Skip to main content
SpringerLink
Log in

Alternative Compensation Schemes for Medical Malpractice in the United Kingdom

  • Chapter
  • First Online:
Compensation Schemes for Damages Caused by Healthcare and Alternatives to Court Proceedings

Part of the book series: Ius Comparatum - Global Studies in Comparative Law ((GSCL,volume 53))

Abstract

This chapter examines the state of law and regulation concerning medical malpractice in the UK in the context of alternative compensation or redress schemes available for patients who find themselves injured in the course of a healthcare interaction. A reader will find that the overwhelming majority of such injuries are left to be dealt with by more or less unaltered private law rules. It is characteristic of the English common law that there is little by way of a lex specialis that deals with such injuries. Indeed, suggestions of generally implementing anything akin to many continental-style no-fault compensation or redress schemes have been rejected on grounds of the likely cost of doing so. Nevertheless, there are a number of small scale, specific schemes, along with a redress scheme for relatively low-level injuries now in operation in Wales, and a number of specific procedural requirements in the context of malpractice litigation generally that are worth considering as relevant in this space.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Chatterton v Gerson [1981] QB 432.

  2. 2.

    Kralj v McGrath and St Theresa’s Hospital [1986] 1 All ER 54.

  3. 3.

    Pickett v British Rail Engineering Ltd [1980] AC 136.

  4. 4.

    H West & Son Ltd v Shephard [1964] AC 326.

  5. 5.

    West Bromwich Albion Football Club Ltd v El-Safty [2006] EWCA Civ 1299; [2007] PIQR P7.

  6. 6.

    Thake v Maurice [1986] QB 644.

  7. 7.

    Roe v Ministry of Health [1954] 2 QB 66; Various Claimants v Catholic Child Welfare Society [2013] 2 AC 1.

  8. 8.

    It should be noted that this scheme does not extend to primary healthcare services such as General Practitioners, who, other than in emergency situations, form the gateway to accessing secondary services such as hospital treatment under the NHS.

  9. 9.

    Notable examples include Chester v Afshar [2004] UKHL 41; [2005] 1 AC 134 and Thake v Maurice [1986] QB 644.

  10. 10.

    Glynn and Gomez (2012), pp. 116, 2-047f.

  11. 11.

    Glynn and Gomez (2012), pp. 88–89.

  12. 12.

    Allinson v General Council of Medical Education and Registration [1894] 1 QB 750. For a developmental overview of this system see Smith (1994); Quick (2017), p. 88ff.

  13. 13.

    Treverton-Jones et al. (2017) para 2.56ff.

  14. 14.

    Glynn and Gomez (2012), pp 857–860; Treverton-Jones et al. (2017) para 2.56ff.

  15. 15.

    Cane (2013), p. 199ff.

  16. 16.

    Morgan (2018).

  17. 17.

    Goldberg (2013), p. 469.

  18. 18.

    The two most trenchant invectives can be found in: Atiyah (1997) and Cane (2013).

  19. 19.

    Sumption (2018).

  20. 20.

    Lunney et al. (2017), p. 998.

  21. 21.

    Department of Health (2001), pp. 365–366.

  22. 22.

    Department of Health (2001), p. 451.

  23. 23.

    Chief Medical Office (2003), p. 108.

  24. 24.

    Sweden, Finland, Denmark, Norway, France and New Zealand; Chief Medical Office (2003), p. 96f.

  25. 25.

    Chief Medical Office (2003), pp. 111–112. Whether this would necessarily lead to a spike in claims, as feared, is unclear. See Taylor (2015), p. 87, noting that one Welsh Health Board reported a two-thirds increase in complaints (rather than claims) following the introduction of Putting Things Right.

  26. 26.

    NHS Redress Act 2006, see generally Cave (2011).

  27. 27.

    NHS Redress Act 2006, s 3(2) c.

  28. 28.

    Jones (2018a), pp. 38–41.

  29. 29.

    Consultation on Recommendations for No-Fault Compensation in Scotland for injuries resulting from clinical treatment (2014).

  30. 30.

    No-Blame’ Redress Scheme: A Public Consultation on Draft Proposals for a ‘No-blame’ Redress Scheme in Scotland for Harm Resulting from Clinical Treatment (2016).

  31. 31.

    The National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011, 2011 No 704 (W 108); as amended by The National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) (Amendment) Regulations 2011, 2011 No 1706 (W 192). It should be noted that the explanatory note to the regulations makes clear that this scheme does not apply to either primary care providers (such as General Practitioners) or, obviously, private practitioners outside the NHS.

  32. 32.

    The National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011, 2011 No 704 (W 108) r 44(1).

  33. 33.

    Macleod and Hodges (2017), p. 557ff. In the case of infection with Hepatitis C, since 1st November 2017 this has been shifted from a central UK-wide fund, the Skipton Fund, to regional bodies for each of the constituent parts of the UK.

