UK Supreme Court backs GP who refused to pay £10 000 compensation to patient’s widow

BMJ 2016; 353 doi: (Published 13 May 2016) Cite this as: BMJ 2016;353:i2743
  1. Clare Dyer
  1. The BMJ

The Northern Ireland complaints commissioner was acting beyond his powers when he recommended that a GP give the widow of a patient who died from a heart attack a consolatory payment of £10 000, the United Kingdom’s Supreme Court has ruled.

The unnamed GP apologised but refused to pay the £10 000, even though the commissioner threatened to lay a special report about the case before the Northern Ireland Assembly if he failed to pay.

The GP mounted a legal challenge to the commissioner’s decision, which initially failed but was successful in the Northern Ireland Court of Appeal in 2014. The appeal court judges ruled by two to one that, although the commissioner had power to recommend that a public body such as a health trust pay a sum of money to a complainant, there was no such power in the case of GPs.

The appeal court judgment has now been upheld unanimously by the UK Supreme Court. The five judges in the country’s highest court held that the complaints commissioner had no power either to recommend that the GP make the payment or to lay a report before the assembly in default of payment.

The commissioner’s powers were laid down by legislation in 1996. The role has now been abolished and taken over by a new Northern Ireland public services ombudsman, who was given specific powers in a law enacted in February 2016 to recommend payments by GPs.

A spokesperson for the ombudsman was unable to provide figures for the number of GPs who had been asked to make a payment in the past but said that no special reports had been laid before the assembly because the doctors had always complied with the recommendations.

Annual reports published on the ombudsman’ s website, which cover 2012-15, give details of only two GPs who were asked to make a payment, one of £2000 and another of £500.

In the case that went to the Supreme Court the commissioner found that the GP’s practice had failed to provide a reasonable level of care and treatment and was guilty of maladministration. The patient, at that time without symptoms, had been referred by the GP for an electrocardiogram in July 2008, which was reported negative for ischaemic heart disease.

The patient complained of chest pains to a locum doctor on 10 December 2008. He was referred to a chest pain clinic, which refused to see him because of the earlier negative test and sent a report to the practice on 20 December, which was not marked urgent or reviewed. The patient asked on 6 January why he had not received an appointment and was referred for another electrocardiogram but died of a heart attack later that day.

The GP apologised to the patient’s widow and changed procedures at the practice, as recommended by the commissioner, but refused to make the payment. Not only was there no power for the commissioner to recommend it, said the Supreme Court judge Jonathan Sumption, delivering the judgment, but the figure of £10 000 seemed “to have been plucked out of the air.”

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