Letter: Settling NHS negligence claims

Sir: Professor Harris ("Patients' damages can wait, says professor", 20 June) addresses only part of the problems of malpractice litigation on the economics of the health service since he considers only successful claims. He does not consider unsuccessful claims.

Most medical negligence claims are legally aided and are unsuccessful. The Legal Aid Board generally relies on the advice of the plaintiff's legal advisers in deciding whether or not to fund an action. This advice is not independent. It is not uncommon for such claims to be unsuitable or misconceived. A health authority, however blameless, is not able to recover its legal costs. It may even find itself under pressure to settle claims regardless of the merits on the grounds of commercial expediency, so called legal aid "blackmail".

The combined effect of the costs rule and poor decisions by the Board is to impoverish the health service such that funds are diverted from patient care to lawyers' fees. Only a surprisingly modest proportion is paid out as compensation.

There is no reason why the Board should not be required to reimburse health authorities the costs of defending hopeless claims.

Dr ANTHONY BARTON

London, N1