  34. 34.

    The sum has varied over time with the original payment being £10,000. See Jones (2018b), p. 36, n162.

  35. 35.

    The Regulatory Reform (Vaccine Damage Payments Act 1979) Order 2002 (SI 2002/1592) art 2.

  36. 36.

    Vaccine Damage Payments Act 1979 s 1(4).

  37. 37.

    Vaccine Damage Payments Act 1979 s 3(1) c(i).

  38. 38.

    Vaccine Damage Payments Act 1979 s 1(3).

  39. 39.

    Chief Medical Office (2003), p. 104, para 48.

  40. 40.

    Jones (2018b), p. 36, para 1-049.

  41. 41.

    Cane (2013), p. 107.

  42. 42.

    Jones (2018b), p. 35, para 1-048.

  43. 43.

    Jones (2018b), p. 34, para 1-047.

  44. 44.

    Blyth v Birmingham Waterworks Co (1856) 11 Ex 781.

  45. 45.

    Montgomery v Lanarkshire Health Board [2015] UKSC 1; [2015] AC 1430, see below.

  46. 46.

    Roe v Ministry of Health [1954] 2 QB 66 at 84.

  47. 47.

    Warren v Greig (1935) The Lancet 1, which concerned a very remote possibility of the patient bleeding to death following the removal of teeth.

  48. 48.

    Paris v Stepney Borough Council [1951] A.C. 367.

  49. 49.

    Hucks v Cole [1993] 4 Med LR 393.

  50. 50.

    Compensation Act 2006 s 1; Tomlinson v Congleton Borough Council [2003] UKHL 47; [2004] 1 AC 46.

  51. 51.

    Jones (2018b), p. 304, para 3-087.

  52. 52.

    Wilsher v Essex Area Health Authority [1987] QB 730 at 749, although that case, which involved injury suffered by a premature child who was injured when a junior doctor inserted a catheter into the wrong vein, did not fall in that category.

  53. 53.

    Bull v Devon Area Health Authority [1993] 4 Med LR 117.

  54. 54.

    Jones (2018b), p. 301, para 3-080.

  55. 55.

    [1957] 1 WLR 582.

  56. 56.

    [1957] 1 WLR 582, 586.

  57. 57.

    [1957] 1 WLR 582, 587.

  58. 58.

    Bolitho v City and Hackney Health Authority Respondents [1998] AC 232, at 241–242.

  59. 59.

    Ndri v Moorfields Eye Hosptial NHS Trust [2006] EWHC 3652.

  60. 60.

    Montgomery v Lanarkshire Health Board [2015] UKSC 1; [2015] AC 1430.

  61. 61.

    Montgomery v Lanarkshire Health Board [2015] UKSC 1, at [81].

  62. 62.

    Montgomery v Lanarkshire Health Board [2015] UKSC 1, at [87].

  63. 63.

    A v East Kent Hospitals University NHS Foundation Trust [2015] EWHC 1038; [2015] Med LR 262.

  64. 64.

    See the discussion in the Court of Appeal in Wilsher v Essex Area Health Authority [1987] QB 730.

  65. 65.

    Barnett v Medway NHS Foundation Trust [2017] EWCA Civ 235; [2017] Med LR 217.

  66. 66.

    Jones (2018b), p. 358, para 3-171.

  67. 67.

    Scott v London & St Katherine Docks [1861-73] All ER Rep 248.

  68. 68.

    Mahon v Osbourne [1939] 2 KB 14; Cassidy v Ministry of Health [1951] 2 KB 343; Thomas v Curley [2013] EWCA Civ 117; [2013] Med LR 141.

  69. 69.

    Morris v Winsbury-White [1937] 4 All ER 494.

  70. 70.

    Fletcher v Bench (1973) 4 BMJ 17.

  71. 71.

    Ratcliffe v Plymouth and Torbay Health Authority [1998] PIQR P170.

  72. 72.

    Roe v Ministry of Health [1954] 2 QB 66; Horton Rogers (2011), pp. 186–187; Jones (2018b), p. 80, para 2-012.

  73. 73.

    Thake v Maurice [1986] QB 644.

  74. 74.

    A concern equally apparent in other areas of medical malpractice law, see Montgomery v Lanarkshire Health Board [2015] UKSC 1 at [55].

  75. 75.

    Jones (2018a), p. 646, para 10-043; Pantelli Associates Ltd v Corporate City Developments Number Two Ltd [2010] EWHC 3189 (TCC); ACD (Landscape Architects) Ltd v Overall [2012] EWHC 100 (TCC).

  76. 76.

    Caribbean Steel Co Ltd v Price Waterhouse [2013] UKPC 18.

  77. 77.

    Goldberg (2013), p. 452f.

  78. 78.

