When it comes to clinical negligence claims, the NHS is facing a financial storm that seems almost impossible to navigate.
Last year alone, taxpayers forked out a staggering £538 million to lawyers pursuing these claims—often far more than the patients at the heart of these cases actually received.
A new report from MPs paints a damning picture of how legal fees are spiraling out of control while patient compensation struggles to keep pace.
Legal Fees Outpace Damages
The Commons Public Accounts Committee (PAC) found that many legal teams are taking home nearly four times what injured patients receive in damages.
For smaller claims under £25,000—which make up roughly 75% of cases—this disparity is even starker, with lawyers pocketing £3.70 for every £1 awarded to victims.
The committee called these figures “unacceptable” and warned that such costs divert vital resources away from frontline NHS care.
Rising Costs and Delays
Clinical negligence costs have skyrocketed over the past two decades, with claimant legal fees jumping from £148 million in 2006/07 to over half a billion in 2024/25.
The government’s liability for such claims has quadrupled to £60 billion, yet ministers have shown little meaningful action to address the problem.
Meanwhile, patients continue to wait years for settlements—brain injury claims involving children, for instance, can take 11 to 12 years to resolve, racking up enormous legal bills over time.
Delayed Reforms and Proposed Solutions
Rules designed to cap legal fees for low-value claims were meant to be implemented two years ago, but delays have left the system stuck.
The cross-party PAC urged the government to develop alternative mechanisms to speed up decisions and reduce costs.
Sir Geoffrey Clifton-Brown, PAC chair, emphasized that a less adversarial approach could save money, cut delays, and ease the burden on families affected by negligence.
Experts Weigh In
Legal and medical experts have weighed in on the crisis.
Suzanne Trask from the Association of Personal Injury Lawyers said a lack of transparency leaves patients in the dark, prolonging cases and inflating legal costs.
Sharon Allison of the Society of Clinical Injury Lawyers argued that cutting access to justice is not the solution; instead, collaboration and preventive measures could reduce both harm and costs.
Thomas Reynolds from the Medical Defence Union called for urgent capping of legal fees in low-value cases to stop the financial drain on the NHS.
Government and NHS Response
The Department of Health and Social Care highlighted its Ten Year Health Plan and ongoing review led by David Lock KC as steps toward controlling costs and improving patient care.
NHS England added that while staff work hard to keep patients safe, more must be done to tackle safety issues and enhance care for affected families.
A System in Need of Change
The report underscores a system struggling to balance patient safety, timely compensation, and rising costs.
With legal fees accounting for almost a fifth of the total settled claims bill and settlements predicted to exceed £4 billion annually by the end of the decade, MPs say urgent reforms are needed to protect both patients and the public purse.
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