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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There is nothing compassionate about Britain’s Dickensian tolerance of begging

I was called “heartless” for urging police to refer beggars to support services. But funding drug habits to salve a liberal conscience is the truly cruel approach.

In Rochdale, like many other towns across the country, we’re working hard to support small businesses and make our high streets inviting places for people to visit. So it doesn’t help when growing numbers of aggressive street beggars are becoming a regular fixture on the streets, accosting shoppers.

I’ve raised this with the police on several occasions now and when I tweeted that they needed to enforce laws preventing begging and refer them to appropriate services, all hell broke loose on social media. I was condemned as heartless, evil and, of course, the favourite insult of all left-wing trolls, “a Tory”.

An article in the Guardian supported this knee-jerk consensus that I was a typically out-of-touch politician who didn’t understand the underlying reasons for begging and accused me of being “misguided” and showing “open disdain” for the poor. 

The problem is, this isn’t true, as I know plenty about begging.

Before I became an MP, I worked as a researcher for The Big Issue and went on to set up a social research company that carried out significant research on street begging, including a major report that was published by the homeless charity, Crisis.

When I worked at The Big Issue, the strapline on the magazine used to say: “Working not Begging”. This encapsulated its philosophy of dignity in work and empowering people to help themselves. I’ve seen many people’s lives transformed through the work of The Big Issue, but I’ve never seen one person’s life transformed by thrusting small change at them as they beg in the street.

The Big Issue’s founder, John Bird, has argued this position very eloquently over the years. Giving to beggars helps no one, he says. “On the contrary, it locks the beggar in a downward spiral of abject dependency and victimhood, where all self-respect, honesty and hope are lost.”

Even though he’s now doing great work in the House of Lords, much of Bird’s transformative zeal is lost on politicians. Too many on the right have no interest in helping the poor, while too many on the left are more interested in easing their conscience than grappling with the hard solutions required to turn chaotic lives around.

But a good starting point is always to examine the facts.

The Labour leader of Manchester City Council, Richard Leese, has cited evidence that suggests that 80 per cent of street beggars in Manchester are not homeless. And national police figures have shown that fewer than one in five people arrested for begging are homeless.

Further research overwhelmingly shows the most powerful motivating force behind begging is to fund drug addiction. The homeless charity, Thames Reach, estimates that 80 per cent of beggars in London do so to support a drug habit, particularly crack cocaine and heroin, while drug-testing figures by the Metropolitan Police on beggars indicated that between 70 and 80 per cent tested positive for Class A drugs.

It’s important to distinguish that homelessness and begging can be very different sets of circumstances. As Thames Reach puts it, “most rough sleepers don’t beg and most beggars aren’t rough sleepers”.

And this is why they often require different solutions.

In the case of begging, breaking a chaotic drug dependency is hard and the important first step is arrest referral – ie. the police referring beggars on to specialised support services.  The police approach to begging is inconsistent – with action often only coming after local pressure. For example, when West Midlands Police received over 1,000 complaints about street begging, a crackdown was launched. This is not the case everywhere, but only the police have the power to pick beggars up and start a process that can turn their lives around.

With drug-related deaths hitting record levels in England and Wales in recent years, combined with cuts to drug addiction services and a nine per cent cut to local authority health budgets over the next three years, all the conditions are in place for things to get a lot worse.

This week there will be an important homelessness debate in Parliament, as Bob Blackman MP's Homelessness Reduction Bill is due to come back before the House of Commons for report stage. This is welcome legislation, but until we start to properly distinguish the unique set of problems and needs that beggars have, I fear begging on the streets will increase.

Eighteen years ago, I was involved in a report called Drugs at the Sharp End, which called on the government to urgently review its drug strategy. Its findings were presented to the government’s drugs czar Keith Hellawell on Newsnight and there was a sense that the penny was finally dropping.

I feel we’ve gone backwards since then. Not just in the progress that has been undone through services being cut, but also in terms of general attitudes towards begging.

A Dickensian tolerance of begging demonstrates an appalling Victorian attitude that has no place in 21st century Britain. Do we really think it’s acceptable for our fellow citizens to live as beggars with no real way out? And well-meaning displays of “compassion” are losing touch with pragmatic policy. This well-intentioned approach is starting to become symptomatic of the shallow, placard-waving gesture politics of the left, which helps no one and has no connection to meaningful action.

If we’re going make sure begging has no place in modern Britain, then we can’t let misguided sentiment get in the way of a genuine drive to transform lives through evidenced-based effective policy.

Simon Danczuk is MP for Rochdale.