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Friday, 19 November 2021

Medical Negligence. A huge cost to patients, the NHS, and the national economy

The NHS is dominated by pharmaceutical medicine. And pharmaceutical medicine can, and often does, cause serious harm and injury to the patients it treats. This is costing the NHS dearly, at every level. Patients are harmed. The NHS has to pay compensation for the damage it has caused. And the national exchequer has to foot the ever-increasing bill.

This is why the Parliamentary Health and Social Care Committee is looking into the situation, seeking reforms to reduce massive cost of litigation.

The Medical Defence Union (MDU) is the UK's leading provider of medical indemnity, and clincial negligence claims for the medical profession. In the evidence it gave to the committee it said that litigation was now costing £2.2 billion annually. This massive sum is a rarely considered cost incurred by the NHS. The MDU's head of Professional Standards and Liaison, Dr Michael Devlin, told the inquiry:

            “The MDU has been sounding the alarm about the cost of compensation claims against the NHS for years, so we are relieved that the Health and Social Care Committee is examining the case for NHS litigation reform. Amounts being paid out in compensation annually are spiralling, increasing nearly 50% in the last five years from £1.48 billion to £2.2 billion last year..... With the NHS facing a funding crisis, we simply cannot sit by any longer and ignore numbers like £2.2 billion". (My emphasis).

So what is the MDU's solution to the problem? 

  • To ensure that there are fewer mistakes? 
  • To reduce the harm caused to patients? 
  • To better understand the nature and cause of the mistakes that are damaging patients? 
  • To look for safer treatments?

None of this appears to be what the MDU has in mind, at least not according to Dr Devlin, who continued:

            "The government must grasp the nettle and reform the system surrounding clinical negligence, so that it is fairer and mirrors society’s ability to pay. Reforms to the system for compensating patients could make a significant difference. One example is the need to ensure payments for long term care are based on the cost of NHS rather than private care, as is currently the case. Clinical negligence claims are not an indicator of poor medical standards nevertheless legal reforms must go hand in hand with improvements in patient safety. A learning culture in which incidents are thoroughly investigated and lessons learned and shared must be fostered.” (My emphasis).

So the MDU's answer to the problem, it would appear, is for the NHS to pay less compensation; and for patient's damaged by pharmaceutical medicine to receive less.

The GP magazine, Pulse, seems to have come to a similar conclusion in an article dated 12 November 2021. It stated that NHS Resolution, "an arm’s length body of the Department of Health and Social Care. that provides expertise to the NHS on resolving concerns and disputes fairly, sharing learning for improvement and preserving resources for patient care" said in their annual report that general practice could face £44m in Covid-related clinical negligence claims alone. It said that an estimated £44m, out of a forecast £885m total new claims due to the pandemic, may come through the clinical negligence scheme for general practice in 2020/21. It said that Trusts are expected to face negligence claims of £665m, then amazingly, that Covid-19 "would mean lower numbers of claims due to clinical work being cancelled - reducing claims by around £400m and resulting in a £500m net expected impact of the pandemic on claims made against the NHS".

So when the NHS does NOT provide patients with medical treatment it is calculated that it will save money! No treatment, no harm!

Perhaps they might have added that many patients are better off without the kind of 'treatment' currently being offered by the NHS! A doctor is quoted as saying the the forecasts are "concerning" but "not surprising", which again suggests that harming patients within the NHS is the expected norm.

The same doctor added that "since the first lockdown in March 2020, we’ve supported members with nearly 7,000 complaints and adverse incidents. While this isn’t an increase overall on numbers compared to pre-pandemic, we are surprised at the volume, given public understanding and sympathy with healthcare professionals, and also because complaints processes were put on hold at the height of the pandemic."  

NHS medical staff, it would appear, actually expected patients to be more 'understanding' and 'sympathetic towards medical negligence!

What this all demonstrates is that medical mistakes have become a routine, and accepted part of the performance of the NHS. 

I wonder how many patients realise this, or are told this, when they go to see their local GP, or walk through the door of an NHS hospital? The Pulse article certainly makes it clear what doctors wanted - 'reassurance' that complaints were dealt with 'proportionately and fairly' - and that compensation is 'more reasonable'. One doctors is quoted as saying

            "A package of legal reforms is needed to control rising costs and help to strike a balance between compensation that is reasonable, but also affordable for the NHS and society." (My emphasis).

So it is clear that within the NHS there is a routine acceptance that pharmaceutical medicine will cause patient harm, that is it, perhaps, a 'matter of concern', but the primary concern of the NHS is to protect itself from compensation claims for medical negligence. It has to be 'affordable' for the country so the solution is to reduce the cost. Patients can be seriously harmed by pharmaceutical medicine; but the objective is to make it cheaper!

The NHS considers the dangers of pharmaceutical medicine to be unavoidable. Nothing can be done about it. The costs (about 1.5% of the total NHS budget) are already factored into the NHS's budget plans. And more harm is expected in the future.

Yet no action is suggested to reduce medical negligence. It is notable that there is no suggestion that other medical therapies, safer natural therapies like homeopathy, should be reintroduced back into the NHS, so that patients could be offered a choice between risking medical negligence with conventional treatment; or to choose treatment that will not damage the patient, that will not  significant additional costs to the NHS, and an unnecessary charge on the national exchequer.

That would, of course, be too simple!

Postscript May 2022 

More evidence that concern about high levels of compensation being paid to damaged patients is not about concern for patients, or the dangerous medical system that is harming them, but concern about the costs!