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Reducing Harm to Patients in the National Health Service. Will the Government’s Compensation Proposals Help?

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  • Paul Fenn;Alastair Gray;Neil Rickman;Rodrigo Salinas;Adrian Towse

Abstract

The UK government hopes that the proposals in the report of the Department of Health’s Chief Medical Officer "Making Amends" (CMO, 2003) will make its NHS safer whilst ensuring that patients who are harmed get compensation more quickly and more efficiently than at present. The Making Amends proposals seek to achieve this by setting up administrative mechanisms for compensating patients. These will provide an alternative to the existing court based "tort" system, whereby patients sue doctors and hospitals for negligence in order to get compensation. These changes should be helpful. They will reduce administrative costs and lead to more patients injured by adverse events getting compensated. However, the changes will only contribute to the overriding objective of reducing the number of NHS patients harmed in the future if the administrative mechanisms for compensating patients who are harmed are linked to those aimed at improving patient safety. It is not clear that the government’s proposals will achieve this. Yet the link is essential for two reasons: so that information from patient compensation claims can be used to improve patient safety; and so that a hospital’s record in harming patients costs it money, giving it a strong financial incentive to invest in preventing errors. This paper sets out the context of the extent of medical error in the NHS and the current tort system for negligence, discusses the issues the government’s proposals raise, and sets out how these proposals can be made more effective by ensuring a link between safety systems and compensation mechanisms.

Suggested Citation

  • Paul Fenn;Alastair Gray;Neil Rickman;Rodrigo Salinas;Adrian Towse, 2003. "Reducing Harm to Patients in the National Health Service. Will the Government’s Compensation Proposals Help?," Briefing 000484, Office of Health Economics.
  • Handle: RePEc:ohe:briefg:000484
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    File URL: https://www.ohe.org/publications/reducing-harm-patients-national-health-service-will-governments-compensation-proposals/attachment-287-2003_reducing_harm_towse/
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    References listed on IDEAS

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    1. Daniel P. Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," NBER Working Papers 5466, National Bureau of Economic Research, Inc.
    2. Daniel P. Kessler & Mark B. McClellan, 2000. "How Liability Law Affects Medical Productivity," NBER Working Papers 7533, National Bureau of Economic Research, Inc.
    3. Danzon, Patricia M., 2000. "Liability for medical malpractice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 26, pages 1339-1404, Elsevier.
    4. Daniel Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 353-390.
    5. Danzon, Patrigia M., 1994. "The Swedish patient compensation system: Myths and realities," International Review of Law and Economics, Elsevier, vol. 14(4), pages 453-466, December.
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    Cited by:

    1. Anne R. Mason;Andrew Street, 2004. "To Publish or Not: Experience and Evidence About Publishing Hospital Outcomes Data," Monograph 000493, Office of Health Economics.

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    More about this item

    Keywords

    Reducing Harm to Patients in the National Health Service. Will the Government’s Compensation Proposals Help?;

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

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