Politics: Legal aid curbs to cut NHS bill a

THE Lord Chancellor, Lord Irvine of Lairg, is planning to limit the legal aid in medical negligence cases to specialist lawyers in an attempt to reduce the pounds 200m cost of such cases to the NHS.

The move is supported by Frank Dobson, the Health Secretary, who yesterday warned against Britain following the American system where claims for medical negligence are plentiful but only half of the compensation reaches the patients.

The restrictions on legal aid for medical negligence cases to be proposed next week in a consultation paper could alarm patients, who may have to travel greater distances to have their cases taken up by specialist lawyers, and it will upset lawyers.

The Law Society has a panel of about 100 lawyers who specialise in complicated medical negligence cases, but it said yesterday it was against restricting people's access to legal help.

Lord Irvine's consultation paper will water down the threat made last year to withdraw all legal aid from civil cases, although legal aid will be withdrawn for personal injury cases, where there is a growing market in conditional fee insurance, under which clients take out insurance costing around pounds 100 for claims for accidents.

Ministers looked at the possibility of extending this idea to medical negligence but have been persuaded that it would be too expensive for patients. Some experts have estimated the insurance cover against losing a case for medical negligence could cost from pounds 5,000 to pounds 20,000, debarring the poor from taking action.

The Law Society said such litigation was highly complex, and vehemently denied lawyers were seeking high profits from such cases.

The Health Secretary has met Lord Irvine to discuss possible action in reducing the cost of medical claims now facing doctors. Mr Dobson, in a speech issued yesterday, said: "At present clinical negligence is costing the NHS around pounds 200m a year. We've got to stop that figure rising."

With the Lord Chancellor ready to launch his consultation exercise with lawyers, Mr Dobson appealed to everyone involved in the health service including patients to put forward their views on how to reduce the threat of litigation in the NHS. "We've got to act now before things get out of hand. Otherwise, the cost to the NHS will be enormous."

The Health Secretary said that the harm went further than the cost of legal action, by involving doctors in lengthy periods in court, instead of in hospital, treating patients.

Mr Dobson said doctors felt increasingly threatened by actions, and were practising "defensive medicine". He said: "Instead of asking themselves what's best for this patient, they are increasingly looking over their shoulder and asking how it will this look in court."

Only 17 per cent of medical negligence cases succeed in court, and Mr Dobson said the lawyers were the only ones to benefit from the 83 per cent of cases which failed.