APIL has
published its response to the proposals for fixed fees in Clinical Negligence
cases. Interestingly they emphasise the important and unsung screening work
done by claimant’s legal advisers.
This is
something which I have mentioned in the past. It is very easy to overlook the
importance of this in weeding out the weaker cases and ensuring that only the
clearest of cases are presented to the NHS. I have never seen any acknowledgment
of this by the government or NHSLA.
The impression
is given of aggressive ambulance chasers who are simply building up case loads
to attack the beleaguered health service. In fact, in the case of my own firm
an average of 60 cases is pursued for every 1000 unhappy patients
In most
cases this work is done without payment. It is, of course, in our interests to
select the strongest cases. In a world of no win no fee litigation – imposed by
successive governments – no litigator can earn a living by taking on weaker
cases. This will ultimately lead to a reduction in the number of ‘cutting edge’
cases that have historically developed the common law. But that is another topic for another day. But
the reality is that the volume of cases faced by the NHS is controlled by this unpaid
work done by claimant lawyers.
I have to
agree with APIL that a squeeze on payments in lower value reduce lawyers’
capacity to carry out this exercise. Although I suspect that many firms will
still be cautious, for the sake of their own commercial viability. Equally they
do have a point that a deluge of poorly screened cases will ultimately lead to much
higher costs overall.
I am not in
fact against the idea of fixed costs in principle. Any arrangement that rewards
speed and efficiency must be preferable to one that encourages the chalking up
of as many hours as possible. But if the aim is to use this to reduce the
number of claims then any economy will be false.
This is of course based on the
government’s fixation with blaming victims and their advisers.
Far more significant
savings will be achieved by a focussing on the avoiding of negligence in the first
place. It would also lead to huge savings if early admissions were made. How
often to these cases develop into a war of attrition only to settle at the 11th
hours after eye watering costs have been incurred?
The NHS has notably, been
criticised by the courts for refusing to mediate in some cases –
These
fundamental changes in attitude will achieve far more than any tinkering with
the costs regime.
Great blog as always, Steve. Interestingly I was talking to a senior doctor last night who was saying the whole NHS system would be so much better if complainants were referred to a panel of lawyers in the first place, to assist them in presenting their case and weed out what were genuine concerns; so the ones which are just grumbles/moans but not negligence matters could be dealt with as that at an earlier stage and NHSLA resources concentrated on the valid ones. And that's from someone within the system!
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