We should be able to sue the NHS

This culture of secrecy and gagging orders needs to be changed.

There are few more divisive political topics than the NHS. Those interfering with it risk the wrath of keyboard warriors, campaigners, journalists and politicians.

At the extremes, there are views that we are either dangerously nudging towards privatisation, or sleep walking into low quality "socialised" health provision that is far below the average standard of care within the developed world.

But regardless of which side of the political divide you sit on, it is hard to deny that the NHS needs to up its game.

However at the top of both camps’ hitlist are lawyers, it seems. “Ambulance chasers” lining their pockets on tax payers’ money, fleecing the NHS for every last penny when things go wrong. Because of this it seems anyone bringing a case against the NHS feels guilty for doing so, or, worse, treacherous.

But should that be the case?  No one else has the political will to change the NHS for the better. One could argue we are in a catch 22 situation where a decade of Labour "investment" is followed by a few more years of partial privatisation and Tory tinkering. None of which confronts the main problems faced by the NHS: massive institutional failings.

As a lawyer who has experienced the very best of NHS care when I severed my spinal cord during a motorcycle accident, it saddens me that now the NHS is stuck between a rock and a hard place, where politicians seem unable to tackle the institutions’ problems head on.

Alongside waste and poor distribution of resources, another major failing is at the frontline. While the NHS is staffed by compassionate, caring and committed workers, there are huge understaffing problems and many are locked into a system that breeds institutional negligence and huge, catastrophic mistakes. That’s why lawyers step in - as an important check and balance to try and raise standards of care within the NHS by investigating wrong doing, highlighting malpractice, negligence and failed systems.

This is not a small issue. Data shows that NHS negligence claims are on the increase - by 20 per cent year-on-year and 80 per cent since 2008. That’s a monumental £19bn bill – one fifth of the NHS budget. This is to service claims made by over 16,000 patients and families of those bereaved. These are voters of both political persuasions – left and right.

So are these costs purely to line the pockets of ambulance chasing scum or is this money compensation for patients and families who have suffered horrendous, life changing, often preventable incidents?

Month on month at Fletchers Solicitors, we are contacted about hundreds of new clinical negligence cases. These are terrible cases of people who have been denied basic care, such as food or water, suffered catastrophic injuries from simple surgical errors, right through to repeated and systematic failure to diagnose symptoms of preventable yet life-threatening illnesses.

While the individual stories are of course tragic the cost to the exchequer is also appalling. The fact of the matter is that the bulk of the £19bn cost could be dramatically reduced if the NHS’ culture of secrecy and gagging orders were changed in favour of a more open and honest approach to dealing with negligence investigations.

The majority of costs are not for compensation but proportional to the time taken to investigate the facts of the case and establish guilt. Claims against the NHS take longer than any other industry, and accrue more costs as a result.  Often cases take three times as long when most private sector businesses would have admitted guilt at a much earlier stage. An accountable NHS could shave tens of billions of its legal bill.

So should we sue the NHS? In a perfect world the medical negligence marketplace would be small and compensation would be given to people who deserved it.

Today there is now a large legal market which ultimately feeds off a sometimes disorganised and chaotic NHS. It’s our view, however, that the most important consideration for legal action against the NHS is that families whose lives have been destroyed by failings can in some way rebuild them again using their compensation.  Yes, it’s controversial but we’ve been very open and honest about the state of the NHS and our role in it. In fact, we are running a campaign to determine opinion about litigation, and we’re starting a debate to gauge the public mood around whether suing the NHS is ethical.

Ed Fletcher is the chief executive of Fletchers Solicitors

More information on the campaign can be found via its Facebook page.

Photograph: Getty Images

Ed Fletcher is the chief executive of Fletchers Solicitors

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How “cli-fi” novels humanise the science of climate change

The paradox is that the harder climate-fiction novels try, the less effective they are.

When the Paris UN Climate Change Conference begins at the end of November, the world’s leaders will review the climate framework agreed in Rio in 1992. For well over 20 years, the world has not just been thinking and talking about climate change, it has also been writing and reading about it, in blogs, newspapers, magazines – and in novels.

