Practice Direction No 49 is headed 'medical negligence' and appoints Master Foster to take on all new medical negligence (MN) cases assigned in the High Court in London from 1 November 1996.

This concentration of all MN business in the hands of one person should enable him to develop case management experience in preparation for the Woolf reforms.

It is also a move towards the medical negligence list recommended in the Woolf report.The practice direction draws on the existing rules to produce a regime halfway between the present practice and a reformed Woolf one.The initial move came from the senior master, who sent out copies of a draft practice note for consultation.

With his blessing an informal group of about 20 people was convened, nominated by the Professional Negligence Bar Association, the Association of Personal Injury Lawyer's MN special interest group, the Healthcare Lawyers Association (a recently formed group of MN specialists acting for defendants), the Law Society, Action for the Victims of Medical Accidents, the National Consumer Council, the Defence Societies, the National Health Service Litigation Authority, the just-formed Experts' Institute, and the Lord Chancellor's Department.The group's views were received favourably by Master Foster and Master Turner and resulted in the practice direction shown below.

Points to consider include the following.-- The plaintiff is urged to serve a letter three months before starting proceedings.

If this is done then an application for an extension of time for the defence may be refused.

The court's view is that proper pre-litigation conduct requires a reasonable attempt to resolve the action without litigation.-- From now on, once the defence is served, the parties are on a firm timetable which will carry on to trial.

The plaintiff must issue a summons for directions within 28 days of close of pleadings, and the first hearing of the summons will fix a timetable for the exchange of evidence and provide for fixing a trial date.

A second hearing will monitor the workings of the timetable.

A plaintiff who allows a defendant too much rope may find the master looking askance when he reaches his first directions hearing.-- Alternative dispute resolution must be given real consideration early in the action.

It is no longer something to think about at trial checklist stage.-- The system will generate useful tools for case management both by the parties and the courts early on -- a brief summary of the action, a chronology and a brief list of issues.

These documents will be an invaluable quick reference system for Master Foster.

The vast amount of documents are to be lodged 48 hours before the hearing.

Note that the pleadings are not required at this stage; these will be reduced to the list of issues summarising what needs to be decided in the action and should be under 250 words.-- Litigation will become more open because the defendant will have to identify the issues, and both parties will be expected to identify their witnesses (personally in the case of factual ones; by specialty, following practice form 50, for experts).-- The development of issues-based litigation means focusing on the point of each piece.

What does it establish? Is it value for money?-- Lawyers will have to attend the directions hearings for their own cases.

It may no longer be worth agreeing directions over the phone.Practice form 50, on which this practice direction is based, has been more honoured in the breach than the observance in this area of practice until very lately.

Master Foster is interested in the problems of MN and is keen to make case management in this area work.

His success can only benefit our clients and the speedy operation of justice.PRACTICE DIRECTION NO 49 -- MEDICAL NEGLIGENCE (Practice direction issues by Senior Master Robert Turner of the Queen's Bench Division)1.

From 1 November 1996, Master Foster has been assigned to hear all interlocutory applications in actions involving claims arising out of allegations of medical/clinical negligence.2.

The following arrangements will apply to all such actions to which a master has not been assigned prior to 1 November 1996.3.

(a) The plaintiff in such actions must issue a summons for directions within 28 days of the close of pleadings and shall mark the summons in the bottom right hand corner 'medical negligence'.

On seeking a hearing for the summons, the counter staff in room E214 are to be told that the case involves allegations of medical negligence.(b) The plaintiff shall serve with a copy of the summons:(i) a summary description of the action limited to 250 words; and(ii) a chronology of material events in the form of a schedule.(c) The defendant shall, within 14 days of receipt of a copy of the summons:(i) produce an initial list of outstanding issues limited to 250 words;(ii) comment on the plaintiff's chronology.4.

Such applications will be listed before Master Foster on Tuesdays or Fridays within 28 days of issue.

In the vacation, the summons will be listed within 28 days of the start of the next term or will be taken by one of the vacation masters.5.

At the first hearing of the summons for directions:(a) Each party shall produce an initial list of their potential witnesses as to fact.(b) Each party shall specify the number and discipline of the experts it currently intends to rely on, when their reports will be available and the issues to which they will be directed.(c) Each party must state whether alternative dispute resolution has been considered and if not why not, and if alternative dispute resolution has been rejected why this is so.(d) Paras 1 to 12 and 19 of practice form 50 will be dealt with and a date fixed for dealing with the remaining directions including updating the list of issues and the listing of admissions.

This date will be shortly after the latest date for exchange of experts' reports and witness statements.6.

The documents referred to in para 3(b) and 3(c) should be lodged with Master Foster at least 48 hours before the time fixed for hearing the summons for directions.7.

All time summonses in medical negligence cases after 1 November 1996 will be heard:(a) in term, by Master Foster at 10am on Tuesdays and Fridays;(b) in vacation, in accordance with the current practice.8.

In all medical negligence actions the plaintiff should serve each intended defendant with a letter before action, at least three months before issue of the writ.

S uch a letter should set out the fullest available information as to the basis of the claim.

If the plaintiff does not serve such a letter then the court may grant an appropriate extension of time to the defendant for serving a defence.9.

The hearing of all summonses (other than time summonses) in medical negligence actions must be attended by the solicitor in charge of the case or counsel instructed therein.

If, for good reason, this is not possible, a fully briefed deputy may attend.

However, if the summons cannot be dealt with properly because of the deputy's lack of familiarity with the case, a wasted costs order may be made.