MPs Deliver Scathing Verdict on Clinical Negligence Inaction
The government and NHS England have faced severe criticism from MPs for their failure to implement "any meaningful steps" to address the escalating costs of clinical negligence in England, despite repeated warnings spanning two decades. The Public Accounts Committee (PAC) has branded this persistent inaction as "especially disappointing" given the current climate of budget constraints and workforce reductions across the health service.
Spiralling Financial Liabilities Revealed
New figures reveal the staggering scale of the problem, with total liabilities for medical negligence claims having quadrupled to £60 billion since the 2006-07 period. Meanwhile, annual settlement costs have more than tripled, now standing at an eye-watering £3.6 billion. These alarming statistics present what the PAC describes as "a system struggling to keep its patients safe from avoidable harm."
The committee's comprehensive report highlights that despite numerous examinations of clinical negligence issues over the years, the Department of Health and Social Care (DHSC) "cannot provide reassurance" that it has taken substantive action to address the crisis. Furthermore, the DHSC has indicated it will not commit to any new improvement initiatives until completion of an ongoing review of clinical negligence, for which no expected completion date exists.
Systemic Failures in Patient Safety
Sir Geoffrey Clifton-Brown, chairman of the PAC, delivered a powerful statement emphasising the human cost behind these financial figures: "This is a swelling accounting of profound suffering. Each case can represent unspeakable devastation for the victims involved, and the overall picture is of a system struggling to keep its patients safe from avoidable harm."
The committee identified significant shortcomings in how patient safety is managed, noting that the NHS "has not done enough to tackle the underlying causes of harm to patients" and that approaches by both NHS England and the DHSC "lack co-ordination." MPs also expressed serious concerns about inadequate data collection regarding the factors contributing to clinical negligence incidents.
Maternity Care Failings Highlighted
Particular attention was drawn to "tragic failings" in maternity care as a significant driver of rising claims. In the 2024-25 period alone, costs for claims involving brain injury at birth exceeded £1.5 billion, with total costs for paediatric failings reaching £325 million. These figures follow recent news of a family receiving £37 million in one of the largest maternity negligence claims in NHS history.
The PAC has called for urgent publication of the Amos Review within two months, alongside a comprehensive government response outlining concrete plans to reduce harm and associated costs in maternity care. This follows Baroness Valerie Amos's recent launch of a call for evidence for the National Maternity and Neonatal Investigation, which will examine failings at twelve NHS trusts.
Calls for Comprehensive Reform
The committee has made several key recommendations to address the crisis:
- A detailed government plan to tackle clinical negligence systematically
- A national framework to improve patient safety with clear annual targets
- A national system for sharing data between NHS trusts to facilitate learning and prevention
Sir Geoffrey Clifton-Brown emphasised the urgency of the situation: "Whatever happens next, government has been in unacceptable stasis on the issue of clinical negligence for the majority of my political life, as numbers have continued to creep up. For those harmed by the outcomes of this system, the time for change has long since come and gone."
Government and NHS Responses
A DHSC spokesperson defended the government's record, stating they had "inherited an NHS that was failing too many people" and had taken rapid action to strengthen patient safety. They highlighted several initiatives including:
- Overhauling the Care Quality Commission
- Rolling out Martha's Rule and Jess's Rule for fresh clinical reviews
- Introducing hospital league tables to drive improvement
- Implementing new maternity safety measures
- Establishing a taskforce to restore confidence in NHS maternity care
The spokesperson added: "For the first time in years, we've put the NHS back on firm financial ground – meeting its 2.7% productivity target, cutting waste, and getting patients seen faster as waiting lists come down. In the Ten Year Health Plan, to tackle the rising costs of clinical negligence and to improve the system, we asked David Lock KC to carry out a review, so every penny can be spent on patient care."
An NHS spokesperson acknowledged that while staff "work incredibly hard to keep patients safe," there remains "more to do to tackle safety issues and improve care for many families." The PAC expressed hope that its recommendations, alongside forthcoming reviews, would help both government and NHS leadership fulfil their duties to prevent future harm and address this long-standing crisis in clinical negligence management.