    Civil Procedure Rules, SI 1998/3132 (L17) r 35.4.

  79. 79.

    Civil Procedure Rules, SI 1998/3132 (L17) r 35.7(1).

  80. 80.

    Jones (2018b), p. 1271, para 13-020.

  81. 81.

    Legal Aid, Sentencing and Punishment of Offenders Act 2012 Sch 1, Pt 1 para 23. It is important to note that, even where this requirement is satisfied there is a further assessment of the merits of the claim and a cost/benefit analysis of bringing it, see Jones (2018b), pp. 1271–1272.

  82. 82.

    Goldberg (2013), p. 470.

  83. 83.

    Limitation Act 1980 s 11(4).

  84. 84.

    A v Hoare [2008] UKHL 6; [2008] 1 AC 844, interpreting s 11(1) of the 1980 Act.

  85. 85.

    Limitation Act 1980 s 11(5).

  86. 86.

    Jones (2018b), p. 1168, para 12-002; Wells v Wells [1999] AC 345.

  87. 87.

    Cane (2013), p. 142.

  88. 88.

    Cane (2013), p. 157.

  89. 89.

    Horton Rogers (2011), p. 192, noting, however, that in practice there may be limits set by precedent on recovery for non-pecuniary losses.

  90. 90.

    See the documents available on the website of the Department of Health and Social Care: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/681387/2018_FRC_Consultation_response_.pdf. (last accessed March 2020).

  91. 91.

    Cane (2013), p. 167, referring to the Guidelines for the Assessment of Damages in Personal Injury Cases.

  92. 92.

    Cane (2013), p. 171.

  93. 93.

    Cane (2013), p. 172, n 141, stressing the proportion of such awards that goes to long-term care.

  94. 94.

    Variance after the fact is possible, but, in practice severely limited by tying any such application to the period of time within which, after trial, an appeal would have been possible. This allows, in principle, for new evidence to be considered on appeal, but, in practice, the window is, at most, a matter of weeks, see CPR R.52.4, r. 52.5. See also Horton Rogers (2011), pp. 191–192.

  95. 95.

    Lim Poh Choo v Camden and Islington AHA [1980] AC 174, at 183.

  96. 96.

    Damages Act 1996 (amended by the Courts Act 2003 s100).

  97. 97.

    Damages Act 1996 s 2(1)b.

  98. 98.

    Cane (2013), p. 140, n 33.

  99. 99.

    See also the 2005 regulations.

  100. 100.

    Cane (2013), p. 141.

  101. 101.

    Lunney et al. (2017), pp. 899–900.

  102. 102.

    Lewis (2006), p. 418.

  103. 103.

    Cane (2013), p. 141.

  104. 104.

    Ibid.

  105. 105.

    Jones notes that the proposals for an additional scheme in Scotland now amount to little more than a fast-track element of the existing claims model, Jones (2018b), p. 41.

  106. 106.

    Civil Procedure Act 1997.

  107. 107.

    SI 1998/3132 (L17).

  108. 108.

    Civil Procedure Rules, SI 1998/3132 (L17) r 1.1 (1).

  109. 109.

    Horton Rogers (2011), p. 194.

  110. 110.

    Pre-Action Protocol r 2.1; r 2.2.

  111. 111.

    Pre-Action Protocol r 2.2.

  112. 112.

    Pre-Action Protocol, r 5.

  113. 113.

    Civil Procedure Rules, SI 1998/3132 (L17) r 35.7(1).

  114. 114.

    Daniels v Walker [2000] 1 WLR 1382.

  115. 115.

    Jones (2018b), p. 1317, para 13-108.

  116. 116.

    Ibid, 59–60, para 1-094, discussing Making Amends.

  117. 117.

    Ibid, 57 para 1-088.

  118. 118.

    Jones notes, sagely, that it may be said that tort litigation has not obviously slowed the ‘staggering numbers of adverse clinical incidents’ but that, equally, these may well have prompted the institutional reflection and discussion over potential other models for compensating medical injury within the NHS that have been discussed here, Jones (2018b), pp. 20–24; Morgan (2018).

  119. 119.

    Chief Medical Office (2003), p. 117.

  120. 120.

    As Jones suggests, it is hard to see what would be an incentive to improve practice if this is not understood as an incentive, Jones (2018b), p. 52, para 1-078.

  121. 121.

    Chief Medical Office (2003), p. 117. The report noted the world-wide impetus on open recognition of medical errors and putting in place systems to learn from them.

  122. 122.

    Putting Things Right: Guidance on dealing with concerns about the NHS from 1 April 2011, 80.

  123. 123.

    One prominent charitable body (amongst others) is Action against Medical Accidents, see https://www.avma.org.uk. See generally Quick (2017). Quick assesses the broad contribution of myriad regulatory bodies internal and external to medical practice as contributing to efforts to improve patient safety overall.

