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At the heart of general practice since 1960

Compensation nightmare facing GPs over complaints

New legislation could have far-reaching implications for GPs with the prospect of financial compensation now on the agenda ­

Dr Gerard Panting explains

he storm over foundation hospitals stole the headlines in coverage of Labour's Health and Social Care Bill, but the Bill contains other provisions. These include the introduction of limited financial compensation through the NHS complaints procedure, and this threatens to have a major impact on GPs practising in England.

The Bill itself does not say this will happen, and the Department of Health would say no decision has yet been made, but the Bill does provide the legislative framework for compensation to be brought into the complaints system.

The rationale behind the proposal is that health care is out of step with other sectors in failing to recognise that inconvenience and poor service warrant financial compensation, and that small claims are uneconomic for solicitors to take on.

In fact it is not true that small claims are not pursued. Some 30 per cent of clinical negligence claims are settled for £5,000 or less.

Settlement times for low-value claims are also relatively short, especially where the claim follows an NHS complaint. The average is just 10 months for claims of less than £5,000.

The integration of compensation and complaints would result in a two-tier system, with claims worth less than £10,000 or £15,000 being determined on some woolly notion of acceptable standards, and those over the threshold being subjected to the full rigour of the legal process.

How much, if any, compensation should be awarded requires experience and expertise which does not exist among complaints officers or members of independent review panels.

The prospect of financial compensation on the horizon can do nothing but encourage the majority of complainants to remain dissatisfied until they get some compensation.

Increased numbers of complainants less willing to allow their complaint to be resolved until money is received is a bureaucratic nightmare likely to result in medical, nursing and administrative resources being diverted from health care delivery to complaints handling.

There are wider implications too. The award of compensation will inevitably be seen as a reflection of the culpability of the practitioners concerned and the severity of their error.

Such awards may be reported in local newspapers. Adverse publicity will reduce public confidence in the NHS as well as denting the reputation of the health care workers involved, further undermining morale. The current complaints and compensation systems are not perfect, but what is required is the development of both, not the fudge of integration.

Adverse publicity could still further undermine the morale of health care workers~

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