It emerged at the inquest of his son, Joshua, that midwives missed several chances to treat an infection.
When the CQC carried out a spot check on the labour ward in June it found that patients were being put at risk by dirty conditions and a lack of staff.
The organisation that runs the hospital in Barrow, University Hospitals of Morecambe Bay NHS Foundation Trust, has now been investigated by Monitor, the regulator for leading hospitals and found to be in “significant breach” of its conditions.
Monitor said it needed more assurance that “patient care will remain safe in the long term” and issued a statutory notice of intervention, its first in 18 months and only the ninth in its history, on Tuesday.
This orders the hospital to accept the appointment of clinical advisors to review “underlying problems in maternity services and its interface with paediatrics”, and the establishment of an independent review into overall governance.
Stephen Hay, Monitor’s Chief Operating Officer, said: “If we have concerns that the leadership of this hospital is not acting quickly and effectively on issues affecting patient care, then we have a duty to act.”
“We’ve used our powers to commission an expert review of maternity services at the Trust so that we can get a complete picture of that department and make sure there are no other problems. We are also requiring the Trust to commission an independent review into the way the Trust is managed to understand whether its leaders are acting effectively to identify issues affecting patient care and resolve them.”
In a separate report the NMC watchdog for nurses and midwives said: “We were concerned to note a culture of supporting midwives and past midwifery practice, rather than focusing on what needs to be done to fulfil the primary purpose of supervision, which is protecting mothers and babies.”
It found more than 100 confidential medical records, some dating back as far as 1965, lying around the maternity unit because of a row between departments.
Women also have to be pushed along a public corridor, where vending machines and the entrance to the children’s unit are located, when being taken from the operating theatre to the labour ward.
Even dead babies have to be taken across the corridor, which “can be difficult as members of the public like to try to see the baby”.
The trust said: “We recognise that Monitor needs to be assured that we are addressing all its concerns as a matter of urgency and we will therefore continue to work hard to take rapid and effective action in order to comply with the terms of our authorisation as a FT. The Trust Board is fully committed to ensuring the actions required are addressed quickly and are embedded within the Trust.”
It added: “We welcome the report and are pleased that the NMC recognised that there have been a number of significant service improvements that demonstrate commitment to providing women focused services.”
A police spokesperson said: “A team of Cumbrian detectives is continuing their investigation into a number of deaths that occurred after mothers and infants received care at the maternity unit in Furness General Hospital in Barrow.”