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

Photo: Getty
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The rise of the green mayor – Sadiq Khan and the politics of clean energy

At an event at Tate Modern, Sadiq Khan pledged to clean up London's act.

On Thursday night, deep in the bowls of Tate Modern’s turbine hall, London Mayor Sadiq Khan renewed his promise to make the capital a world leader in clean energy and air. Yet his focus was as much on people as power plants – in particular, the need for local authorities to lead where central governments will not.

Khan was there to introduce the screening of a new documentary, From the Ashes, about the demise of the American coal industry. As he noted, Britain continues to battle against the legacy of fossil fuels: “In London today we burn very little coal but we are facing new air pollution challenges brought about for different reasons." 

At a time when the world's leaders are struggling to keep international agreements on climate change afloat, what can mayors do? Khan has pledged to buy only hybrid and zero-emissions buses from next year, and is working towards London becoming a zero carbon city.

Khan has, of course, also gained heroic status for being a bête noire of climate-change-denier-in-chief Donald Trump. On the US president's withdrawal from the Paris Agreement, Khan quipped: “If only he had withdrawn from Twitter.” He had more favourable things to say about the former mayor of New York and climate change activist Michael Bloomberg, who Khan said hailed from “the second greatest city in the world.”

Yet behind his humour was a serious point. Local authorities are having to pick up where both countries' central governments are leaving a void – in improving our air and supporting renewable technology and jobs. Most concerning of all, perhaps, is the way that interest groups representing business are slashing away at the regulations which protect public health, and claiming it as a virtue.

In the UK, documents leaked to Greenpeace’s energy desk show that a government-backed initiative considered proposals for reducing EU rules on fire-safety on the very day of the Grenfell Tower fire. The director of this Red Tape Initiative, Nick Tyrone, told the Guardian that these proposals were rejected. Yet government attempts to water down other EU regulations, such as the energy efficiency directive, still stand.

In America, this blame-game is even more highly charged. Republicans have sworn to replace what they describe as Obama’s “war on coal” with a war on regulation. “I am taking historic steps to lift the restrictions on American energy, to reverse government intrusion, and to cancel job-killing regulations,” Trump announced in March. While he has vowed “to promote clean air and clear water,” he has almost simultaneously signed an order to unravel the Clean Water Rule.

This rhetoric is hurting the very people it claims to protect: miners. From the Ashes shows the many ways that the industry harms wider public health, from water contamination, to air pollution. It also makes a strong case that the American coal industry is in terminal decline, regardless of possibile interventions from government or carbon capture.

Charities like Bloomberg can only do so much to pick up the pieces. The foundation, which helped fund the film, now not only helps support job training programs in coal communities after the Trump administration pulled their funding, but in recent weeks it also promised $15m to UN efforts to tackle climate change – again to help cover Trump's withdrawal from Paris Agreement. “I'm a bit worried about how many cards we're going to have to keep adding to the end of the film”, joked Antha Williams, a Bloomberg representative at the screening, with gallows humour.

Hope also lies with local governments and mayors. The publication of the mayor’s own environment strategy is coming “soon”. Speaking in panel discussion after the film, his deputy mayor for environment and energy, Shirley Rodrigues, described the move to a cleaner future as "an inevitable transition".

Confronting the troubled legacies of our fossil fuel past will not be easy. "We have our own experiences here of our coal mining communities being devastated by the closure of their mines," said Khan. But clean air begins with clean politics; maintaining old ways at the price of health is not one any government must pay. 

'From The Ashes' will premiere on National Geograhpic in the United Kingdom at 9pm on Tuesday, June 27th.

India Bourke is an environment writer and editorial assistant at the New Statesman.

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