One in four hospitals letting down pregnant women by not scanning foetuses properly for birth defects

Almost one in four hospitals is letting down pregnant women by not scanning foetuses properly to check for birth defects.

And more than a third of trusts are still not meeting a Government pledge that all mothers should have one-to-one care from a named midwife.

The first nationwide survey of maternity services by the Healthcare Commission, the Government's health standards watchdog, says there is a clear link between the shortage of midwives and poor standards - despite ministers' assurances that this is not the case.

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A league table of England's 148 trusts, published with the report today, rated 21 per cent of maternity units as poor. The situation is worst in London, where no less than 70 per cent of trusts have poor maternity provision.

Dame Karlene Davis, general secretary

of the Royal College of Midwives, said: 'The report shows that everything is far from rosy in the garden, and it should be a wake-up call that jolts the Government from its slumbers.

'They need to rub the sleep from their eyes and reverse the lack of action. They are sleeping while mothers and babies are

not getting the high-quality care they deserve, while maternity services are crumbling and midwives are working themselves into the ground. We are selling women short.'

Anna Walker, chief executive of the Healthcare Commission, said: 'There have been serious concerns about maternity services.'

She claimed that those trusts rated poor were not unsafe - if they were the commission 'would not hesitate' to take action to ensure patient safety was protected.

The report found that many hospitals were not scanning unborn babies properly for birth defects.

Thirty-nine per cent of trusts do not carry out the full 11 checks to be performed during ultrasound scans, laid down by the National Institute for Health and Clinical Excellence.

These include studying the baby's heart function, length of spine,

counting bones in the arms and legs and looking at head shape and size. The scans should also examine the development of the baby's face and lips.

Only 11 per cent are meeting NICE requirements on screening for Down's syndrome. The commission said the remaining 89 per cent were receiving inferior screening.

The report raises concerns about staffing levels in English maternity units. The Royal College of Midwives say there is a national shortage of 5,000 midwives. Its guidelines say there should be 36 midwives per 1,000 deliveries.

But at the average trust there are only 31 midwives and at some trusts the number is as low as 26.

Two-thirds of trusts with low midwife levels have poor services. The report says this suggests very low staffing levels may be associated with poor overall performance. The commission said the shortage of midwives means that 36 per cent of units are not providing one-to-one care for all women, despite that being a Government pledge.

The report says there are too few consultants on maternity units. The Royal College of Obstetricians and Gynaecologists says there should be consultant cover for 40 hours a week - but a third of trusts do not meet this minimum.

Campaigners say an extra 900 consultants are needed to ensure safe levels of care.

Responding to the report, Health Secretary Alan Johnson announced an extra £122million of funding by 2011 for maternity services.

The money will be spent on more flexible opening hours for maternity centres, better training for midwives and increased access to home births. He said: 'The NHS has much more work to do to ensure women receive the most modern maternity care. Alongside the extra funding, we have this year made improving maternity services a national priority for the NHS.'

LibDem health spokesman Norman Lamb said: 'This report makes for disturbing reading. It is simply unacceptable that one in five maternity units is putting mothers and babies at risk because staff are stretched to breaking point.

'Close attention from midwives and doctors is not a luxury. It is vital to ensure that all the appropriate scans are done and any problems are identified before they become life-threatening.'

•BEST TRUSTS (out of 148 with full maternity provision)

1. Stockport NHS Foundation Trust (best performing)

2. Gateshead Health NHS Foundation Trust

3. North Cumbria Acute Hospitals NHS Trust

4. Northern Devon Healthcare NHS Trust

5. Northumbria Healthcare NHS Foundation Trust

6. County Durham and Darlington NHS Foundation Trust

7. Royal Cornwall Hospitals NHS Trust

8. Salford Royal NHS Foundation Trust

9. Hull and East Yorkshire Hospitals NHS Trust

10. Wirral University Teaching Hospital NHS Foundation Trust

•WORST TRUSTS

1. West Hertfordshire Hospitals NHS Trust (worst performing)

2. Newham University Hospital NHS Trust, east London

3. Barking, Havering and Redbridge Hospitals NHS Trust

4. Chelsea and Westminster Hospital NHS Foundation Trust, west London

5. Homerton University Hospital NHS Foundation Trust, east London

6. Mayday Healthcare NHS Trust, south London

7. Bromley Hospitals NHS Trust, south London

8. Luton and Dunstable Hospital NHS Foundation Trust

9. Barts and the London NHS Trust

10. St George's Healthcare NHS Trust, south London