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The committee is effectively saying that the NHS has a systemic problem managing the defence of clinical negligence claims and, fundamentally, that it fails to learn from them.

I defended clinical negligence claims for an NHS Trust about 20 years ago and on a number of cases I noted the mistakes by the same surgeon cropping up on claims and I could see where practice failures had led to injury. I raised this internally with the Trust but there appeared to a lack of willingness to confront the issue or to enact changes or processes to improve practice (or monitor or retrain negligent or dangerous surgeons).

I was confounded then, as I am now, by an apparent unwillingness to be open and to learn from mistakes - surely the NHS, which has the concept and delivery of 'care' at its very heart would be confident enough to be able to challenge itself to do better in the performance of its core objectives? It is pathetic that it has failed to do so, it's bizarre and it is also madness because, as Ms Hillier points out, it locks the NHS in a spiraling struggle to defend claims by diverting funding from front-line services.

Ms Hillier is merely discovering what those in practice have known for years.