The PAC report, ‘Costs of clinical negligence’, published last week, highlighted ‘disproportionate legal costs’ with claimant legal fees more than tripling to £538m in 2024-25. Lower value claims with damages of £25,000 or less cost 3.7 times more in legal fees than victims received in damages.
In terms of types of case, brain injury suffered during maternity care represented 2% of all claims by volume but the damages accounted for 68% of total costs.
One factor behind the increasing costs is that claims are settled based on how much care would cost in the private sector rather than the NHS, which stems from a 1948 law. The PAC said this means the taxpayer may pay twice for clinical negligence—once for compensation and again if the victims uses the NHS for their care.
The PAC called on the government to produce within two months a national framework for improving patient safety with annual targets, and a national system for sharing data between NHS trusts. It called, in particular, for a government plan to improve maternity care and reduce the cost of claims in this area.
Sir Geoffrey Clifton-Brown, PAC chair, said a less adversarial system would reduce costs and ensure claims are paid more quickly.
Dr Pallavi Bradshaw, medical director at Medical Protection Society, which assists healthcare professionals, said: ‘The government simply cannot afford to do nothing. A comprehensive strategy—which balances fair compensation for patients and affordability for the NHS—is urgently needed. This strategy must iron out the many inequities and flaws in the system—not least disproportionate legal fees in lower-value claims.’
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