Jackson eyes clinical reform

Sir Rupert Jackson―architect of the 2013 civil costs reforms―has proposed radical ideas to transform clinical negligence.

The retired Lord Justice of Appeal gave the keynote speech at the Medico-Legal Conference 2019 in London last week, on the subject of ‘Medical errors: sanctions and compensation―is there another way?’

‘The legal system does not adopt a coherent approach to medical cases in the same way that it does to family cases or other specialist cases,’ Sir Rupert said. 

‘It is therefore worth considering whether a more joined-up approach might be desirable.’

A medical mishap may be investigated in three different places―a professional institution’s tribunal; the civil courts; and, in extreme cases, the criminal courts. ‘This involves repetition of evidence, re-examination of the same documents and waste of scarce resources,’ he said, and the procedures ‘generate massive costs, lengthy delays and much stress for all involved’.

Sir Rupert proposed abolishing the Medical Practitioners Tribunal Service and other tribunals dealing with health professionals. Instead, disciplinary proceedings against all health professionals would be brought within the general tribunals system. Both the First-tier Tribunal and the Upper Tribunal would have Clinical Chambers, which would determine ‘whether an individual’s fitness to practise was impaired by reason of clinical incompetence, misconduct or poor health’.

Sir Rupert said his proposals could lead to a higher quality of decision-making at all levels and would remove the ‘proliferation’ of health profession tribunals. Moreover, he said, his proposals would make what happened to Dr Bawa-Garba less likely. Specialist registrar Dr Hadiza Bawa-Garba was convicted of manslaughter and struck off after clinical errors, which she admitted, led to the death of a six-year-old boy in 2011. Last month, she was told she can return to practice. Her case caused uproar among many doctors who felt she was unfairly blamed for wider problems at play.