Written evidence submitted by Dr T Derry (NLR0025)

I am a general practitioner and have worked for the NHS for 20 years and have concerns about the increasing cost of litigation from the NHS budget.

Thank you for recognising that there is a big and increasing problem with NHS litigation.

I believe that changing as soon as possible to a New Zealand style no-fault compensation for treatment injury1 rather than our current US style compensation for clinical negligence would have significant benefits for the UK:

• It is hugely stressful for the accused health care professional, with a case often taking years to come to a resolution. The emotional damage often contributes to health care professionals leaving the profession.
• I feel it is very wasteful to take nearly £600,000,000 for legal fees2 from the NHS budget, in order to prove fault, instead of improving patient care.
• With legal costs being so high, many cases are settled by the NHS, even when they have little merit. This may in the short term, keep costs down however it does encourage increasing numbers of cases to be brought. The use of “no-win, no-fee” adverts also increases the number of cases.
• Many hours are spent by expert medical witnesses on each case (12629 cases in 2020/213 compared with 5697 cases in 2005/64). These doctors could use this time to provide clinical care for thousands of patients.
• Patients, who have suffered significant injury, will have the same needs regardless of whether clinical negligence has been proved. A compensation scheme not taken from the NHS budget should provide for them.
• Finding fault with an individual does not reduce risk. A no-blame culture allows lessons to be learnt from mistakes and looks to improve systems to reduce risk.
• The giving of NHS money as compensation does not lessen the chance of further mistakes being made in the future but it does encourage the “compensation culture”. For other patients / relatives no amount of money can compensate for their true loss.

Dr T. Derry (General Practitioner)

References:

1)      https://www.commonwealthfund.org/publications/journal-article/2006/feb/no-fault-compensation-new-zealand-harmonizing-injury

2)      https://resolution.nhs.uk/2021/07/15/nhs-resolution-publishes-annual-report-and-accounts-for-2020-21/ - 599.5 million figure comes from 151.4m + 448.1m figures which can be seen on page 43

3)      https://resolution.nhs.uk/2021/07/15/nhs-resolution-publishes-annual-report-and-accounts-for-2020-21 -on page 18

4)      https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/247399/1113.pdf - on page 12

Oct 2021