what's the problem?
http://www.100md.com
《英国医生杂志》
Hempsons Solicitors, London WC2N 6NJ mamsl@hempsons.co.uk
Brian Capstick's views will come as a surprise to people who suppose that negligence litigation is out of control or a large burden to the NHS. As he shows, it costs well under 1% of turnover, and most of that is the cost of caring for birth injured children, a bill that ought to be met under any system. Given that there are 850 000 adverse events causing harm, 6000 claims seems modest.
The volume of claims is also falling. Making Amends noted that it had fallen in two successive years from a peak of 8000. The Legal Services Commission's new evidence to the chief medical officer's inquiry is that last year they issued only 6000 new certificates and closed 8000 files. This compares with 18 000 new certificates at the peak in 1991. Since 55% of certificates do not result in writs being issued, it is likely that only 2700 new writs will be issued next year.
Time and costs
Capstick refers to the problem of cases that take over five years to resolve as highlighted in the 2001 National Audit Office report.1 The chairman of the Public Accounts Committee in parliament described this as an almost systematic lack of compassion. However, the report looked only at an atypical group of cases: those concerning events before 1995 and closed in 2000. It ignored the cases closed before 2000 and the fact that the legal system changed in 1998. In November 2003, the Litigation Authority announced that the resolution time for cases under ￡30 000 had fallen to eight months. This means the average case is now settled under English tort law faster than it is settled under the New Zealand no fault scheme.
Nor is it true that that much money could be saved by mediation. About 98% of claims are settled without going to trial, virtually all of them by simple negotiation or a payment into court, both of which are much quicker and cheaper than mediation.
Today the English system provides a swift and reasonably robust means of disposing of a modest volume of claims. Any alternative is likely to expand the number of cases. Capstick is surely right when he says that publicising a system in which there is no penalty for a spurious claim would attract a much larger proportion of the 850 000 who are harmed. There are good arguments for expanding the compensation culture, but those against seem more popular.
When liability is conceded in the redress scheme, lawyers will be engaged by many claimants anxious to maximise the value of the concession made. Obviously, legal fees for disputing liability can be avoided if liability is conceded at the start, but far more arguments about the amount of compenasation will exhaust any savings.
Competing interests: BL is senior partner at a firm of solicitors that specialises in advising the healthcare professions and the NHS.
References
National Audit Office. Handling clinical negligence claims in England. London: Stationery Office, 2001. (HC 403 2000-2001).(Bertie Leigh, senior part)
Brian Capstick's views will come as a surprise to people who suppose that negligence litigation is out of control or a large burden to the NHS. As he shows, it costs well under 1% of turnover, and most of that is the cost of caring for birth injured children, a bill that ought to be met under any system. Given that there are 850 000 adverse events causing harm, 6000 claims seems modest.
The volume of claims is also falling. Making Amends noted that it had fallen in two successive years from a peak of 8000. The Legal Services Commission's new evidence to the chief medical officer's inquiry is that last year they issued only 6000 new certificates and closed 8000 files. This compares with 18 000 new certificates at the peak in 1991. Since 55% of certificates do not result in writs being issued, it is likely that only 2700 new writs will be issued next year.
Time and costs
Capstick refers to the problem of cases that take over five years to resolve as highlighted in the 2001 National Audit Office report.1 The chairman of the Public Accounts Committee in parliament described this as an almost systematic lack of compassion. However, the report looked only at an atypical group of cases: those concerning events before 1995 and closed in 2000. It ignored the cases closed before 2000 and the fact that the legal system changed in 1998. In November 2003, the Litigation Authority announced that the resolution time for cases under ￡30 000 had fallen to eight months. This means the average case is now settled under English tort law faster than it is settled under the New Zealand no fault scheme.
Nor is it true that that much money could be saved by mediation. About 98% of claims are settled without going to trial, virtually all of them by simple negotiation or a payment into court, both of which are much quicker and cheaper than mediation.
Today the English system provides a swift and reasonably robust means of disposing of a modest volume of claims. Any alternative is likely to expand the number of cases. Capstick is surely right when he says that publicising a system in which there is no penalty for a spurious claim would attract a much larger proportion of the 850 000 who are harmed. There are good arguments for expanding the compensation culture, but those against seem more popular.
When liability is conceded in the redress scheme, lawyers will be engaged by many claimants anxious to maximise the value of the concession made. Obviously, legal fees for disputing liability can be avoided if liability is conceded at the start, but far more arguments about the amount of compenasation will exhaust any savings.
Competing interests: BL is senior partner at a firm of solicitors that specialises in advising the healthcare professions and the NHS.
References
National Audit Office. Handling clinical negligence claims in England. London: Stationery Office, 2001. (HC 403 2000-2001).(Bertie Leigh, senior part)