Therese Copey, the new Health and Social Care Secretary and deputy Prime Minister, faces a lot of in-tray. As the new government takes shape, we are told that the priorities of the new Secretary of State will be ‘ABCD’: ambulances, backlogs, care, doctors and dentists. Anyone involved in the delivery of healthcare knows, there are no quick fixes to the multitude of difficulties faced – not least because of the lasting effects of the pandemic on the NHS.
From concerns over NHS pay and pensions, to long term workforce planning and a sustainable plan for social care – there are no shortage of issues that healthcare professionals and patients expect to see at the top of the new Secretary of State’s ‘to-do ‘list.
The MDU however, focuses in this blog on three key medicolegal issues that will demonstrate government commitment to healthcare professionals. They are:
- Support an exhausted workforce
- Modern healthcare professional regulation
- Get to grips about the runaway costs of clinical negligence
Support for exhausted workers
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Everybody will be a patient at one point or another. We want to be treated well by a doctor who is alert, rested, and alert. It is not surprising that many people believe that being constantly tired is a cost of pursuing a career as a doctor. Recent studies have shown that the workforce is really running out of gas.
A survey conducted by the MDU of over 530 doctorsA third of doctors felt sleep-deprived on a regular basis, and nearly a quarter felt that their ability to care for patients was affected by tiredness.
The GMC’s latest national training survey reported that three in five trainees said they ‘always’ or ‘often’ feel worn out at the end of the working day.44% of respondents feel that their work is emotionally exhausting.
Both the government and NHS employers must do more to ensure that sufficient resources are available to allow doctors to take frequent breaks. It’s possible to make a difference with small things. This could include ensuring that employees have access to adequate food and drink 24 hours a day, and creating robust rotas. Those holding the profession to account – regulators like the GMC, the courts and indeed employers – must also properly take the current context into account
Modern healthcare professional regulation
MDU members have shared with us that the GMC or GDC investigation was one of the most difficult times in their professional lives. Particularly for those who are dedicated to caring for others, the stress of being scrutinized during a lengthy and possibly career-ending fitness to practice process can have a devastating affect.
Part of the problem is the rigidity of the GMC and GDC fitness-to-practice procedures, which are still largely governed by outdated legislation. While some progress has been made, there have been limited successes such as the introduction of provisional enquires at the GMC, only a complete reset of the regulators’ governing legislation can bring about a system that is truly modern, proportionate, timely and, above all, fair.
Legislation to bring about reform was promised earlier this year and seems to be on track. We know that the Department has been working on these issues for some time. The changes that are so urgently needed have been moved to 2024. This is a significant setback and can only negatively impact morale in a time when doctors need to be attracted and retained as many as possible.
GMC and GDC reform are two policies that the government should consider if they want to quickly show their support for the medical and dental professions.
Get to grips about the cost of clinical negligence.
The cost of meeting future claims liabilities now stands at a staggering £128 billion The NHS in England Payments for settled claims during the year to April 2022 also increased to £2.5 billion. The NHS is experiencing serious workforce issues, and the NHS needs additional funds to train and recruit more healthcare workers.
It is sobering to realise that the cost of future claims liabilities are not far off the total budget for NHS England spending in 2022/23 – which is expected to be about £152.55 billion.
The MDU has been a champion of ambitious, but achievable legal reforms. We believe this could have a positive effect on costs and leave more money in the system for patients.
We are calling for the following reforms:
- Section 2(4) of Law Reform (Personal Injuries Act 1948 must be repealed. It requires that the courts disregard the existence and cost of NHS care when determining compensation awards.
- To provide the highest quality care for all patients, a separate body should determine the NHS health and social services packages. Compensating organizations such as the MDU and NHS should be required by law to fund care packages to ensure the highest standard of care. This would ensure that more money is available for the NHS.
- Tackle disproportionate legal costs. MDU figures show the average sum paid in claimants’ legal costs on lower value claims continue to exceed the amount paid to claimants by two or three times. The Government needs to deliver on its promise to introduce fixed, proportionate, legal costs for cases valued up to £25,000 as soon as possible. This should not be the end. We are urging the government to go further and increase the range of the fixed costs scheme to £250,000.
- The national average salary should be used to calculate the damages for earnings loss.
This swift legislative action would be a welcome step in addressing the unsustainable costs of clinical negligence to taxpayers.
Healthcare is one of the most difficult areas of government policy. It is a challenge because the health of the nation should be one of the first duties a government has.
We call on the new government to seriously consider the issues we raised in this paper. Healthcare professionals care for us. We need to make sure they are looked after in return.