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Rapid response to:


Physician spending and subsequent risk of malpractice claims: observational study

BMJ 2015; 351 doi: (Published 04 November 2015) Cite this as: BMJ 2015;351:h5516

Rapid Response:

Legal case marks the beginning of the end for NHS

NHS care is sometimes appalling and appalling care needs to be punished. But the virtual line between medical (civil) negligence and criminal negligence is becoming increasingly blurred.[1].

The recent case where a doctor and nurse have been convicted for manslaughter following the death of a Down's syndrome child from sepsis has significant implications for the future of NHS.[2].

Medical malpractice claims has lead to the slow trickle of defensive medicine.[3]. But manslaughter charges would open the flood gates for defensive medicine. Defensive medicine in face of threat to livelihood and liberty would undermine the financial sustainability of NHS.

A societal intolerance to all medical errors would imperil the moral and ethical foundation of NHS. The dismantling of NHS, desired by some privileged groups, is going to disproportionately affect the less well off. The resulting insurance based system would disadvantage the poor, vulnerable and most importantly adults and children with multiple co- morbidity as they would find it difficult to get medical cover.[4].

1 White P. More doctors charged with manslaughter are being convicted, shows analysis. The BMJ 2015;351:h4402. doi:10.1136/bmj.h4402

2 Dyer C. Paediatrician found guilty of manslaughter after boy’s death from septic shock. The BMJ 2015;351:h5969. doi:10.1136/bmj.h5969

3 Jena AB, Schoemaker L, Bhattacharya J, et al. Physician spending and subsequent risk of malpractice claims: observational study. The BMJ 2015;351:h5516. doi:10.1136/bmj.h5516

4 Abdullah F, Zhang Y, Lardaro T, et al. Analysis of 23 million US hospitalizations: uninsured children have higher all-cause in-hospital mortality. J Public Health Oxf Engl 2010;32:236–44. doi:10.1093/pubmed/fdp099

Competing interests: No competing interests

05 November 2015
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospital NHS Trust