Competency comes first

The latest report from the National Audit Office kicks off the perennial debate about how much of the NHS budget has to be spent on clinical negligence claims. We are talking largely about the cost of successful claims that our courts, applying the law of this country, consider justified.

There are two ways to save money. One is not to foul up in the first place. The other is not to play brinkmanship when you do. Who says? It isn't the rapacious 'fat cat' lawyers on conditional fee agreements who make rules for their own benefit. It's the law of country. If we can't or won't improve the standards of performance, the other way of reducing claims is to lower standards.

Instead of an objective evaluation of what could and should be achieved or avoided, we have a quota system. For instance, one in five, one in 10, or however many birth defects is an acceptable fail rate.

Faced with a claim, all the health service does is point to the statistics and say "we're within quota, sorry it happened to your child but we can't get it right all the time. It's better here than elsewhere in the world." That's it. Is that where we're going? Is that what the '¨country wants?

If so, we should legislate now so that all those who think it better than compensating innocent victims can stop whinging about costs. Those of us who think it isn't good enough can make some life decisions like move to another country with higher standards and aspirations. And if government is going to act, then it must do so through parliamentary debate, not by executive blocking of access '¨to justice.

The words of the Public Committee Chair, Margaret Hodge, have given us some cause for optimism: "The department needs to buck up and take responsibility for this. It needs to review its '¨monitoring and reporting process to ensure that all relevant bodies can work effectively together to deliver maternity services that are '¨value for money and fit '¨for purpose."

We shouldn't be oblivious to cost, but 'value for money' bothers me slightly. If we spent as much as we do cleaning up on making sure that we are properly managing competent people who have an understanding of the true value of human life, that would be money well spent and we'd have something fit for purpose. SJ

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