Dr Christine Tomkins
If we truly value its contribution, the NHS and its workforce must now be shielded from the additional burden of coronavirus civil claims, says Dr Christine Tomkins.
The pandemic has been a crucible for rapid change in the healthcare sector. Innovations in medical care that might have taken 20 years to evolve have been implemented virtually overnight, from the shift to remote consultations to research programmes investigating possible vaccines and treatments for critical COVID-19 patients.
Throughout this health crisis, MDU members have made enormous sacrifices, putting themselves in the way of danger to work long hours in intense conditions, despite concerns about PPE. Many came out of retirement or worked in unfamiliar settings to contribute to the effort. Some were forced to live apart from their loved ones to protect them from infection.
It is cruel and unfair to pile the morale-sapping burden of negligence claims on clinicians who have already been deeply affected by the pandemic.
And yet the impact went beyond radical shifts in practice, or the physical discomfort of treating patients wearing full PPE. There was also the immense psychological strain of seeing so many patients die in such a short space of time. Of course, doctors have experienced death, but few will have known the feeling of helplessness caused by doing your best for someone without being able to save them, experienced with COVID-19. When that happens over and over again, it inevitably results in trauma and we are likely to see the consequences of this for a long time to come.
Little wonder, then, that in a survey of 250 MDU members, including consultants, GPs, trainees, and staff grade doctors, 70% of respondents said their stress and anxiety levels had increased since the beginning of the pandemic, with 22% reporting they were feeling significantly worse. More recently, a BMA survey of more than 7,000 doctors revealed that 41% were suffering with depression, anxiety, stress, burnout, distress or another mental health condition relating to or made worse by their work, with 29% saying this had got worse during the pandemic. At the same time, the BMA revealed its wellbeing and support services had seen a 40% increase in use over the last three months.
I think the public respect the huge collective effort made to tackle the pandemic - the weekly 'clap for carers' event was a morale boost for many on the frontline - but I am not convinced they fully understood the unrelenting emotional toll on clinicians. And as far as complaints and claims are concerned, I'm sorry to say that some memories can be very short. As we revealed in June, members are already reporting hundreds of complaints since lockdown began, many related to the impact of the coronavirus response on NHS routine care.
We have already seen headlines about restricted access to cancer diagnostic services during the pandemic and we fully expect to see claims from patients arising from this situation, as well as cases where doctors have been working outside their usual practice areas or where treatment has been compromised because of shortages.
Although doctors won't be financially liable for claims relating to COVID-19, they would still face the distress and anxiety of having their clinical work scrutinised and every decision questioned. And given that medical claims have a long 'tail', that is likely to be several years down the line when the exact circumstances have faded in the public memory. Doctors can already be held accountable for their professional conduct and performance in multiple ways, not least the GMC. It is cruel and unfair to pile the morale-sapping burden of negligence claims on clinicians who have already been deeply affected by the pandemic.
And from the perspective of patients who have been harmed, legal action is surely counterproductive as it further impairs the NHS's ability to provide speedy, good quality treatment for the claimant and for every other patient in need. If our goal is to provide the best health service possible in difficult circumstances, then suing that service is the surest way to undermine it.
When the country is facing economic hardship, the health service and tax payers can ill-afford the prospect of multiple coronavirus-related negligence cases, which will be processed through an outdated and destructive civil claims system. Bear in mind that NHS Resolution's provision for claims in its latest annual report was £83.4bn (as of March 2019), a staggering sum that owes more to legal and economic factors than the standard of care provided.
That is why the MDU is calling on the government to exempt the NHS and its workforce from COVID-19 claims and follow the example of several states in the USA. Such a move would command widespread public support; according to a poll of 2,108 UK adults, commissioned by the MDU, 70% think doctors, dentists and other NHS staff involved in providing treatment to patients during the COVID-19 pandemic should be able to do so without the risk of the NHS being sued for negligence. Only 7% of respondents disagreed.
'Protect the NHS' was the government's mantra throughout lockdown and it seems to me that this message has struck a chord with the British public. While the danger from the coronavirus has not yet passed, the government now has a golden opportunity to do the right thing for the future of the NHS and for healthcare professionals who have already endured so much on our behalf.