HC Deb 17 December 1992 vol 216 cc404-5W
Mr. Alex Carlile

To ask the Secretary of State for Wales (1) what is the source of the funds used to satisfy damages and costs awarded in litigation against district health authorities in Wales;

(2) what is to be the source of the funds used to satisfy damages and costs awarded in litigation against NHS trusts in Wales; and if he will make a statement;

(3) if NHS trusts in Wales will be required to carry insurance against claims for medical negligence and other forms of public liability; and if he will make a statement.

Mr. Gwilym Jones

Health authorities and NHS trusts in Wales meet the first £30,000 of any claim made under legal obligation from their own resources. The exess costs above this level are met from a centrally managed pool to which contributions are made by participating health authorities and trusts. The pool also covers risks of loss above this threshold arising from incidents of fire/arson, theft, subsidence, flooding and storm damage. In the case of medical negligence, 80 per cent. of any excess above a further threshold of £300,000 is met by the Medical Defence Organisation reserves while these remain.

Participation in these pooling arrangements is not compulsory. It is open to health authorities and trusts to take out commercial insurance for all risks other than medical negligence if they perceive this to be advantageous. Indeed, pool participants may choose to insure themselves against such risks where claims fall below the £30,000 threshold for access to the pool. However, in the case of medical negligence, any NHS bodies which decide to remain outside the pooling arrangements must bear their own risk for all costs other than the 80 per cent. above the £300,000 which may be claimed from the Medical Defence Organisation reserves. In such circumstances health authorities would be able to seek repayable temporary cash allocation increases from the Department, and NHS trusts would be able to seek increased loan finance from approved sources where necessary to meet large claims.

NHS trusts will not be expected to bear the cost of meeting any claims which have arisen prior to the date at which the trust concerned became operational. However, if they choose to participate in the pooling arrangements, their contributions will be geared to anticipated claims on the pool irrespective of the date at which the incident giving rise to the claim occurred. The pool is a system of mutual risk sharing, and participants must accept all of the shared costs as well as all of the shared benefits of pool membership.