During a debate at the UK LMCs conference in York, GPs argued that it was time to ‘de-couple’ patients seeking medical reparation and blaming clinicians for mistakes triggered by system failures.
LMC representatives said that a no blame system would ‘embolden’ clinicians to share adverse events - encouraging a ‘culture of learning’ - and saving clinicans from fearing for their professional careers and reputations.
GPs also said that a different scheme could encourage doctors to stay in the profession for longer, with some tempted to retire earlier than planned to avoid staining their career records.
The motion follows a recent case involving Lincolnshire GP Dr Phillip Mitchell who was sued by a patient for medical advice he gave 20 years ago. Grassroots GPs have expressed concern that the case would affect the patient-doctor relationship.
Cambridge LMC representative Dr Hayley Haworth, who proposed the motion, said the case of Dr Mitchell had set a ‘worrying precedent’ for GPs who were at increased risk of litigation due to huge workload pressures.
She said: ‘While GPs are currently insured against the financial risk of litigation, this does not extend to the mental health time and reputational damages, with the process being just as much a punishment as a penalty. This engenders fear and defensive medicine which is costly to the patients in the NHS.
‘In a time when the NHS is on its knees and GPs are leaving the profession in their droves, a radical overhaul of the NHS compensation system to a no blame alternative might offer some relief from the overwhelming fear of change and litigation.’
She added: ‘We need to follow the aviation industry for example, which has learned from failure to make the industry safer. Errors are treated as a symptom of system failure, with a need for systems to become more resilient to human error and eliminate future risk.
Chair of the BMA's legal committee and Manchester GP Dr Simon Minkoff spoke against the motion, explaining that work was already being done by the BMA on this area, and the motion could disrupt it. But the motion was taken as a straight vote, with all parts passing.
Evie Toombes, who was born with a rare neural tube defect lipomyelomeningocele won her legal case against GP Dr Philip Mitchell last December. It argued that if Ms Toombes’ mother had been given advice to take folic acid, she would have postponed getting pregnant and therefore her daughter would not have been born.
The judge ruled that Dr Mitchell was liable for damages but he will not personally be expected to pay them, and will be covered by NHS Resolution. Dr Mitchell's solicitor said he would not be able to appeal the verdict because it stood very little chance of success.
Motion in full:
CAMBRIDGESHIRE: That conference notes the recent ‘folic acid’ legal case in the media, and supports GPC UK researching the benefits of a no-fault medical compensation scheme to replace the current tort-based system, with the intention of providing this data to the government to add weight to their patient-centred reviews, particularly assessing whether a no-fault scheme would:
(i) reduce GPs' anxiety associated with possible litigation and therefore reduce defensive medicine
(ii) improve doctors' and patients' experiences of resolving a claim, particularly with regard to mental health impact
(iii) improve patient safety by enabling doctors to more freely admit to adverse events and share learning from these episodes.