The Future Healthcare Journal is published by the Royal College of Physicians (RCP). In that journal, the inequity of medical negligence-based adversarial litigation (used in the USA, UK and Australia) is debated (Epstein, 2023). It is a recognised target for reform.
Plaintiff autonomy is weakened by a dispute resolution system that has evolved around lawyers, opposed experts and insurers; the need to definitively prove causation excludes compensation for other categories of medical injury; and patient access to the system is restricted by high entry costs.
Two strategies towards reform are raised in the article. A short-term approach involves routine initial use of a single court-appointed medical expert for assessment of errors and liabilities, thus improving access while relegating fault-finding to a reserve role.
In the longer term, adversarial litigation could be replaced in part by a ‘no-fault compensation scheme’ – such as in Scandinavia, France and New Zealand – funded by taxation and by re-directed medical indemnity fees. Many argue that this type of litigation is more intelligent, quicker, cheaper and fairer – and more importantly, gives the patient (and family) answers and an apology.
Reforms such as these would be challenging to implement, but are achievable. So it is not premature for relevant bodies to consider a timetable for action.
