The Commons health select committee has given its backing to calls for the introduction of no-fault compensation schemes for the NHS.
It has urged the Department of Health to consult on schemes under which patients would not have to prove fault in court, but only demonstrate a link between their treatment and any injury they received.
The recommendation in a report published this week, Procedures Related to Adverse Clinical Incidents and Outcomes in Medical Care , supports a case argued for a decade by the British Medical Association and the Royal College of Physicians.
But it acknowledges fears that without financial limits on compensation, schemes could end up becoming 'very costly', while removing the 'deterrent effect' of litigation in ensuring professional accountability.
David Towns, a spokesman for the NHS Litigation Authority, said: 'The introduction on no-fault schemes would mean the amount of compensation given to individuals would be reduced, assuming the total pool of money is the same.'
He said the DoH would 'need to talk to colleagues in the Treasury' ahead of any reform.
The NHS Confederation also sounded a sceptical note. Policy director Nigel Edwards said: 'There is no evidence that a no-fault compensation scheme is fairer, quicker, cheaper or more effective than the current system.'
But the BMA welcomed support for 'something for which we have been pressing for many years'.
It opposed another of the report's recommendations - constitutional change to put a lay majority on both the General Medical Council and the UK Central Council for Nursing, Midwifery and Health Visiting.
Both the BMA and the UKCC flagged up the government's 'very recent' commitment to principles of self-regulation in the Health Bill. The UKCC described the proposal as 'interesting and challenging' but stressed that it had done 'all we could' to strengthen lay membership on its policy and professional bodies without legislative change.
The health committee report also calls for a shake-up in complaints procedures to tackle 'scepticism about the independence' of panels chaired by staff employed by trusts and health authorities that are subject to complaint.
It urges the abolition of the current role of convenors on independent review panels, to be replaced by fewer chairs recruited and funded by regional offices and operating across regions to 'build up expertise'.
The new panels would have increased powers to summon witnesses and take evidence, recommend disciplinary action, and refer any major concerns to the Commission for Health Improvement or to the health service ombudsman.
But the NHS Confederation warned against 'beefing up systems' to create a 'quasi-judicial review process' which could be more complex and slower than the current system.
The DoH welcomed publication of the report which 'will feed into the work already under way on poorly performing doctors and incident-reporting arrangements and to the evaluation of the NHS complaints procedure'.
The select committee's other recommendations
Department of Health guidance to regional offices, health authorities and trusts giving 'clear advice' as to which incidents should be reported, to whom and when, with the information feeding into a national database held by the DoH.
The creation of a standard proforma so parallel investigations can share information.
The DoH to address any 'early indications of problems' shown in the interim report from NHS evaluation of complaints procedures due in spring.
Patients' advocates based at every community health council.
Procedures Related to Adverse Clinical Incidents and Outcomes in Medical Care: volume 1 report and proceedings of the committee. Stationery Office, 0845-702 3474.£9.80.