Almost a third of that – more than £19 million – went into the pockets of legal teams.

At a time when there is growing concern over midwife shortages and maternity unit mergers, the majority of claims, far and above any other, were in the obstetrics and gynaecology department responsible for births.

Cases involving maternity and obstetrics care in the past year saw Dudley Group of Hospitals pay out the most with £2.8 million in damages and £530,000 in legal fees.

This was followed by Sandwell and West Birmingham Hospitals Trust which paid out £2.6 million plus legal costs of £586,000. Worcestershire Acute Hospitals paid out £1.9 million damages and £592,000 on solicitors fees.

Guay Ong, Royal College of Midwives regional manager, said shortages of midwives and NHS cuts to hospitals were partly to blame for high numbers of claims when care was compromised.

Ms Ong also warned that the NHS Litigation Authority settled many cases out of court when there is no admittance of negligence and no errors proved.

“We know that obstetrics tends to have the highest number of compensation payouts, but a lot of these are settled out of court,” added Ms Ong. “Sometimes mistakes happen and others are related to system failings or midwives making a wrong decision because they are so busy.

“Midwives can be put in a difficult position where they are looking after more than one woman in labour, which is not a situation they want to be in. They don’t want to compromise care.

“There has been a promise of more midwives but it is not happening.”

The NHS Litigation Authority handles negligence claims on behalf of NHS organisations in England.

From 2000 to 2010, only four per cent of claims were settled in court, with 43 per cent agreed out of court and 40 per cent abandoned by the claimant.

The remaining 13 per cent are still unresolved.

Shamed Mid Staffordshire NHS Foundation Trust, the focus of a public inquiry into why 400 patients died needlessly due to poor care, had the most claims and incidents registered with the Litigation Authority with 132 in the past year across all departments, from April 2010 to April 2011. Heart of England NHS Foundation Trust, running Sutton Coldfield’s Good Hope Hospital, Heartlands and Solihull hospitals, had the second highest claims in the region with 102.

University of Coventry and Warwickshire then stood at 68 and University Hospitals Birmingham Foundation Trust, in charge of Edgbaston’s Queen Elizabeth and Selly Oak hospitals, had 66 claims.

Historic claims for the region dating back to before April 1995 are placed under the responsibility of NHS West Midlands health authority.

For these negligence claims finally settled in the past year, NHS West Midlands ran up a bill of £16.2 million for the Department of Health – of which 10 per cent was legal fees.

£14.5 million was paid out to patients or their relatives, with £1.17 million for the claimant’s legal team and £502,000 for the NHS’ defence lawyers.

Paul Vaughan, director of the Royal College of Nursing in the West Midlands, said: “We do know the cutbacks in jobs and services in the NHS are increasing the pressure on nursing staff.

“We cannot say if this contributing to more mistakes in the delivery of treatment and care, but the risk should not be ignored.

“The increase in costs surrounding negligence claims ultimately means there is less to spend on direct patient care.

“If people have been harmed, it is right that they are adequately compensated but NHS organisations need to ensure they are identifying and managing the risks robustly in the first place.

“The legal costs arising from some negligence claims are a real cause for concern, particularly where they are totally disproportionate to the compensation payout to the claimant.”

The Medical Defence Union has said claims against GPs nationally rose by 20 per cent from 2009 to 2010, mainly due to wrong or missed diagnoses.

The union said for the first time, as many as 13 of the claims cost more than £1 million to settle. The NHS Litigation Authority said in a report that larger trusts and those providing more complex treatments were more likely to receive claims than smaller trusts.

“Different institutions face different levels of risk because of the variations in the nature and complexity of procedures they perform,” reported an Authority spokesman

“Approximately 20 per cent of all claims and 60 per cent of all payments relate to claims arising out of birth.”