Where There's Blame, There's a Claim: Patients Are Increasingly Suing Doctors in Cases of Medical Negligence. Doctors Are Paranoid and Lawyers Richer, but What of the Patients? (Health)
Dalrymple, Theodore, New Statesman (1996)
Lastweek in my hospital's postgraduate centre, I noticed a stall set up by a large firm of solicitors, manned by some very cheerful and confident-looking people. It was a firm that specialised in medical negligence, and for a moment I felt much as I imagine the hen must feel when the fox breaks into the hen house.
The curious thing is that most hospitals these days seem positively to encourage malpractice lawyers and give them every facility. Each time I go to my outpatients clinic, for example, I pass an electrically illuminated poster asking the outpatients whether they feel they have been the victim of what is called, with barely disguised irony, "a medical accident", in which case they are urged to ring the following number... As a television advertising jingle put it as I walked on to my ward not long ago: "Remember, where there's blame, there's a claim." What's more, the law is a lottery you can't lose: the good old taxpayer will pick up the tab for your claim, whether it is upheld or not.
If only our economy grew at the rate of claims for medical negligence. We would soon all be millionaires. Alas, not only is the economy considerably more sluggish than the legal profession, but medical negligence practised upon us is almost our only hope of ever accumulating a substantial lump sum.
It is not as straightforward as it might seem to establish the rate at which claims for medical negligence are increasing, either in size or number, because of changes in accountancy rules and the way in which statistics are gathered. But everything points in the same general direction. Doctors, as a result of their common experience, have become paranoid about litigation in the same way that residents of sink housing estates have become paranoid about burglary and street robbery. According to the National Audit Office, claims per "thousand finished consultant episode" rose by 72 per cent between 1990 and 1998. The total value of claims outstanding in the NHS in England rose from [pounds sterling]1.3bn in 1997 to [pounds sterling]2.6bn in 2000. At this rate of increase, the value of claims against the NHS will be greater than the entire gross domestic product within 25 years. Certainly, the cost of medical malpractice insurance is rising much faster than inflation (it was [pounds sterling]20 a year when I fir st qualified, and now I pay [pounds sterling]1,600 a year without doing any private practice).
It is always possible that medical negligence has actually increased in the same proportion as litigation: after all, high-tech medicine is now more interventionist than ever before, and wherever there are procedures, there are errors. But in general, the safety of medical procedures has increased rather than decreased: it is the cultural climate that has changed. Not only are solicitors now permitted to advertise, but they are allowed to operate on a "no win, no fee" basis, so that people ineligible for legal aid but not rich enough to go to law from their own resources have been drawn into the suing game.
A constant diet of medical stories in the media -- in which the pendulum swings wildly between miracle cure and murderous incompetence -- encourages people to believe that an unfavourable outcome must be someone's fault. It sometimes seems these days as if the grieving process is incomplete without a visit to the malpractice lawyer: in the eternal search for money, no stone should be left unturned.
Cui bono? Not the plaintiffs, that's for sure, much less the defendants. Only about a quarter of legally aided claims against hospitals succeed, and on average the process lasts eight years. In two-thirds of the cases in which the claim is for less than [pounds sterling]50,000, the legal costs exceed the damages awarded. So the answer is clear: medical negligence litigation benefits the apparatus that administers it.
In a small way, I am myself a beneficiary of the system's largesse. …