HL Deb 11 May 1987 vol 487 cc418-20

2.46 p.m.

Lord Allen of Abbeydale

My Lords, I beg leave to ask the second Question standing in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government whether they are prepared to facilitate the introduction of an experimental no-fault scheme for medical accidents.

Lord Hesketh

My Lords, we have at present no plans to introduce an experimental no-fault scheme to compensate those people who suffer from medical accidents.

Lord Allen of Abbeydale

My Lords, I am much obliged for that Answer, which is clearer than some we occasionally have from the Front Bench opposite. Is the Minister aware that medical negligence claims have been increasing in number, that insurance premiums have been rocketing upwards and that some valuable resources are already being diverted to defensive medicine in case there should be a subsequent claim for negligence? If the Government are not prepared to fall in with the proposal which emanates from the BMA for a pilot no-fault scheme, what are they proposing to do? We are on a slippery slope and if nothing is done and we go drifting on, will not things get steadily worse?

Lord Hesketh

My Lords, with regard to the noble Lord's question concerning insurance costs for the medical profession, in the past year average annual medical insurance costs have increased by 70 per cent. to £576. These subscriptions are still low compared with other professional groups in the United Kingdom. For example, one insurance company has quoted the percentage costs of gross income for architects as 5.15 per cent., solicitors 2.4 per cent., surveyors 7 to 10 per cent. and for doctors 0.5 to 3.5 per cent.

Lord Allen of Abbeydale

My Lords, it would have been nice to have had an answer to my Question. However, if I am unlucky on that, may I ask whether the Government, as the Pearson Royal Commission recommended in 1978, have been keeping a close eye on the way that no-fault medical injury schemes are operating in the countries where they are in force, notably New Zealand, Sweden and more recently in Finland?

Lord Hesketh

My Lords, we are well aware of developments in both Sweden and New Zealand. I am sure the noble Lord is aware that the New Zealand scheme is not considered entirely satisfactory and is now the subject of three reviews in New Zealand; the Royal Commission on Social Policy, the Law Commission, and the Ministerial Committee of Inquiry.

Lord Denning

My Lords, is the Minister aware that medical accident cases in this country are getting entirely out of hand, not only because of the enormous damages being awarded but also the time and expense of the legal and medical professions in dealing with them? Even if there were a no-fault compensation scheme, is it not appropriate, as their Lordships in their initial report in 1980 suggested, that there should be an inquiry on the proper principles on which damages should be assessed?

Lord Hesketh

My Lords, I am very grateful to the noble and learned Lord for his question. I entirely agree with him about rising costs. The Observer newspaper has suggested costs in this country of £46.5 million per annum if we introduce the Swedish scheme compared with total health authority payments last year of around £7.4 million.

Lord Nugent of Guildford

My Lords, is my noble friend aware that in the United States of America legal awards are now astronomically high, literally running into tens of millions of pounds? I am told that the measure of insurance which a surgeon has to take out amounts to around a third of his fees, with the result that fees rise higher and higher and everybody suffers. Will my noble friend direct the attention of his right honourable friend the Secretary of State to the danger we are in and the need to find the means to check this, and ask him to consider very seriously the suggestions that have been made this afternoon?

Lord Hesketh

My Lords, I am grateful to my noble friend Lord Nugent for again drawing our attention to the fact that in the United States in some cases on a percentage basis the costs are 10 times as high as they are in the United Kingdom. I shall certainly draw his remarks to the attention of the Secretary of State.

Lord Stallard

My Lords, will the noble Lord accept that there is great concern in the country about the issues raised by the noble Lord, Lord Allen? Although there may not be the same kind of impetus for the solutions that he has suggested, there is certainly a great deal of concern. Perhaps I may suggest two areas in which the Minister might act in advance of the remedies suggested. There are other people—the victims—to be considered. At the moment it is very difficult for a victim of an accident in a hospital to obtain the notes on his case without the issue of a writ. This could be looked at in order to make it slightly easier for victims.

Noble Lords

Question!

Lord Stallard

My Lords, will the Minister accept that it is also very difficult for patients who are ill, who have lost their jobs and who are dependent on legal aid to conduct cases of negligence? Will he look into those aspects of the matter and try to persuade doctors that their job does not finish when the patient has the accident; that they ought to be prepared to co-operate with organisations such as Action for the Victims of Medical Accidents in order to assist patients?

Lord Hesketh

My Lords, I note the suggestions of the noble Lord, Lord Stallard.

Lord Elwyn-Jones

My Lords, is it not the case that the awards in such cases in this country are made by judges and not by juries, and that the principles on which the judges act in medical matters are by now very well known indeed?

Lord Hesketh

My Lords, I am very grateful to the noble and learned Lord for bringing that matter to the attention of the House.

Lord Elton

My Lords, is it not the case that those who advise my noble friend and his right honourable friend on these matters will have a comparatively restful three weeks in the near future? Can they not look more closely at the merits of this case in answer to what must be admitted is one of the more clearly expressed Questions to come from the other side?

Lord Hesketh

My Lords, I have not had a chance to see the tape yet.

Lord Allen of Abbeydale

My Lords. I do not wish to pursue this matter now but perhaps I may tell the Minister that the difficulties are very well known. Will he not convey to his right honourable friend the need to do something? We have a perfectly good no-fault system for industrial injuries. Is it not possible to consider introducing some solution in this very important and difficult field?

Lord Hesketh

My Lords. I take note of the suggestion of the noble Lord. Lord Allen of Abbeydale.