Patients' damages can wait, says professor

Victims of medical negligence who win large compensation awards against NHS trusts should not expect an immediate payout but take their place in the queue for scarce resources, a professor of medical ethics says.

Paying large sums in compensation is unjust when the shortage of NHS resources means that other NHS patients who need treatment to save their lives are denied it, says Professor John Harris.

On Tuesday, Liam Batty, 9, who was brain damaged at birth, was awarded pounds 1.25m in a claim against South Manchester Health Authority. Lawyers estimate that between pounds 250m and pounds 1bn will be paid out for similar accidents between now and the end of the century.

Since 1995, all hospital negligence awards have been met out of the NHS budget and when judgment is delivered hospitals have to pay the compensation immediately.

Professor Harris, of the Institute of Medicine, Law and Ethics at the Universities of Manchester and Liverpool, says in the British Medical Journal that it is inequitable to give successful litigants absolute priority in the sharing-out of NHS resources.

"The important question is whether it is just for awards of damages to be enforced when the effect of so doing may be to deny more important or urgent claims on the same budget."

He suggests that successful claimants should have their needs assessed and go on a waiting list for payment only when there were no more urgent claims to be met. Priority should be given to paying the costs of continuing care.

A separately funded "no fault" compensation scheme which would be fairer to victims of accidents and avoid the stigmatisation of doctors could be introduced, Professor Harris says.

However, ministers have in the past ruled out no fault schemes as being too costly.