Like Health Secretary Jeremy Hunt, our team of medical negligence specialists at Hudgell Solicitors have met far too many families of NHS patients who, in his words, ‘have faced a closed and defensive culture when they’ve tried to find out the truth about things that go wrong’.
Stating that the NHS needs to develop ‘a culture where we really are better at learning from mistakes”, Mr Hunt has hit the nail on the head.
How can anybody, in any walk of life, improve from mistakes when they fail to admit them in the first place?
As experts in handling cases of medical negligence, which covers things such as hospital errors, misdiagnosis and birth negligence, we see far too many cases where obvious and costly errors have been made, only for patients and relatives to then face a wall of denial.
Errors are disputed and causation of any injuries suffered as a result fiercely defended, only for hospital Trusts to often finally offer compensation settlements (not always admitting blame) shortly before they are due to explain themselves in a courtroom.
That line of defence often appears to be aimed at pushing the complainant to the limit and seeing if they will crack, hoping they will give up on trying to find real answers – or securing apologies – for the errors made.
When a matter is settled in this way, for the Trusts, it has gone away as soon as the cheque clears. For the patient and their family however, it is rarely that simple. For other patients that will follow in their footsteps also, lessons will not have been learned.
Such an approach is costly in a number of ways.
First, legal costs rise, and we make no excuse for that. In the face of a ‘closed and defensive culture’ – as Mr Hunt calls it – people need expert legal advice and support to help them fight for answers, and the only way to do this is for firms such as ourselves to offer them help on a no win, no fee agreement. They have nothing to lose financially, but can rightly hold the NHS to account.
Health Trusts will all too quickly tell all that rising legal costs are the fault of claims firms, but in reality, as we have demonstrated in the past by revealing our own costs, many cases would be settled at a fraction of cost to the public purse if Trusts admitted mistakes early and avoided the need for independent expert reports, appointments of counsel for court hearings, and insurance cover on the claim.
Secondly, such an approach can often deny the patient, who has suffered as a result of poor treatment, the rehabilitation or remedial treatment they may need to set them on the road to recovery. Early admissions can often allow firms such as ourselves to secure interim payments, before a full settlement is agreed, to help the patient get the support they need quicker.
Lessons must be learned in hospitals
Finally, as Mr Hunt has said today, an approach of denial prevents valuable lessons being learned on wards and in theatres across the UK. Therefore procedures are not changed, policies are not tightened, errors are repeated, and more patients suffer avoidable harm.
A new ‘honesty’ league table, published by the Department of Health today, has shown that half of all hospitals are failing to report mistakes or near misses.
It shows that 110 out of 230 hospital and mental health trusts are failing to report mistakes properly, including 78 trusts where there are ‘significant concerns’ about transparency, and 32 which are deemed even worse and to have a ‘poor reporting culture’.
There is also widespread evidence that medical staff are still too scared to flag up poor care, despite repeated attempts by ministers to open up the NHS’s culture of secrecy.
NHS needs more honesty and accountability
The Government pledged to make the NHS more open after a damning inquiry into the Mid Staffs hospital scandal three years ago, where hundreds of patients died after receiving poor care.
In a speech tomorrow, Mr Hunt is expected to say that although ‘huge improvements’ have been made, there is still a ‘quick fix blame culture’, and that there are still potentially 150 avoidable deaths in UK hospitals every week.
Sadly, from my viewpoint, nothing seems to have improved on the transparency front from the days when I was a hospital manager in the 1980s.
Mr Hunt has suggested introducing Ofsted-style inspections for NHS organisations, and publicly available ratings of hospitals, alongside legal protection for people giving information following a hospital mistake.
He also proposes that doctors and nurses who report their mistakes should be protected from being sued by a patient’s relatives or disciplined by their regulator. This would enable their hospital to carry out a full investigation, and if it decides the error was a one-off – or not entirely the staff member’s fault – they would be cleared of blame.
On the other hand, if doctors and nurses are found to have been careless or negligent, they would no longer be protected from legal action or from disciplinary tribunals.
It is this kind of honesty and accountability which we continue to campaign for on behalf of our thousands of clients we represent each year.
We recognise mistakes can be made, but careless and negligent errors cannot simply be brushed under the carpet, and victims must be compensated for the life-changing impact such mistakes can have.