I have believed for years that there must be a correlation between government spending on the NHS and the number of medical negligence cases brought against it. The pressures on healthcare professionals are always going to be much greater when hospital budgets are tighter, one of the main problems being staff shortages which lead to overstretched hospitals. The saying ‘tiredness can kill’ is as true of our hospitals as it is of our roads. New statistics from the Office for National Statistics (ONS) and Health Service Ombudsman support this view.
In 20 years of dealing with medical negligence claims, the first 10 of which were spent acting for the defendant, I have seen many medical mistakes which could in some way or other be linked back to underfunding, such as inadequately staffed units, underqualified or inadequately trained individuals, or simply overworked hospital staff.
The ONS figures show a dramatic fall in the growth rate of healthcare expenditure; from a high of 8.1% between 1997 and 2009 to a low of 1.4% from 2009 to 2011. In addition, capital spending on healthcare has dropped by over 34%, from £8bn in 2008 to £5.2bn in 2011. Figures released by the ombudsman show that the NHS received over 150,000 complaints in 2011-2012 – a rise of 1.3% on the previous year.
My firm has definitely noticed an increase in the number of people who have suffered at the hands of a GP, nurse, doctor, midwife or dentist; the very people who should be caring for the public. Many tell us that the reason they are pursuing a claim is because they felt that their problems were not taken seriously – that they were not listened to. And when they asked for more information, they were given advice which was either vague or too complicated, so that they did not understand exactly what was going on.
A major concern expressed by most clients is that there has been a ‘cover-up’; this is a far cry from the culture of openness and candour which is needed. When an error is made, a simple apology and explanation would go a long way. Many of our clients just want answers and it is only when these are not given that they seek legal advice. Many tell us that they would have been satisfied with this approach from the NHS and would not in that event have sought legal advice.
This is perfectly aligned with the ombudsman’s report, which states that between 2011 and 2012 there was a 50% increase in complaints from patients who felt that mistakes in care had not been properly acknowledged. In a recent interview with the Guardian, parliamentary and health service ombudsman Dame Julie Mellor said that many hospital boards were ‘defensive’ when the ombudsman approached them with complaints of failings in care.
We regularly negotiate substantial sums of money for clients who have suffered as a result of such shortcomings. We see simple things which go wrong, such as foreign bodies left behind after surgical procedures, causing months of pain and suffering before detection; patients assessed as ‘not being susceptible to sores’ who develop pressure sores and blisters which then become gangrenous and result in limb amputation. We see badly trained A&E staff who discharge patients presenting with serious conditions, such as Cauda Equina Syndrome and deep vein thrombosis, leading to irreversible double incontinence and fatalities respectively.
And, most costly to the NHS are those overstretched maternity units where mistakes cause brain damage to babies and cost the public purse millions of pounds per case in compensation. Further cuts to a service which is already stretched do not bode well; nor indeed does denying access to justice for victims of medical negligence cases by cutting legal aid.
This vicious circle can only be broken by identifying and homing in on those key areas of the NHS where the biggest claims emanate from, and investing in better training and increasing resources.
Mehmooda Duke is managing director of medical negligence lawyers Moosa-Duke, based in Leicester