As the NHS turns 75, Dr Michael Devlin, Head of Professional Standards and Liaison for the Medical Defense Union (MDU), reviews some key legal milestones and examines the challenges ahead.
the 5thhe In July this year, it will be 75 years since the NHS was created. During that time, the NHS has been at the forefront of medical advances, achieving many world firsts. These include the first CT scan in 1971, the first test-tube baby born in 1978 and, more recently, NHS hospitals played a key role in providing evidence for the use of dexamethasone to effectively treat covid-19 patients, thereby helped save approximately one million. lives all over the world.
The NHS is needed more than ever, but it and its staff are under increasing pressure. Despite this, doctors and nurses continue to top the lists of most trusted professionals.
Here we take a look at some iconic medico-legal cases, many of which still shape NHS care and treatment today, and examine the key challenges facing this struggling institution:
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1957 – The Bolam test is established
John Henry Bolam suffered serious injuries during a course of electroconvulsive therapy (ECT). He sued and the historic court ruling that bears his name continues to influence the behavior of healthcare professionals today when judging whether there has been a breach of care in the treatment of their patients (negligence).
The Bolam test established that a professional is required to exercise the ordinary skill of a competent professional in his or her field. A health professional will be considered to have achieved the required standard of clinical care if a responsible body of medical opinion, even a minority, finds their actions acceptable.
1988: MDU pays its first claim of over £1 million
The MDU becomes the first medical advocacy organization to pay compensation in excess of £1 million. This settlement was paid to a man who suffered severe brain damage following an operation to remove a cyst in his brain. Today, compensation claims involving patients treated by the NHS regularly exceed £20 million and can even reach £30 million.
2015 – Montgomery trial establishes informed consent
This case concerned a woman who had given birth to a baby with cerebral palsy as a result of shoulder dystocia. The patient, who suffered from diabetes, expressed concern about the size of the baby but was not warned about the risks of vaginal delivery or offered a caesarean section. Although her claim was initially unsuccessful in the Scottish Magistrate Court, the patient eventually took the case to the High Court, which ruled that a doctor has a duty of reasonable care to ensure that the patient is aware of any material risk in the proposed and reasonable treatment. alternatives.
Unlike the Bolam ruling, the Supreme Court approached this from the patient’s perspective, rather than the doctor’s. A risk would be ‘material’ if a reasonable person in the patient’s position could attach importance to it, or if the physician is or should reasonably be aware that the particular patient is likely to attach importance to it. Established the principle of informed consent in UK clinical malpractice law.
2022: NHS claims liabilities top £100bn for the first time
According to the latest estimate, the cost of meeting future claims liabilities for the NHS in England stood at a staggering £128 billion, a figure that has more than quadrupled in the last decade. It was £17.5 billion in 2011.
This huge financial responsibility for the NHS does not exist in isolation. Every penny expected to be spent on claims means less money for patient care. This is not a sustainable situation and legal reform is desperately needed to rebalance the system.
2022: Staff shortages pose a risk to patient safety
The Health and Social Care committee’s report on the workforce, recruitment, training and retention in medical and social care highlighted the worrying risk posed to patient safety by staff shortages. Without sufficient trained clinical staff, the NHS cannot deal with the current backlog of waiting lists or adapt to the increased demand expected as our population ages.
Study after study has shown that doctors and other health professionals suffer from burnout. This is not good for them or for the patients. The government must do more to support the well-being of doctors and implement its Long-Term Workforce Plan without delay.
Read MDU’s commentary on the recently published Long Range Workforce Plan here.
Now test your knowledge of Britain’s health service with the MDU NHS 75th Anniversary Quiz
For more information and help addressing claims of negligence, see MDU’s Opinion Former profile.