Rapid Responses to:

EDITORIALS:
Paul Fenn, Alastair Gray, Neil Rickman, and Adrian Towse
Making amends for negligence
BMJ 2004; 328: 417-418 [Full text]
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Rapid Responses published:

[Read Rapid Response] Litigation and negligence: distant relatives
Anthony C Barton   (20 February 2004)
[Read Rapid Response] Making amends;the solicitors' way
Jay Ilangaratne   (23 February 2004)
[Read Rapid Response] First Party Insurance would serve better than third party insurance
R Merlyn Wilcox   (1 March 2004)

Litigation and negligence: distant relatives 20 February 2004
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Anthony C Barton,
solicitor
London EC1

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Re: Litigation and negligence: distant relatives

The various items on clinical negligence in this week's BMJ fail to address its main weakness: litigation and liability are scarcely related. Most cases of actual negligence are uncompensated, most cases of alleged negligence are unsustainable. This is because legal aid, which funds most cases, is available to only a small proportion of the population and rewards lawyers for pursuing unmeritorious cases. This is amply borne out by the dismal success rates. As such, litigation does not provide a rational system for either compensation or professional accountability.

Anthony Barton
solicitor and medical practitioner

Competing interests: solicitor practising in pharmaceutical litigation and clinical negligence

Making amends;the solicitors' way 23 February 2004
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Jay Ilangaratne,
Founder
Medical-Journals.com

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Re: Making amends;the solicitors' way

The latest edition of the Law Society's weekly magazine 'The Gazette'(www.lawgazette.co.uk) reports:

**Concern was raised this week that some City law firms are attempting to restrict their liability for the potential professional negligence of solicitors in relation to work done between midnight and 6am.**

Just imagine the reaction if the medical profession even vaguely suggested such an outrageous idea.Of course,unlike solicitors, doctors are expected to maintain the same 'magical' level of mental alertness and stamina from 12-6 and 6-12.But the moment something goes wrong with medical practice,the liability-free 'night solicitor' will be hounding the doctor with generous financial backing from 'Legal Aid'.No solace for hard -pressed doctors. So becoming a 'night solicitor' might be the answer if one wants to be a liability-free professional;what a wonderful world it would be for some.

Why don't doctors readily come up with such innovative [and self- serving] ideas like solicitors?.Or perhaps, some doctors at the BMA House do quietly develop some good self-serving mechanisms to ensure their pockets are lined generously[of course,"all above board"], thanks to subservient BMA members.

Competing interests: None declared

First Party Insurance would serve better than third party insurance 1 March 2004
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R Merlyn Wilcox,
general practice
Wychall Lane Surgery B30 1JD

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Re: First Party Insurance would serve better than third party insurance

There is a standard principal in Britain that if a tile falls off my roof and injures a passer by, he takes legal action to prove me liable and this is his passage to a claim on my third party insurance. This has the disadvantage of his having to show that I was to blame and, more importantly, removes him from cycle of considering the cost.

Think how this would look if the standard insurance were not third party but first party - that he insured himself against all risks. He would claim off his own insurance for the injury. He would not have to show blame - just the injury and would be included in the loop of cost. Advantage that he would insure himself at the level that he considered appropriate to his needs - and pay a premium level appropriate to his cover. Those who did not make any claim would presumably be given a no- claims bonus

The present system encourages the misapprehension that a claim costs the claimant nothing. Claims like this do cost us all a great deal of money as the third party premiums are incorporated into all prices (or taxes if the third party is a government body)

Taking this analogy into the health field, if a hernia operation failed the patient would claim on his own insurance and not have to prove negligence - merely that his hernia is back again. He would have an incentive to ensure that he did not cause a recurrence as this would put his no claims bonus in jeopardy. The failure would be looked at in a true "no blaim culture" and the patient would receive an apology (only) from the doctor and hospital involved.

Competing interests: None declared