View From A Surgeon – A Question of Ethics

View From A Surgeon – A Question of Ethics

I’m mad as a box of frogs today because of something I feel to be a question of ethics.

£56 billion was set aside by the NHS last year to “defend the rising number of claims” against doctors.

That is half the budget of the NHS – imagine what the NHS could do with £56 billion?! And the year before, in 2015, the NHS set aside a quarter of its budget, £26 billion for the same reason.

In fact, the number of claims has declined against the NHS, but what has risen are the legal costs associated with defending those claims. Most cases never get to court; rather they are settled “out of court” for an undisclosed fee, as this is seen as a more “commercially viable” option compared to litigation costs. Worse still, the current £1.5 billion bill is set to double by 2023.

Now – if there is a true fault, then I would be among the first to suggest that there needs to be a fair and reasonable judgement, and that any doctor, nurse or healthcare worker needs to be accountable for any mistake made. But it seems that money is the new compensation, as if money solves every problem. Why if something goes wrong is money the answer? And do the blame and claim culture lawyers really understand the true depth of what they have done to society? Now doctors practice defensive medicine, and insurances are prohibitively expensive. Some surgeons can pay over £80,000 every year just so that they can practice! Not only that but if they have a claim against them, they may have to pay the first £70,000 in every claim! And 99.999% of the time that claim is not because they kill or maim – it’s because the claimant does not like the result of their surgery.  Often that is the case – it’s not because of a true fault; it’s because it is easier to sue than it is to work out a solution that is fair.

Remember if you are thinking of taking out such a claim that these lawyers invariably get more money than any claimant gets in settlement.  For example, having researched one clinical negligence lawyer in particular, their CV is full of £13 million for this case, £9 million for that case. And did you know there is an insurance that lawyers can take out called “after the event insurance” (ATE insurance), which means that they take out a policy that pays them and the claimant even if they lose – how disgracefully unethical is that?! So, when you see companies such as the ubiquitous “injury lawyers 4 u” (the use of “4 u” instead of “for you” tells you the level of client they are aiming for…) – really it is only injury lawyers “4” themselves. Not wishing to solely pick on one lawyer and one company: there is also Britain’s biggest clinical negligence firm, which was paid over £29 million in 2015-16 from the NHS. The excuse for this? The aforementioned lawyer says that legal costs are increasing because the NHS “requires” cases to go through the courts instead of conceding mistakes. This lawyer has sadly forgotten the principle that everyone deserves a defence, and one is always “innocent until proven guilty”.

So, a note to those types of lawyers – I go to work every day intending to do the best I can – what doctor doesn’t? I’m a man, not a god, and things happen. But I can look myself in the mirror every day and know that I’m a caring professional who abides by strict ethics and morals. The question I have for those lawyers who specialise in these areas is this: Can you honestly look me square in the eye and tell me that your first concern is for the patient and that it has nothing to do with the money?

Unfortunately, I think I know the true response.

Finally – when the call goes out for more money from the NHS, remember that half of the total budget goes to lawyers as of last year. When there isn’t enough money to treat your son, daughter, partner, father, or mother – remember where it’s all going.

Now that is a true, national disgrace.

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