This article is indirectly about cats as they need their caregivers to be healthier enough to discharge their duties towards them 🙏😉😻.
Like many other British institutions, the NHS is somewhat broken. It feels like the country is in a funk, a malaise of soggy work practices and a lack of self-discipline and desire to work. That’s probably an extreme viewpoint but it can look like that sometimes.
It is not just me; MPs have alleged that NHS management is complacent and lacks the desire and even the ability to push through much desired and needed change to make the NHS more effective and efficient.
Placing them under a contractual obligation to provide excellent services as is the case in the private healthcare sector, which is much better, would sharpen their minds and slough off some of that complacency.
Initially the services subject to a direct contract could be limited to allow for a gradual introduction to the concept of a direct contractual obligation. If this was not the case, I sense that the NHS would literally come to a standstill in successful litigation brought by unhappy patients. Think of the thousands of patients dying in corridors every month who probably would have survived in a ward.
In the UK you can sue under contract within 6 years after the breach compared to a limit of 3 years for negligence. And establishing a breach of contract is much easier than proving medical negligence (very hard).
This is because in this instance the contracts would be in writing resulting in clarity of obligation on both parties. Less wriggle room.
The contract would be drawn up by the Health Department and it would set high but attainable targets. The patient would read the entirety of the contract before treatment and an advice centre would be available. The language employed would be extremely straightforward and understandable by the poorest educated.
Plans to radically reform the health service are at risk because senior leaders of both NHS England and the Department of Health and Social Care (DHSC) are “complacent” and lack dynamism, MPs have said. – The Guardian newspaper
More: Michael Broad
Placing NHS health service providers under contract would expose the shocking level of failure. It is worse than most think. But even under negligence claims the amount paid annually by the NHS in compensation amounts to enormous sums.
In 2023/24, the NHS paid out a record £2.8 billion in compensation for medical negligence claims. This was an increase from £2.7 billion the previous year. The majority of these payouts were related to obstetric claims, which, while accounting for only 13% of clinical claims (excluding general practice), made up 57% of the total compensation due to the severity of injuries, particularly birth-related brain injuries requiring lifelong care.
The number of new clinical negligence claims and reported incidents rose to 13,784, with £4.7 billion set aside for future claims. However, eight out of ten claims were resolved without litigation, and only 50 cases went to trial, of which 17 resulted in damages being awarded.
We could start with obstetrics in creating contractual obligations. 😱💖😢.
Some more:
Yes, in the UK, the limitation period for bringing a claim is:
- Negligence claims: 3 years from the date of injury or the date of knowledge (when the claimant first became aware of the negligence). This is set out in the Limitation Act 1980.
- Contract claims: 6 years from the date of breach (or 12 years if the contract is under deed).
For medical negligence cases, the 3-year limit typically starts from the date of the alleged negligence or the date the patient reasonably became aware of it. However, exceptions exist:
- Children: The limitation period starts when they turn 18, meaning they have until age 21 to bring a claim.
- Mental incapacity: No time limit applies until the claimant regains capacity.
- Deceased patients: The 3-year period runs from the date of death or knowledge of negligence contributing to death.
This difference in limitation periods is one reason why a contractual obligation for NHS care could provide extended legal recourse for patients.
Yes, medical negligence is difficult to prove because the law recognizes that doctors are not expected to be infallible—mistakes can happen without necessarily constituting negligence.
Key Reasons Why Medical Negligence is Hard to Prove:
- The Bolam Test (Standard of Care)
- A doctor is not negligent if their actions were supported by a responsible body of medical professionals, even if another approach could have been better.
- Courts rely on expert witnesses to determine if the care met a reasonable professional standard.
- Causation is Difficult to Establish
- It must be proven that the doctor’s mistake directly caused harm that would not have occurred otherwise.
- Many patients already have underlying conditions, making it hard to prove that negligence, rather than the illness itself, caused the damage.
- Errors vs. Negligence
- Medicine is complex, and not all errors are considered negligence.
- Courts recognize that even skilled professionals make reasonable mistakes under difficult conditions.
- Time Limits on Claims (3 Years)
- Patients have only 3 years to bring a claim, which can be challenging if symptoms develop later or if evidence is hard to gather.
- Legal and Financial Barriers
- Litigation is costly, requiring expert opinions and legal representation.
- Many cases are settled out of court to avoid lengthy disputes.
- Defensive Medicine and NHS Protections
- Some doctors practice defensive medicine (ordering extra tests, avoiding riskier treatments) to reduce liability.
- The NHS is heavily protected by legal defenses and compensation schemes, making claims harder for patients.
Because of these challenges, negligence claims have a high threshold for success, meaning many valid cases may never succeed in court.