One of the authors of a major report on birth statistics has criticised the government's new systems for collecting health data. Janet Snell finds out why co-ordinating national health statistics is not child's play

When former Conservative health secretary Virginia Bottomley abolished regional health authorities, England lost a key mechanism for collecting and analysing health statistics.

National data was seen as irrelevant under an internal market made up of local health purchasers and providers.

The current government's much vaunted information strategy is meant to re-establish an integrated data collection system, but according to one of the authors of a major new statistical report, it is far from clear that the planned changes will succeed.

Alison Macfarlane, who co-wrote Birth Counts, a review of statistics on pregnancy and childbirth, questions whether the architects of the strategy have got it right and whether enough money is being allocated to fund the new arrangements.

'The best way to get good population-based data is from records for individual patients. But unless a system is in place to output that data, it won't happen, ' she says.

'As for the new regional observatories, they're being set up on a shoestring, but you can't re-establish regional data by spending peanuts.'

Ms Macfarlane, a statistician at the National Perinatal Epidemiology Unit , also believes the new proposals are confusing.

'The information strategy is called something different in each of the UK's four countries, and even electronic health records have four different names. We also know very little about how the changes are to be implemented.'

This is a crucial issue, shown up by the Bristol Royal Infirmary inquiry.

'The last government zapped the South West regional database, leading to the loss of data that could have been useful to the inquiry, ' says Ms Macfarlane. 'It's really important that we get this right.'

Her report highlights serious gaps in data, except in Scotland, on care in pregnancy, labour, delivery and the first year of life. It also notes there are few figures on resources for maternity care.

As well as detailing what statistics are, and are not, available, Birth Counts charts trends in pregnancy and childbirth. For example, it looks at a furore in the late 1970s over geographical variations in perinatal mortality - when The Observer newspaper famously demanded: 'Why do so many Rochdale babies die?' - and harks back to a similar outcry at the turn of the century.

At the second national conference on infant mortality, held in 1908, a clergyman from Rochdale reported that 'when he had endeavoured to tell the members of his mothers' meeting how to bring up their babies, those Lancashire women had told him to go and play at marbles'.

The report notes that two decades after being targeted in the late 1970s, Rochdale was included in a health action zone in 1998.

Birth Counts is a weighty tome in two volumes. It covers everything from the cost of having a baby to inequalities in parents' social backgrounds, and from the effects of occupational and environmental hazards to fertility control and foetal loss in early pregnancy.

The report picks up on new trends such as the rise in multiple births as a result of the increased use of fertility treatment. This has created a statistical quirk where by the average birth weight is rising although there is also a rise in low birth weight babies. But the data for multiple births is difficult to interpret because it is collected in different ways in different areas.

Inadequate, inconsistent or nonexistent data is a recurring theme throughout the report, which recalls that as far back as 1860 Florence Nightingale set out a 'proposal for an uniform plan of hospital statistics'. But 140 years later, considerable differences remain between the four UK countries over systems for linking and analysing data.

The report highlights general practice computer systems as having the potential for giving more information on the health problems of babies. But, the authors warn, 'there are many problems of access and data quality to be tackled before they can do so'.

Launching the new information strategies will not be straightforward, as data is recorded in many systems but cannot be extracted consistently at national level. 'This is a major challenge in the implementation of the NHS information strategies, ' claims the report.

The report's authors conclude by noting that the sort of data to be collected is under review 'yet again'.

It adds: 'We hope that the resources will be made available to implement these plans and that they will improve the quality and range of data needed to monitor and audit the care provided to babies and their mothers.'

Stats more like it: facts and figures

In 1997, 26 per cent of women aged 16-49 used the pill while 21 per cent had partners who used condoms.

Eleven per cent of women had been sterilised and 10 per cent had a partner who had been sterilised.

In 1907, 3,520 women died in childbirth (3.8 per 1,000 live births). The 1997 figure was 38 deaths (0.059 per 1,000).

Figures for 1995 suggest women with partners in manual occupations are more likely to smoke but less likely to drink alcohol.

The number of maternity units with 4,000 or more births per year increased in England until 1990 and fell slightly by 1996.