NEWS

Plans to reform the clinical negligence system in an attempt to cap spiralling legal costs have been greeted with scepticism by groups representing doctors and patients.

Last week, chief medical officer Professor Liam Donaldson issued a consultation document Call for Ideas in which he set out plans to make clinical negligence faster and fairer while reducing costs by cutting bureaucracy.

Comments are invited from NHS staff and patients, which will inform a newly convened advisory committee that plans to revamp the system.

Ideas under discussion include a no-fault system, a scheme of structured settlements which would see payments adjusted to take account of changing needs, fixed tariffs for specific injuries and greater use of mediation instead of financial compensation.

The committee will include representatives of trusts, doctors, lawyers and patients' groups including doctors' indemnity organisation the Medical Defence Union, and patients' groups Action for Victims of Medical Accidents and Scope.

But the MDU, AVMA and Scope told HSJ they had concerns about the usefulness of some of the document's proposals. Marcus Ward, deputy director of AVMA, said:

'The main thing we will be pushing for is a totally independent complaints process for the NHS, which operates outside trusts and looks at cases in a more holistic context.

'No-fault compensation is not something we are in favour of because it takes away any sense of accountability.'

Dr Frances Szekely, the senior medical claims handler at the MDU, agreed that no-fault compensation was 'contrary to natural justice and the rules of tort - the right to redress through the civil court'.

She said mediation was something the MDU had been trying to use for many years. 'But it is something that it is difficult to get patients interested in.'

However, she welcomed more emphasis on structured settlements.

'We believe they are in the patients' best interests and we have been offering such settlements for some time.'

Robert McLean, a spokesman for cerebral palsy charity Scope, agreed that no-fault took away the right to a court action. He said:

'At present, the legal system is the only way of getting a really detailed examination of what happened to a patient.'

Mr McLean added: 'We want to use the committee as a chance to clarify some of the fundamental post-birth rights for children and their families.'