Clinical negligence lawyers billing the NHS £130m a year have rejected a claim that their fees are ‘indefensibly expensive’ by blaming rising costs on the NHS Litigation Authority (NHSLA) and its panel solicitors.

The NHSLA, in its submission to Lord Justice Jackson’s review of civil litigation costs, said conditional fee agreements (CFAs) are the cause of rising costs. It said some claimant solicitors charge 100% success fees, doubling the Supreme Court Costs Office guideline hourly rate for a City partner to £804 an hour.

The submission’s author, NHSLA chief executive Steve Walker, said: ‘Claimant solicitors are like any business trying to maximise profits, but the steep rise in costs and premiums has made them indefensibly expensive.’ He called for cost-capping, earlier intervention and the use of ‘templates and precedents’ to speed up the process.

Pressure group Action Against Medical Accidents (AvMA) said costs are inflated by defence lawyers’ slowness to admit liability and settle. ‘They have little incentive to run cases efficiently because they are paid for as long as the cases drag on,’ spokesman Peter Walsh said.

Walsh pointed to the ‘hidden cost’ of inexperienced defence lawyers. ‘Our members say market forces have led to the development of specialist expertise on the claimant side. The defence side, however, is comparatively under-resourced and without the same level of well-honed professionalism.’

AvMA member and deputy vice-president of the Law Society Linda Lee said individual doctors and trusts also delay cases and prevent quick settlements.

Law Society Chief Executive Des Hudson said: ‘The NHSLA, according to its website, takes an average of nearly one-and-a-half years to deal with claims. Instead of focusing on the fees of solicitors... it should cut legal costs, including its own, by settling quickly – and reducing negligence.’

David Body, medical law head at Irwin Mitchell, the national firm whose £10.75m bill topped last year’s league table for billing the NHS, said the NHSLA figures show only the cost of medical mistakes that are litigated. ‘Only a small proportion of medical accident victims make claims, but even those not resulting in claims cost the NHS in follow-up treatment and care... Cut mistakes and the NHS will cut its costs as well.’