myth
To make sense of the full cost of austerity, let’s propose a new tool: an “Austerity Fund” that accounts for the downstream costs of government cuts.
Just as some governments create climate funds to pay for the long-term damage of environmental policy failures, this fund would tally the financial liabilities caused by austerity-era decisions.
Here is a breakdown of what such a fund might include:
| Sector |
Cost Category |
Estimated Cost |
| NHS Maternity |
Negligence claims since 2019 |
£27.4bn |
| NHS Wider Claims |
Broader clinical negligence liabilities (maternity is ~65%) |
£60bn (total) |
| Legal Aid & Justice |
Downstream costs from 46% legal aid cuts; increased prison/court costs |
£8-10bn |
| Local Government |
Emergency housing, service failures, bankrupt councils |
£5-7bn |
| Social Care |
Crisis responses, missed interventions, children taken into care |
£15-20bn |
| MoD Compensation |
Afghan translator legal claims due to data leaks |
£1bn |
| Staffing Shortfalls |
Agency fees, re-training, loss of experienced staff |
£10-15bn |
| Public Health Impact |
Estimated value of excess deaths (190,000) |
£20-25bn+ |
| Total |
Conservative estimate |
£75-90bn+ |
This is not a comprehensive list. The long-term impacts of austerity on education, mental health, productivity, and public trust are harder to quantify but no less real.
What this table shows, however, is that the costs of austerity vastly exceed the savings it was supposed to deliver.
MPs and ministers: from denial to recognition
Not all ministers are willing to confront this truth.
But some are beginning to.
In addition to Hunt’s admission that maternity litigation has surpassed service funding, the Labour MP Paulette Hamilton has said: “The words ‘eye-watering’ come nowhere near to describing the enormous financial cost of these cases to the NHS, arising from failings within its own provision of care.”
Jess Brown-Fuller, the Liberal Democrat spokesperson for hospitals, has called the government’s record on maternity care “scandalous” and described the trauma families face as a direct consequence of political neglect.
The cross-party Public Accounts Committee has repeatedly warned that austerity-era savings are “short-termist” and risk creating bigger costs later.
In 2023, it concluded that the failure to invest in preventative services across health and social care had led to a surge in emergency interventions, undermining both efficiency and outcomes.
Time for a reckoning
It is time to move beyond the fiction that austerity was a necessary evil.
It was a political choice, not an economic inevitability.
And its costs—financial, social, and human—are now being paid by a different generation.
Let us propose that the Treasury, the Office for Budget Responsibility, or an independent commission should be tasked with producing an annual “Austerity Cost Statement” that sets out, in financial terms, the liabilities incurred by past government cuts.
Such a statement would not just hold policymakers accountable.
It would serve as a warning to future governments tempted to balance the books by hollowing out the state.
The £27.4 billion maternity bill is not a standalone scandal.
It is a symptom of a deeper disease.
Austerity was sold to the public as a way to save money.
In truth, it has made everything more expensive—most of all, the price of care, dignity, and trust.
The question now is not whether we can afford to undo the damage.
The question is: how much longer can we afford not to?
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Maternity isn’t the problem: the NHS can’t afford AUSTERITY – nor can the rest of us
Share this post:
A £27 billion bill for NHS maternity failings is only the beginning. Across public services, the hidden cost of austerity now far exceeds any money it ever saved.
The Observer has revealed that the NHS in England is facing an “absolutely shocking” £27.4 billion bill for maternity failings since 2019.
These failings have resulted in hundreds of deaths and life-altering injuries to mothers and babies.
The scale of the harm is appalling.
So too is the cost: it is more than the entire NHS budget for newborn care over the same period.
According to NHS Resolution (the body that handles clinical negligence claims) maternity-related claims now account for nearly two-thirds of all NHS clinical negligence liabilities.
Former health secretary Jeremy Hunt has called it a “national shame” that the NHS spends more on maternity litigation than on running maternity services themselves.
It would be easy to treat this as a problem confined to the NHS.
But that would be a mistake.
The scale and scope of this disaster did not emerge in a vacuum.
It is the direct consequence of a decade of underfunding, understaffing, and erosion of public services under austerity.
And the NHS is far from the only casualty.
Austerity and its consequences
When the Conservative-led coalition came to power in 2010, it introduced sweeping cuts to public spending in the name of reducing the national deficit.
But austerity was not simply about trimming excess.
It meant pay freezes for NHS staff and local government workers.
It meant reductions in social care budgets, the dismantling of legal aid, and deep cuts to local councils.
It meant fewer doctors, fewer midwives, fewer housing officers, fewer inspectors, and fewer people keeping the system safe.
The effects of this hollowing-out are now impossible to ignore.
In maternity care, understaffing is systemic.
The Royal College of Midwives estimates that England is short of more than 2,000 midwives.
Units have been described as unsafe by the Care Quality Commission.
Staff report burnout, fear of blame, and being unable to provide safe care.
But this is just one part of a much larger picture. Across the justice system, courts have been overwhelmed and backlogged following legal aid cuts and court closures.
In social care, councils have been forced to ration services, with devastating effects on vulnerable families.
In housing, cuts to local authority budgets have led to a rise in temporary accommodation and homelessness.
Even the Ministry of Defence now faces a potential £1 billion compensation claim over a data leak affecting Afghan personnel.
Austerity has not saved the country money.
It has simply moved the costs elsewhere—and magnified them.
The Austerity Fund: a mirror to the myth
To make sense of the full cost of austerity, let’s propose a new tool: an “Austerity Fund” that accounts for the downstream costs of government cuts.
Just as some governments create climate funds to pay for the long-term damage of environmental policy failures, this fund would tally the financial liabilities caused by austerity-era decisions.
Here is a breakdown of what such a fund might include:
This is not a comprehensive list. The long-term impacts of austerity on education, mental health, productivity, and public trust are harder to quantify but no less real.
What this table shows, however, is that the costs of austerity vastly exceed the savings it was supposed to deliver.
MPs and ministers: from denial to recognition
Not all ministers are willing to confront this truth.
But some are beginning to.
In addition to Hunt’s admission that maternity litigation has surpassed service funding, the Labour MP Paulette Hamilton has said: “The words ‘eye-watering’ come nowhere near to describing the enormous financial cost of these cases to the NHS, arising from failings within its own provision of care.”
Jess Brown-Fuller, the Liberal Democrat spokesperson for hospitals, has called the government’s record on maternity care “scandalous” and described the trauma families face as a direct consequence of political neglect.
The cross-party Public Accounts Committee has repeatedly warned that austerity-era savings are “short-termist” and risk creating bigger costs later.
In 2023, it concluded that the failure to invest in preventative services across health and social care had led to a surge in emergency interventions, undermining both efficiency and outcomes.
Time for a reckoning
It is time to move beyond the fiction that austerity was a necessary evil.
It was a political choice, not an economic inevitability.
And its costs—financial, social, and human—are now being paid by a different generation.
Let us propose that the Treasury, the Office for Budget Responsibility, or an independent commission should be tasked with producing an annual “Austerity Cost Statement” that sets out, in financial terms, the liabilities incurred by past government cuts.
Such a statement would not just hold policymakers accountable.
It would serve as a warning to future governments tempted to balance the books by hollowing out the state.
The £27.4 billion maternity bill is not a standalone scandal.
It is a symptom of a deeper disease.
Austerity was sold to the public as a way to save money.
In truth, it has made everything more expensive—most of all, the price of care, dignity, and trust.
The question now is not whether we can afford to undo the damage.
The question is: how much longer can we afford not to?
Share this post:
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