National Health Service - Negligence
Claims
Clinical
negligence claims against the NHS soared in 2002
by £850m – enough to run three London
teaching hospitals for 12 months. The total bill
the health service faced leapt from £4.4bn in
March 2001 to £5.25bn in March 2002, an increase
of 19.3 per cent, the National Audit Office (NAO)
reported. Such a huge rise is a serious drain on
the health service and could slow its growth. The
outstanding sum has more than doubled since 1998,
when it stood at £2.3bn, and has alarmed
ministers and MPs. The NAO also disclosed a
growing coyness in the NHS over the salaries paid
to top staff. Sir John Bourn, head of the NAO,
said a "significant number of staff,
including some 50 chief executives" had
claimed rights under the Data Protection Act to
keep their salaries secret.
Salaries for chief executives of the biggest NHS
trusts exceed £100,000. A spokesman for the
Department of Health said it was withdrawing
guidance it had published suggesting that NHS
employees had the right to withhold details of
their salaries. "After obtaining further
legal advice, we fundamentally disagree with that
guidance," he said. On clinical negligence,
the NAO said the £5.25bn figure represented the
best estimate of the liabilities the health
service faced at 31 March 2002. It is not the
amount paid out in a single year, but the amount
which the NHS expects it will have to spend over
a number of years. The amount paid out in 2001-02
was £446m, £31m more than in the previous year.
A spokesman for the NAO said, "Lawyers
criticise us every year and say we are simply
totting up all the claims and presenting a
worst-case scenario, ignoring the fact that many
claims will never succeed. But that is not the
case. We have looked at the claims very carefully
and this is our best estimate of what the outcome
will be." The NAO said a "key
cause" of the rise was "changed
assumptions made by actuaries". The
spokesman said the number of claims had been
underestimated in the past because patients had
been slow to lodge them. NHS trusts, which used
to settle small claims directly, had passed
responsibility to the NHS Litigation Authority,
which had more accurate figures. The discount
rate used to calculate the cost of future
liabilities had also changed.
Professor Sir Liam Donaldson, the Government's
chief medical officer, opened a review of
clinical negligence in 2001 but his report is
still awaited. The existing scheme has been
widely condemned as outdated, bureaucratic and
unfair. In many cases the legal costs of settling
claims outweigh the damages that are paid to
injured patients. The Department of Health said
yesterday that ministers would bring forward
"concrete proposals" within the next
month for a mediation service to deal with small
claims, which make up 70 per cent of the total
number, without involving the courts. "We
are looking at a specific system to speed up the
cases to prevent them getting them into the legal
process. It would deal with issues of who was
responsible and what follow-up there was to
prevent the incident happening again which is
often what people are most interested in,"
the spokesman said.
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