Right of Reply: Richard Parnell

The research manager of Scope, the charity for people with cerebral palsy, responds to our leading article calling for a `no-fault' compensation system for people with disabilities

THE IDEA of no-fault compensation has once again come to the fore in your leading article ("The disabled should not have to rely on vagaries of the law courts") as a way of dealing with the growing cost of providing compensation to people who have been subject to mistakes or malpractice in their health care.

Children with cerebral palsy are often the recipients of such "few in number but high in value" payments, and Scope has considered no-fault compensation schemes.

We reached a number of conclusions. No-fault compensation schemes should not be viewed as a way of reducing the cost to the NHS of "mistakes" by health staff. Nor will any scheme so far published meet in any way the lifelong needs of those people who have received profound impairments through no fault of their own.

Such schemes replicate the problem that haunts the existing system of medical negligence claims, that of establishing causation. So no-fault compensation will not save money, but will increase administration costs. Furthermore, if people wanting to see justice done pursue their rights through the courts, then additional NHS payouts will increase overall costs.

More importantly, if we are serious about meeting the needs of people disabled by whatever circumstances, a three-tier system needs to be put in place. It would comprise: the right to sue for medical negligence; the right for compensation regardless of negligence; and finally a comprehensive system of support. Thus, profoundly disabled people would no longer have to run the gauntlet of inadequate health resources, lack of employment prospects and the whims of social service provision. Above all, disabled people and their representatives must be consulted.