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

Centralisation of Clinical Negligence costs is not the answer

Dear Sir,

Re: Editorial BMJ 3 August 2002 “Counting the Cost of Medical

I am in broad agreement with Professor Fenn’s view. Whatever the
method of patient compensation, significant benefit will be gained from
feeding back risk management issues identified whilst investigating such
compensation claims. Distancing any organisation from financial
responsibility for compensation will inevitably lessen its accountability.

Professor Fenn suggests that with “centralisation” of financial
responsibility now in place, the NHS Litigation Authority should be able
to improve public information on the cost and trends in clinical
negligence. He states that in the period leading up to this year there
were difficulties in producing consolidated estimates for the NHS accounts
and useful information on the frequency and cost of clinical claims.
Having worked on behalf of and within NHS Trusts, both before and since
the inception of the NHS Litigation Authority, it is disappointing to read
the explanations given for these ‘difficulties’ and the excuses offered
for such limited information being available to date.

The fact of the matter is that the NHS Litigation Authority has
simply not delivered on an important function as set out in its framework
document i.e. to specifically disseminate relevant information on clinical
risk. Over the lifespan of this Authority, some 7 years or so, at its
request large quantities of detailed claims data have been provided by NHS
Trusts. This information would have been of considerable benefit to them
if promptly interpreted and fed back. Unfortunately, the NHS Litigation
Authority has completely failed to deliver on this responsibility. A
recent enquiry of them shows there will be no change in this situation in
the near future.

In the current risk management driven environment, on a background of
spiralling clinical negligence costs, NHS Trusts simply cannot afford to
be denied access to this data. The cynic might suggest that this failure
is in the NHS Litigation Authority’s own interests. The vast amount of
claims data provided by NHS Trusts should be passed to a more capable
body, as soon as possible. It can then be processed effectively and
perhaps this will assist the NHS counter the increasing cost of medical
negligence claims by helping to identify preventable risk.

Yours faithfully

Dr K.J.P.Lessey
Barking, Havering & Redbridge Hospitals NHS Trust Solicitor,
Legal Department,
Harold Wood Hospital,

Competing interests: No competing interests

15 September 2002
Kevin J Lessey
Trust Solicitor
Barking, Havering and Redbridge NHS Trust, Harold Wood Hospital, RM3 0BE