Health Check: A high price for the NHS
Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Tuesday 27 April 1999
I admit that my heart sank. Like all health reporters I am a target for aggrieved patients wanting to tell of the crimes and misdemeanours of the NHS. Invariably there is too much detail and too little proof, and the cases are repetitive.
I gave my standard response. Would she like to set down brief details on a single sheet of paper and send it to me? "So you are not interested," she said. I paused. I don't know why I relented - perhaps it was her flat Yorkshire vowels, or her matter-of-fact delivery. "All right," I said. "Tell me, as briefly as you can."
The Independent was not the first newspaper she had called. Others had responded as brusquely as, at first, had I. But as I listened I realised this was a story worth telling. The case of Patricia Briody, who gave birth to two stillborn children and had her womb removed before the age of 20, who spent 15 years in ignorance of what had happened and then a further 10 fighting for compensation to pay for, she hopes, two surrogate births, appeared in yesterday's newspaper.
Mrs Briody had an abnormal pelvis, which was too narrow to allow her to give birth naturally. That might, just, have excused her doctors when her first pregnancy ended with an emergency Caesarean and a stillborn child. But when it happened a second time, with disastrous consequences (an emergency hysterectomy), it looked like culpable carelessness. She was childless, barren and still not 20 years old.
Hers looks like a cast-iron case for compensation and 25 years later that is what the courts have agreed. And yet, and yet. She was offered, and turned down, first pounds 60,000 and then pounds 100,000. If her final award were twice this sum - which is unlikely - it would still be small compared with the pounds 2m and pounds 3m awards made in the last year. But, as with all negligence claims, when the huge costs of the case are added in, it remains a major drain on the NHS.
For, make no mistake, justice for Mrs Briody is bought through the imposition of a tax on the sick. The cost of meeting claims like hers is rising at pounds 100m a year and now tops pounds 300m a year - pounds 300m that is paid out of the NHS budget and would otherwise be available to improve run-down hospitals, train more obstetricians and improve maternity care.
Mrs Briody argues, with justice, that when you look at the sums awarded in libel actions to minor celebrities who have suffered nothing worse than a blow to their pride, pounds 100,000-plus for the loss of a family seems a paltry sum. But in a public service like the NHS should not different rules apply? Negligent staff should be penalised and injured patients compensated, but though the award of punitive damages may salve the consciences of those responsible, it can only harm patients who come later, by depriving them of already limited resources.
Yesterday marked the launch of a new, fast-track process for dealing with medical negligence claims which should help to stem their ferocious growth and improve satisfaction for damaged patients. Some measures should be simple to implement. If Mrs Briody had had an apology and a full explanation 25 years ago, she would have been saved a lot of pain, and the NHS would have been saved a heavy bill.
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