Since I became chief executive of the MDU in September 2021, three people have held the title of secretary of state for health and social care - one of whom now does so for the second time. That alone causes me to pause and reflect on the fact that while personnel change in government seems to happen with some regularity, policy change - particularly on the medico-legal front - is something of a longer game.
We hope the secretary of state will bring renewed energy and impetus to the role, and that during his tenure, longstanding and vital issues will finally be addressed.
Steve Barclay faces a full in-tray. From concerns over NHS pay and pensions, to long term workforce planning issues, there are no shortage of issues on his 'to-do' list. However, we believe medico-legal issues should not be overlooked.
Indeed, we are putting forward number of proposals to the secretary of state, which we believe could be addressed in the short to medium term, and go some way to demonstrating to healthcare professionals that the government recognises the challenges of the environment they are working in.
Here, we look at two of those proposals.
Number 1: reform the GMC
It's a promise that is long overdue, and now is the time to deliver. Members constantly tell us that undergoing a GMC investigation is one of the most difficult experiences of their professional lives.
Part of the problem is that the GMC fitness to practise procedures are rigid and still governed largely by outdated legislation. While limited progress has been possible, only a complete reset of the regulators governing legislation can bring about a system that is truly modern, proportionate, timely and, most of all, fair.
Legislation to bring about reform was promised and seemingly in grasp earlier this year. However, the changes that are so badly needed have now been deferred to 2024 at the earliest. The MDU led a coalition, including the BMA and a number of medical royal colleges, arguing against this delay. We wrote to the last secretary of state expressing our frustration and urging the government to think again on the implementation timetable.
The arrival of a new secretary of state is the perfect opportunity to revisit the issue, and press on with the original committed timetable. We want the government to introduce that legislation this year.
The cost of future claims liabilities are not far off the total budget for NHS England spending in 2022/23 - which is expected to be circa £152 billion. Reform can not be delayed any longer.
Number 2: the cost of clinical negligence
We have long championed a package of ambitious but deliverable legal reforms, which we believe could have a positive impact on the unsustainable costs of clinical negligence. Ultimately, this is all about leaving more money in the system to benefit patients, and supporting members to work in a system where every penny available is spent on patient care.
The reforms we are calling for, include:
- Repeal section 2(4) of the Law Reform (Personal Injuries) Act 1948. It requires the courts to disregard the existence of NHS care when determining compensation awards.
- Tackle disproportionate legal costs. MDU figures show the average sum paid in claimants' legal costs on lower value claims continue to exceed the amount paid to claimants by two or three times. The government needs to deliver on its promise to introduce fixed, proportionate, legal costs for cases valued up to £25,000 as soon as possible. That also should not be the end of it. We are urging the government to go further an increase the range of that fixed costs scheme to £250,000.
We believe swift legislative action, such as this, would be a welcome step forwards in addressing the unsustainable cost of clinical negligence to the taxpayer.
To put the current situation in context, the cost of future claims liabilities are not far off the total budget for NHS England spending in 2022/23 - which is expected to be circa £152 billion. Reform can not be delayed any longer.
The MDU is an unapologetic champion of doctors. With this new government, and this parliament, we will continue to make the case for positive reforms that improve the lot of members. We want the government to deliver for doctors, so doctors can deliver for patients.
Reforming healthcare professional regulation and addressing a clinical negligence bill that is growing constantly are two important areas where we expect to see government delivery.