NHS Redress Bill [Lords]

As I said a moment ago, the majority of clinical negligence cases that are settled involve compensation of less of £20,000. In the past couple of years, in slightly more than half of the cases settled for between £10,000 and £20,000, the legal costs exceeded the damages. For cases settled below £10,000, legal costs exceed compensation in some 90 per cent. of cases. That is not a satisfactory situation. I shall give an example of a case that was dealt with by the health service ombudsman, because it had not been properly dealt with by the hospital concerned. A woman, Mrs. X, injured her foot in a fall. She went to accident and emergency, where X-rays were taken, and she was told that she had sprained her ankle and did not need any treatment. A few weeks later, when she was still in pain, she saw a consultant orthopaedic surgeon who confirmed that the X-ray showed no fracture. The ankle was put in plaster and Mrs. X later had physiotherapy. Still in pain, she went back to the consultant in October 1998 and he arranged an exploratory operation, which took place in February 1999. In July 1999, on reviewing the original X-rays, the consultant surgeon realised that Mrs. X had, in fact, sustained a fracture of the heel bone. She was only told about that in September 1999—18 months after she first attended accident and emergency. The issue should have been dealt with by the hospital trust involved, but as it was not, the ombudsman’s clinical assessor identified a very obvious extensive fracture of the heel bone that had unfortunately been missed by both the consultant radiologist and consultant surgeon. If the diagnosis had been right at the outset, Mrs. X would have had the right treatment, instead of being subjected to what proved to be an unnecessary and painful operation. Once the ombudsman had intervened in the case, the trust apologised to Mrs. X and paid her damages of about £12,000. Of course, that should have happened on the initiative of the trust, without the need for the ombudsman’s intervention. The new redress scheme that the Bill will establish will encourage all the hospitals that it covers—NHS trusts, foundation hospitals and independent providers—to take action themselves on cases like that of Mrs. X, to seek them out even if a complaint is not made, to investigate the facts and, where clinical negligence is established, to apologise, to learn the lessons and, where appropriate, to offer compensation.