  124. 124.

    For example, see the work of the Care Forum in the South West of the UK: https://www.thecareforum.org.

  125. 125.

    See the general criticisms set out above.

  126. 126.

    Morgan (2018) arguing, in part, that the vindicatory function of personal injury law generally is an important feature of this discussion.

  127. 127.

    General Medical Council (2013) para 55.

  128. 128.

    Indeed in the Compensation Act 2006 s 2, it is made clear that an apology cannot be taken as an admission of negligence or a breach of statutory duty.

  129. 129.

    Jones (2018b), p. 408, para 4-053.

  130. 130.

    See also the related dicta in Naylor v Preston Area Health Authority [1987] 1 WLR 958.

  131. 131.

    Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

  132. 132.

    Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 reg 20 (3).

  133. 133.

    Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 reg 22.

  134. 134.

    The National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011 reg 27.

  135. 135.

    Jones (2018b), p. 1284, para 13-052.

  136. 136.

    Senior Courts Act 1981 s 33(2) as it concerns the High Court; County Courts Act 1984 s 52(2).

  137. 137.

    Pre-Action Protocol for Resolution of Clinical Disputes r 3.16.

References

Cases

Statutes and Statutory Instruments

Books, Articles, Chapters

  • Atiyah P (1997) The damages lottery. Hart, Oxford

    Google Scholar 

  • Cane P (2013) Atiyah’s accidents, compensation and the law. CUP, Cambridge, see now Cane P, Goudkamp J (2018) Atiyah’s accidents, compensation and the law. CUP, Cambridge

    Google Scholar 

  • Cave E (2011) Redress in the NHS. J Prof Negl 27:138–158

    Google Scholar 

  • Chief Medical Office (2003) Making Amends: A Consultation Paper

    Google Scholar 

  • Department of Health (2001) Learning from Bristol. Command Paper 5207(I)

    Google Scholar 

  • Glynn J, Gomez D (eds) (2012) The regulation of healthcare professional: law, principle and process. Sweet & Maxwell, London

    Google Scholar 

  • Goldberg R (2013) Medical malpractice and compensation in the UK. In: Oliphant K, Wright R (eds) Medical malpractice and compensation in global perspective. De Gruyter, Berlin, pp 439–472

    Google Scholar 

  • Horton Rogers WV (2011) Medical liability in England. In: Koch BA (ed) Medical liability in Europe. De Gruyter, Berlin, pp 165–206

    Google Scholar 

  • Jones M (ed) (2018a) Clerk & Lindsell on Torts. Sweet & Maxwell, London

    Google Scholar 

  • Jones M (2018b) Medical Negligence. Sweet & Maxwell, London

    Google Scholar 

  • Lewis R (2006) The politics and economics of tort law. Mod Law Rev 69:418–442

    Article  Google Scholar 

  • Lunney M, Nolan D, Oliphant K (2017) Tort law. OUP, Oxford

    Google Scholar 

  • Macleod S, Hodges C (eds) (2017) Redress schemes for personal injuries. Hart, Oxford

    Google Scholar 

  • Morgan J (2018) Abolishing Personal Injuries Law? A response to Lord Sumption. J Prof Negl 34:133–154

    Google Scholar 

  • Quick O (2017) Regulating patient safety: the end of professional dominance? CUP, Cambridge

    Google Scholar 

  • Smith RG (1994) Medical discipline. OUP, Oxford

    Google Scholar 

  • Sumption J (2018) Abolishing personal injury law-a project. J Prof Negl 34:124–132

    Google Scholar 

  • Taylor S (2015) Medical accident liability and redress in English and French law. CUP, Cambridge

    Book  Google Scholar 

  • Treverton-Jones G, Foster A, Hanif S (eds) (2017) Disciplinary and regulatory proceedings. Lexis Nexis, London

    Google Scholar 

Reports

Download references

Author information

Authors and Affiliations

  1. Dickson Poon School of Law, King’s College London, London, UK

    Colm Peter McGrath

Authors
  1. Colm Peter McGrath
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Colm Peter McGrath .

Editor information

Editors and Affiliations

  1. Faculty of Law and Administration, University of Warsaw, Warsaw, Poland

    Dobrochna Bach-Golecka

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McGrath, C.P. (2021). Alternative Compensation Schemes for Medical Malpractice in the United Kingdom. In: Bach-Golecka, D. (eds) Compensation Schemes for Damages Caused by Healthcare and Alternatives to Court Proceedings. Ius Comparatum - Global Studies in Comparative Law, vol 53. Springer, Cham. https://doi.org/10.1007/978-3-030-67000-9_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-67000-9_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-66999-7

  • Online ISBN: 978-3-030-67000-9

  • eBook Packages: Law and CriminologyLaw and Criminology (R0)

Publish with us

Policies and ethics

Search

Navigation