The NHS must do more to reduce “tragic” incidents of patient harm and cut “jaw-dropping” payouts for poor care, MPs have warned as costs spiral to a record high.
Compensation for clinical negligence claims cost £2.8bn in 2023-24 – up from £2.6bn the year before – with hundreds of millions paid out in legal fees.
The highest number of claims were for failings in emergency medicine, obstetrics, orthopaedic and general surgery, with maternity care payouts costing the most, totalling £1.1bn last year.
The Department of Health and Social Care has set aside an “astounding” £58.2bn to cover the potential costs of clinical negligence events occurring before April 2024.
The public accounts committee sounded the alarm on the rise, saying ministers needed to get a grip on NHS finances.
Its chair, Sir Geoffrey Clifton-Brown, said: “The fact that the government has set aside tens of billions of pounds for clinical negligence payments, its second most costly liability after some of the world’s most complex nuclear decommissioning projects, should give our entire society pause.
“It must be a priority of the highest order for the government to reduce tragic incidences of patient harm and lay out a mechanism to reduce legal fees to manage the jaw-dropping costs involved more effectively.”
The most recent NHS data shows 4,076 incidents of severe harm to patients and 4,449 patient deaths were recorded by the NHS in just three months from October to December last year.
And a fifth of last year’s record £2.8bn compensation bill – £545m – went to lawyers. That amount is higher than the entire expenditure of the government’s legal department, the report found, which totalled £341m in the same year.
In the past five years alone, NHS Resolution, which manages negligence claims, has spent over £12bn on payouts – £2.4bn of which has been spent on claimants’ legal fees.
“If we can reduce the leakage of lawyers’ fees in the middle, that benefits the whole of the NHS, because there will be more money available for other services,” said Sir Geoffrey,
Hospital chiefs in England warned last week that they have been forced to cut nurse and doctor posts and scale back emergency and maternity care to meet the government’s “eye watering” savings demands for 2025-26.
The committee challenged the DHSC to set out how it intends to “reduce tragic incidents of patient harm” and manage the costs of negligence “more effectively”.
Acknowledging the high cost of payouts for maternity care failings, Sir Geoffrey said the difference between some maternity units and others “is quite significant”.
He said: “Obstetrics is an inherently dangerous process, so the line between doing harm and negligence is quite narrow, but the NHS need to look carefully at why some units do get more negligence claims than others.”
MPs on the committee also criticised the DHSC, which they said “lacks a grip of the financial pressures it faces”.
MPs also raised concerns over the “uncertainty” surrounding the abolition of NHS England, announced in March, which they said had created “high levels of uncertainty for patients and for staff”.
They said the DHSC had a “lack of firm plans” for its closure and reducing its headcount by 50 per cent.
“At the moment, it looks a little bit like shifting the deck chairs on the Titanic. We really want to make sure that this thing is going to work properly,” Sir Geoffrey told The Independent.
“It has been two months since the government’s decision to remove what up until now has been seen as a key piece of machinery without articulating a clear plan for what comes next, and the future for patients and staff remains hazy,” he said.
MPs highlighted how some hospitals in England had pushed through unauthorised special exit packages – severance payments which require Treasury sign-off because they are new or contentious, totalling more than £180,000 in 2023/24.
“There remain far too many special severance payments where approval has only been sought after the payment has been made,” they added.
The Department of Health and Social Care has been approached for comment.
