- The Observer,
- Sunday December 29 2002
In a major reform of the system for paying victims of hospital mistakes, Alan Milburn, the Health Secretary, is now considering introducing a streamlined process which will mean patients will no longer have to spend thousands of pounds in legal fees battling through the courts to prove their case.
Officials involved in drawing up the plans said that they wanted to get away from the 'blame and shame' culture of the present system in which the NHS shies away from admitting liability for fear of huge payouts.
One scheme under consideration is capping compensation claims at £500,000 with extra help and support for those who have suffered medical errors.
Critics say that a no-fault scheme could mean lower payouts for patients and deny people their right to a 'day in court'.
There are also plans for a small claims system which would fast-track minor cases and an independent mediation service which would allow patients and doctors to avoid lengthy and expensive court cases.
In 2001 the House of Commons Public Accounts Committee estimated that there were 850,000 'adverse events' within the health service every year causing more than 40,000 deaths.
NHS liability for medical claims has also been soaring. Earlier this year it was revealed that if the health service had to pay out on every claim presently outstanding it would be left with a bill of more than £8 billion.
A National Audit Office report found that the number of claims against the NHS had risen from 2,411 to 4,115 in 2000, leaving the NHS with a bill of £400 million a year to settling cases, a figure which has risen from £235m in 1996.
Cerebral palsy and brain damage, particularly among babies and children, make up the bulk of the claims.
In a letter to MPs, passed to the Observer, David Lammy, the health Minister in charge of criminal negligence, made it clear that the Government wanted to act on the burgeoning cost of negligence claims.
Lammy said that the Chief Medical Officer, Sir Liam Donaldson, had been asked to review the present system and come up with recommendations. His report has now been passed to Milburn and an announcement is expected early in the New Year.
'Previously the Government was not convinced of the need for the introduction of a [no-fault compensation] system,' Lammy said.
'However, the context for any judgements about the merit of such a system in the NHS have changed recently. In particular, the argument has been voiced that "no-fault" compensation might be viewed as complementary to the development of the no-blame culture, highlighted by the Bristol Royal Infirmary report and measures being implemented following the Chief Medical Officer's "Organisation with a Memory" recommendations.'
In 2001 Professor Ian Kennedy's report into the scandal of the deaths of babies undergoing heart operations at Bristol Royal Infirmary demanded an end to multi-million pound compensation claims so that doctors could admit mistakes without being dragged through the courts.
'We are very keen to see greater use of structured settlements or periodic payments instead of lump sum payments,' Lammy said. 'These allow part of any award to be paid in the form of tax-free instalments for the duration of the claimant's life.'
Russell Levy, an expert in clinical negligence, said that he supported periodic payments but said that any changes to the system had to be focused on the patient rather than used as a way of saving money for the NHS.
