Arbitration as a means of settling disputes is not commonly used in the NHS. Its greatest use has probably been in general practice to settle partnership disputes. In 1991 the Department of Health issued a consultative paper on the use of arbitration to settle cases of medical negligence,1 but ministers have so far taken this no further. Now at least one health authority has used arbitration to settle a dispute arising from the workings of the internal market in the NHS.2

As part of their job of managing the market, regional health authorities have played an important part in arbitrating - or, more accurately, mediating - in disputes that arise between purchasers and providers. On p 177 Scott and Stokoe describe how North West Hertfordshire Health Authority opted for arbitration in such a dispute - in this case between a resident and the authority over whether to fund continuing treatment at a non-NHS institution.2 The paper raises several important lessons for those who might want to use arbitration.

Arbitration is described by the Chartered Institute of Arbitrators as the only means of resolving a dispute that offers an alternative to litigation because an arbitrator's award is final, binding, and enforceable summarily in the courts.3 Supporters of arbitration claim that it is quicker, more flexible, and consequently cheaper than going to law. The arbitrator, agreed on by both parties, may or may not be an expert in …