Searching for a fairer method of compensation

Published on Monday 26 May 2008 21:46

I RECENTLY looked at information concerning patients' complaints, medical and dental negligence claims, settlement fees and other data about "when things go wrong" in health care.

Earlier this year, the Scottish Government published details of hospital payouts to patients for healthcare mistakes.

The amount paid out in 2005-6 was 9.8 million, but in 2006-7 this figure had jumped to a massive 23 million. The government's explanation was that last year's figures rocketed because of a few large settlements for birth injuries. However, these figures only relate to hospital errors; the government does not provide cover for GPs, dentists or those who work in the private health sector.

Healthcare workers have a choice of suppliers of medical indemnity, but in Scotland such cover is mainly provided by the Medical and Dental Defence Union of Scotland (MDDUS). This Glasgow-based organisation has supported doctors and dentists throughout the UK for more than a century.

Perhaps defence is rather a negative word, suggesting an adversarial approach or a siege mentality. However, this organisation is a vital element in ensuring that medicine and dentistry are practised to the highest standards. By providing advice, education and support, the MDDUS promotes best practice.

Things inevitably do go wrong, and if a patient has suffered because the doctor or dentist has made an error, then there are adequate funds available to ensure that appropriate reparation is made. Having an organisation like this acting as a safety net can be a great reassurance to doctors and patients.

Receiving a complaint about the care you provide is a major psychological blow for a doctor or dentist. I have yet to meet a colleague who didn't want to do his or her best for their patients, but – perhaps because they delayed too long, missed a vital piece of information, or were so time pressured that they took a shortcut – mistakes happen.

I am not making excuses. Mistakes need to be minimised, but when they do happen, doctors, dentists and nurses should acknowledge it, apologise and learn from it so that in future they can avoid similar mishaps. MDDUS helps professionals to make the appropriate response.

Looking at their figures, it was gratifying to see that over the last ten years, despite the increased complexity of medicine and the greater awareness of litigation, the overall number of claims has not increased, although settlement figures have risen faster than inflation. Like those of the Scottish NHS, MDDUS's figures were inflated last year by a multimillion-pound settlement to a child who was allegedly damaged during birth by a private obstetrician.

That first journey we all take down the birth canal is a very dangerous one and, fortunately, there are very few occasions when things go wrong. Even when they do, there is often no-one to blame. The doctors, nurses and midwives will have done everything to minimise the risk, but babies are still born severely handicapped as a result of a birth injury.

This seems incredibly unfair for the child and family. To compound that unfairness, if you can prove a medical mistake, the child can get many millions of pounds to support them through a difficult life, but if the birth injury happened by chance you get nothing.

The children and their families have to live with serious limitations due to birth injury and though the disability for the children is the same, one is supported financially for life while the other has to struggle.

In its 2007 manifesto, the SNP said: "We will replace the NHS clinical negligence scheme with a no-fault compensation scheme." This was a commitment welcomed by the British Medical Association.

We await details, but let's hope that in the area of birth injuries in particular it will support all birth-injured babies, not just those in cases where, after a court battle, it it decided that a health professional was at fault.