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Medical Malpractice Policy: France | Home | Law and Medicine: Canada

Law and Medicine: United Kingdom

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Ezra's covered how the Brits handle medicine, but how do our friends across the pond handle the problem of negligent doctors? It turns out that like the US, the UK relies on the court system to settle patient complaints. Julie Saltman's research has beaten me to the punch in many cases, but her documents a bit out of date.

How does it work? Public-sector doctors, which in the United Kingdom make up 90% of all doctors, are insured by the NHS. So you can think of the NHS as one giant hospital chain that handles all the legal and business aspects of medicine. Doctors are not personally liable for malpractice claims, nor must they purchase malpractice insurance on their own. Private-sector doctors must buy their own insurance, however. With the caveat that jury trials are less common, the actual legal handling of malpractice claims looks exactly like it does in the United States. You sue the doctor and the hospital, you go to court, and if you win, they show you the money.

The plaintiffs' bar in the UK does not take cases on a contingent-fee basis. Worse, the UK legal system is a "loser pays" system, so patients who bring tort claims to court and lose owe the NHS for their legal fees. Unsurprisingly this discourages malpractice claims.

Recently the UK has begun experimenting with a Swedish system of payouts for ophthalmologists and ob-gyns, and also require them to write apologies to their patients explaining what happened. The payment terms for injured infants are very generous, presumably because it makes for good politics to give financial help mothers who suddenly must rearrange their life for a permanently injured child (Michael Howard: tough on babies, soft on bad doctors. I'm Tony Blair and I approved this message).

Who pays? Funds for the NHS indemnity come from the governments general fund, so that big fat VAT, the income tax, and other government revenue streams are the main sources. Your tax dollars at work.

What is the result? There are 40% as fewer malpractice claims made, let alone settled, in the UK (1.8 per 10,000 people) compared to the United States (3.1 per 10,000). According to this Eurotimes article, the average malpractice settlement is about 57,000 pounds, or a shade under $100,000, compared to an average settlement of $250,000 or court award of $500,000 in the US. Malpractice payouts compromise .05% of GDP and .7% of overall health care spending, compared .2% and 3% (!) respectively for the US. The average time to push a case through the court system and receive a claim is measured in years. Years. Therefore almost half of all claims are settled out of court.

The UK system is less than perfect, and much stingier towards wronged patients. But it is an order of magnitude cheaper.

Sources: "Regulatory Matters", Eurotimes 2003 ; EU Study 2004 [1, 2]; National Association of Insurance Commissioners; NHS Indemnity

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Last updated by Nicholas Beaudrot on 09:34 21 April 2005