Written evidence submitted by Shire Latif (NLR0027)

Inquiry

The Committee has launched a new inquiry to examine the case for the reform of NHS litigation against a background of a significant increase in costs, and concerns that the clinical negligence process fails to do enough to encourage lessons being learnt which promote future patient safety.]

Figures show that in 2020/21, £2.26bn was spent from the NHS budget to settle claims and pay legal costs arising from clinical negligence claims.  A further £7.9 billion was spent on compensation from claims settled in previous years, meaning that over £10bn of money was spent on clinical negligence claims which could have been spent on patient care. The total potential liabilities arising from all negligence claims made up to the end of 2020/21 was £82.8bn, increasing by about £5.7 bn every year.

Inquiry deadline - Wednesday 20 October 2021

• What is the impact of the current cost of litigation on the financial sustainability of the NHS and the provision of patient care?

1. One of the richest nations on earth struggles to provide the provision of basic care. It is able to defend most clinical negligence claims through the default system of cover ups using the current complaints system.

• What are the key changes the Government should consider as part of its review of clinical negligence litigation? In particular:
• What changes should be made to the way that compensation is awarded in clinical negligence claims in order to promote learning and avoid the same problem being repeated elsewhere in the system?

2. Early acceptance of error. Refrain from tampering with medical records. Involve families. Open and transparent investigations. Full disclosures of medical records, before investigation and as new facts emerge.

• How can clinical negligence processes be simplified so that patients can receive redress more quickly?

3. As above point 2.

• How can collaboration between legal advisors be strengthened to encourage early and constructive engagement between parties? 

4. Seek advice from appropriate medical experts early.

• What role could an expanded Early Notification scheme play in improving transparency and efficiency system-wide? 

5. Answered in previous question.

• The Government has reiterated its intention to extend fixed recoverable costs, which limit the amount that can be paid out to meet legal costs, to clinical negligence cases with settlements of less than £25,000. At what level should these fixed recoverable costs be set, and are there any circumstances in which they should not apply to low value clinical negligence cases?

6. Current system is to defend at all cost therefore no minimum levels should be set.

• To what extent does the adversarial nature of the current clinical negligence system create a “blame culture” which affects medical advice and decision making?

7. Without the cover up (current default position) it is a due process like any other.

• How important is it that any clinical negligence system encourages lesson learning and commitment to change as the result of any action?

8. Most medical experts already provide clinical care and mentor juniors. That would include anything learnt from a clinical negligence case as details emerge and shared between experts.

• What changes should be made to clinical negligence claims to enable a move away from a blame culture and towards a learning culture in the NHS?

9. None. The culture of state corruption filters downwards to Ineffective regulators.

• How can the Healthcare Safety Investigation Branch work to improve short term responses to patient safety incidences and therefore reduce the number of those who are forced to pursue litigation as a means of obtaining non-financial remedies?

10. HSIB/HSSIB was created to increase secrecy and concealment above the principle of candour therefore should not be conducting maternity investigations. Patient safety investigations were previously conducted by the Healthcare Commission without such restrictions.

https://www.kingsleynapley.co.uk/insights/blogs/medical-negligence-and-personal-injury-blog/new-body-to-conduct-patient-safety-investigations

• What legislative changes would be required to support these changes?

11. No changes are needed as the Clinical Negligence investigation is able to uncover crime due to the nature of the experts involved and evidence presented. Any changes would of been sought previously by medical experts.
12. Advise the return of the Healthcare Commission to better regulate the NHS and to conduct patient safety investigations.
13. Advise closure of the CQC – poorly performing. Ignores cases of clear dishonesty in the NHS yet tasked by parliament to enforce candour.
14. CQC Chief regulator ignored my son’s case and for consistency ignored the case of Baby Harry Richford.
15. Here is Derek Richford grilling the PHSO and shocked at the level of ignorance shown by the regulators:

‘There is nothing for the CQC here.’ To having the biggest criminal prosecution against a Trust that the CQC have ever carried out?”

              https://www.ombudsman.org.uk/news-and-blog/podcast/transcript-radio-ombudsman-24-derek-richford-how-personal-tragedy-led-uncovering

              https://soundcloud.com/user-889008594

16. What happened when I demonstrated evidence of clear dishonesty (falsified records)? The CQC attempts to signpost it to the PHSO. My son as result has now been suffering for over 20 years without treatment.

17. Advise closure of HSIB/HSSIB as the intention is to completely curtail your existing rights to disclosure.

              https://committees.parliament.uk/writtenevidence/13222/pdf/

Oct 2021