Intended for healthcare professionals


Counting the cost of medical negligence

BMJ 2002; 325 doi: (Published 03 August 2002) Cite this as: BMJ 2002;325:233

NHS litigation authority will be able to report on costs and high risk procedures

  1. Paul Fenn, professor of insurance studies
  1. Centre for Risk and Insurance Studies, Nottingham University Business School, Nottingham NG8 1BB

    The financial cost of medical negligence is a topic that rarely recedes from the headlines. In part this is due to a perception that the money paid out to patients is a measure of the adverse health consequences of medical errors, but in part it is due to a concern over the impact such payments will have on healthcare providers themselves. Each million pounds paid in damages is a million pounds that otherwise could be spent on patient care. What is sometimes overlooked is that this financial impact on providers can fulfil a positive role—it gives a signal of where things are going wrong, and an incentive to put them right. For these reasons it is important for consistent data to be collected on the frequency and cost of medical incidents.

    Given the interest generated by the topic, it is perhaps surprising that so little is known with confidence about the cash cost of clinical negligence to the English health service. In a recent article in this journal,1 my colleagues and I attempted to use information from hospitals in the Oxford region to extrapolate a national figure for cash paid out by the NHS in 1998-9. We arrived at a figure in the range of £48m to £130m, which we now believe may be an underestimate owing to the small number of very large claims in our sample. The National Audit Office, in its recent review of claims …

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