The quality of legal advice offered to health authorities and trusts dealing with medical negligence claims is 'varied', according to Steve Walker, chief executive of the NHS Litigation Authority.
Commenting on the authority's annual report, he said that in too many cases the cost of legal fees exceeded the potential settlement.
Cases brought to the authority showed there was often 'an inability to foresee the likely outcome or to bring matters to a conclusion within a reasonable time frame'.
The annual report says the number of medical negligence claims against the NHS last year was far higher than anticipated. It shows 4,285 new claims were received in 1997-98 under the existing liabilities scheme, which covers incidents up to 1995.
HAs and trusts may have been pursuing these cases individually, but would report them to the authority if the settlement was higher than expected or the case unexpectedly went in the appellant's favour.
Since 1995, trusts have been part of the clinical negligence scheme for trusts, a centralised insurance scheme administered by the authority, which only handles settlements over an agreed excess.
The authority spent£100m on claims last year, but estimates that the NHS probably spent£250m in total if smaller settlements dealt with directly by trusts and HAs are included. In the report, Mr Walker says: 'We hope to reduce legal costs on both sides and reduce the drain on NHS funds.'
Report and accounts 1998. NHS Litigation Authority, 5 Pemberton Row, London EC4 3BA. Free.