Climate change fiction is now a recognisable literary phenomenon replete with its own nickname: “cli-fi”. The term was coined in 2007 by Taiwan-based blogger Dan Bloom. Since then, its use has spread: it was even tweeted by Margaret Atwood in 2013:

It is not a genre in the accepted scholarly sense, since it lacks the plot formulas or stylistic conventions that tend to define genres (such as science fiction or the western). However, it does name a remarkable recent literary and publishing trend.

A 21st-century phenomenon?

Putting a number to this phenomenon depends, partly, on how one defines cli-fi. How much of a novel has to be devoted to climate change before it is considered cli-fi? Should we restrict the term to novels about man-made global warming? (If we don’t, we should remember that narratives about global climatic change are as old as The Epic of Gilgamesh and the Biblical story of the flood.) If we define cli-fi as fictional treatments of climate change caused by human activity in terms of setting, theme or plot – and accept there will be grey areas in the extent of this treatment – a conservative estimate would put the all-time number of cli-fi novels at 150 and growing. This is the figure put forward by Adam Trexler, who has worked with me to survey the development of cli-fi.

This definition also gives us a start date for cli-fi’s history. While planetary climatic change occurs in much 20th-century science fiction, it is only after growing scientific awareness of specifically man-made, carbon-induced climate change in the 1960s and 1970s that novels on this subject emerged. The first is Arthur Herzog’s Heat in 1976, followed by George Turner’s The Sun and the Summer (published in the US as Drowning Towers) in 1987.

At the turn of this century, Maggie Gee and TC Boyle were among the first mainstream authors to publish climate change novels. In this century, we can count Atwood, Michael Crichton, Barbara Kingsolver, Ian McEwan, Kim Stanley Robinson, Ilija Trojanow and Jeanette Winterson as major authors who have written about climate change. The past five years have given us notable examples of cli-fi by emerging authors, such as Steven Amsterdam, Edan Lepucki, Jane Rawson, Nathaniel Rich and Antti Tuomainen.

Creative challenges

Cli-fi is all the more noteworthy considering the creative challenge posed by climate change. First, there is the problem of scale – spatial and temporal. Climate change affects the entire planet and all its species – and concerns the end of this planet as we know it. Novels, by contrast, conventionally concern the actions of individual protagonists and/or, sometimes, small communities.

Added to this is the networked nature of climate change: in physical terms, the climate is a large, complex system whose effects are difficult to model. In socio-cultural terms, solutions require intergovernmental agreement – just what COP21 intends – and various top-down and bottom-up transformations. Finally, there exists the difficulty of translating scientific information, with all its predictive uncertainty, into something both accurate and interesting to the average reader.

Still, cli-fi writers have adopted a range of strategies to engage their readers. Many cli-fi novels could be classified as dystopian, post-apocalyptic or, indeed, both – depicting nightmarish societies triggered by sometimes catastrophic climate events. A future world is one effective way of narrating the planetary condition of climate change.

Some novelists are also careful to underpin their scenarios with rigorous climatic predictions and, in this way, translate science fact into a fictional setting. Kingsolver, who trained as an ecologist, is the best example of this – and Atwood and Robinson are also known for their attempts at making their speculations scientifically plausible. Also, cli-fi novels, particularly those set in the present day or very near future rather than in a dystopian future, tend to show the political or psychological dimensions of living with climate change. Readers can identify with protagonists. To some extent, the global community is represented in fictional everymen or everywomen. Or, often, it is through such characters that science is humanised and its role in combating climate change better understood.

Can cli-fi lead to change?

Could cli-fi affect how we think and act on climate change? The paradox is that the harder cli-fi tries, the less effective it is. Many writers want to inspire change, not insist on it: the line between literature and propaganda is one that most novelists respect. Literature invites us to inhabit other worlds and live other lives. Cli-fi at its best lets us travel to climate-changed worlds, to strive there alongside others and then to return armed with that experience.

In Paris, the UN will seek a global agreement on climate action for the first time in more than 20 years. There is plenty of climate change fiction out there to help provide the mental and psychological space to consider that action.

The Conversation

Adeline Johns-Putra, Reader in English Literature, University of Surrey

This article was originally published on The Conversation. Read the original article.