The national tariffs for a normal birth, a delivery with complications and a caesarean section are calculated from data on the average costs of these services as reported by NHS trusts, foundation trusts and primary care trusts, which are used to inform the reference cost index. The reference costs collection is based on a full absorption costing methodology and therefore includes the cost of insurance. However, the cost of insurance is not separately identifiable within the tariff.
We do, however, recognise that insurance premiums are proportionately high for maternity services, which is why we have made it clear in our reference costs guidance ‘Reference costs 2006 collection: Costing and activity guidance and requirements’ that trusts should reflect this in the relevant cost pool(s) when determining the unit costs of all types of maternity activity. This guidance is available on the Department’s website at www.dh.gov.uk/PbR