Clinical negligence cases are, in theory, suitable for mediation.

The high cost and uncertainty of this type of litigation as well as the stress and distress for the litigants on both sides are cited as reasons for looking at alternatives to litigation.

It is absolutely right that for years the cumbersome beast known as a civil claim, with non-specialist lawyers on either side, limitless public funds and the process itself encouraging secrecy and entrenched positions, did not result in amicable, early or satisfactory resolution.Mediation, on the other hand, apparently can and does achieve these aims.

So it is not surprising that mediation is on most practitioners' lips and is being encouraged by the courts and is the subject of a recent Legal Services Commission consultation paper.However, after first-hand experience of a mediated clinical negligence claim, it is questionable whether the advantages are as clear cut as they ought to be, and more importantly, whether mediation can actually present disadvantages for the claimant.In the case in question, mediation was only agreed six weeks before trial.

As with so many medical negligence cases, it was a highly charged and emotional situation.

Although the claimant had her say at the round table meeting of all sides, the doctor admitted nothing, nor as far as I recall, apologised for the claimant's suffering.After 'bartering' through an intermediary for more than 12 hours, the hospital trust vehemently denying responsibility until an offer was made, an agreement was finally drawn up by the mediator.

My client received her compensation but the rest of the agreement was not acted upon until court intervention was threatened, at which point the terms of this 'informal' process were put into action.So were the advantages real or imaginary? Did the mediation live up to expectations? The answer is complex.

Mediation can provide rapid resolution of clinical negligence claims largely through compromise on both sides -- more so than in a negotiated settlement.

However, the mediated and informal process can make it difficult to put your case across strongly and exert any control in an atmosphere where few rules exist -- what evidence is allowed and what is not, for example.As for the advantages, arguably post CPR, pre-action protocols and with the advent of specialist lawyers, limits on public funding and the cards on the table approach means legal claims are being handled quickly and cost effectively.

Most specialist practitioners in this field will carry a 85%-plus success rate in designated legal claims.Having been a strong exponent of mediation, my recent experience leads me to conclude that it is not a panacea for clinical negligence claims and can be a Pandora's Box.

As with all informal processes, you need some ground rules.

Lawyers, used to a far more adversarial approach, need to be trained in mediation skills.

Both sides need a clear idea of what they hope to achieve through mediation and clients should be told what to expect in emotional terms, particularly in clinical negligence cases.

Finally, clients should be advised to prioritise what they are willing to accept by way of compromise and agreement on costs should be obtained prior to entering into mediation.With time, education, and a concerted effort from both sides who are party to litigation, mediation can present a worthwhile alternative.

However, it should only be seen as a viable alternative at the right time and in the right cases.

As with all new approaches to litigation, it will be a while before some of the difficulties are ironed out and practitioners become accustomed to new working practices.