NHS negligence claims rise by £850m

Clinical negligence claims against the NHS soared last year by £850m – enough to run three London teaching hospitals for 12 months.

The total bill the health service faced leapt from £4.4bn in March 2001 to £5.25bn in March 2002, an increase of 19.3 per cent, the National Audit Office (NAO) reported. Such a huge rise is a serious drain on the health service and could slow its growth. The outstanding sum has more than doubled since 1998, when it stood at £2.3bn, and has alarmed ministers and MPs.

The NAO also disclosed a growing coyness in the NHS over the salaries paid to top staff. Sir John Bourn, head of the NAO, said a "significant number of staff, including some 50 chief executives" had claimed rights under the Data Protection Act to keep their salaries secret.

Salaries for chief executives of the biggest NHS trusts exceed £100,000. A spokesman for the Department of Health said it was withdrawing guidance it had published suggesting that NHS employees had the right to withhold details of their salaries."After obtaining further legal advice, we fundamentally disagree with that guidance," he said.

On clinical negligence, the NAO said the £5.25bn figure represented the best estimate of the liabilities the health service faced at 31 March 2002. It is not the amount paid out in a single year, but the amount which the NHS expects it will have to spend over a number of years. The amount paid out in 2001-02 was £446m, £31m more than in the previous year.

A spokesman for the NAO said: "Lawyers criticise us every year and say we are simply totting up all the claims and presenting a worst-case scenario, ignoring the fact that many claims will never succeed. But that is not the case. We have looked at the claims very carefully and this is our best estimate of what the outcome will be."

The NAO said a "key cause" of the rise was "changed assumptions made by actuaries". The spokesman said the number of claims had been underestimated in the past because patients had been slow to lodge them. NHS trusts, which used to settle small claims directly, had passed responsibility to the NHS Litigation Authority, which had more accurate figures. The discount rate used to calculate the cost of future liabilities had also changed.

Professor Sir Liam Donaldson, the Government's chief medical officer, opened a review of clinical negligence in 2001 but his report is still awaited. The existing scheme has been widely condemned as outdated, bureaucratic and unfair. In many cases the legal costs of settling claims outweigh the damages that are paid to injured patients.

The Department of Health said yesterday that ministers would bring forward "concrete proposals" within the next month for a mediation service to deal with small claims, which make up 70 per cent of the total number, without involving the courts.

"We are looking at a specific system to speed up the cases to prevent them getting them into the legal process. It would deal with issues of who was responsible and what follow-up there was to prevent the incident happening again which is often what people are most interested in," the spokesman said.