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Department of Health Sets Aside £21 Billion for Negligence Cases – But Has No Idea if Situation is Getting Better or Worse

A new report has found the ministry spends £3 billion a year on maternity services but paid out an ‘eye-watering’ £1.1 billion in claims for 2022-23

general view of staff on a NHS hospital ward at Ealing Hospital in London. Photo: PA Images/ Alamy
The Department of Health and the NHS have been heavily criticised in a new report showing the cost of negligence claims, with maternity services being one of the worst areas. Photo: PA/Alamy

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MPs have criticised the Department of Health and Social and the NHS for presiding over huge sums in clinical negligence claims, amid the ministry’s failure to audit its spending for the second year running.

The Department of Health and Social Care 2022-23 Annual Report and Accounts reveals that it has had to set aside £21 billion for known cases of clinical negligence, with maternity services being one of the worst areas.

It states that the department spends £3 billion a year on maternity services but paid out £1.1 billion in claims for 2022-23. It describes the pay-out – costing a third of the amount to provide the service – as “eye-watering”.

“Each claim is a tragedy for the people involved,” according to the report. “Yet, the department does not know whether the number of clinical negligence claims across the NHS as a whole are increasing or decreasing.

“The NHS does not benchmark well on clinical negligence compared to many similar health systems, and the department and the NHS recognise that huge improvements need to be made.” 

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The MPs’ findings chime with a report by NHS watchdog, the Care Quality Commission published in February 2024, which found that people’s experiences of maternity services have deteriorated during the past five years.

“The cost of clinical negligence to the NHS in England relative to the population served is significantly higher than those of similar health and social care systems,” the report states. “In 2018-19, it was higher than the combined equivalent costs in the health systems of Australia, Canada, New Zealand, and Sweden.”

The report is highly critical of the failure by the department and the United Kingdom Health Security Agency (UKHSA) to account and audit the billions of pounds they spend, and the lack of planning for another pandemic.

Labour’s Dame Meg Hillier MP, chair of the House of Commons’ Public Accounts Committee, said: “The proper safeguarding and robust accounting of how taxpayers’ money is spent is not an optional extra. The fact that UKHSA’s accounts have been unable to be properly audited for two years in a row – a very rare occurrence for a public body – is deeply concerning.

“But our report also raises wider issues speaking to the DHSC’s grip on spending, and illustrate ongoing and tragic failures experienced by people using the health service. The Government is spending billions on clinical negligence claims. An effective plan to reduce these costs would be an effective plan to reduce clinical harms, but such a plan does not yet exist.”

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UKHSA – which is responsible for keeping the UK safe from pandemics – has failed to produce adequate financial reports for two years and does not have an inventory of stock it purchased for COVID, according to the report. It also has no plan yet on how to tackle future pandemics.

The Department of Health and Social Care is behind in getting NHS trusts audited – similar to the fate of local councils previously reported by Byline Times – and could only produce these accounts at the end of January 2024, some 10 months after the end of the financial year.

At one stage, 23% of the 212 NHS trusts missed deadlines to produce accounts and MPs believe it could take the ministry until 2029 before they will able to produce audited accounts on time.

NHS England is also criticised for overpaying suspended GPs by £1.3 million and only being able to recover £33,000 from them.

A Department of Health and Social Care spokesperson said: “We do not recognise a number of claims within this report, and it is wrong to conclude that UKHSA’s financial controls are weak.

“Negligence claim volumes are decreasing in the NHS, and we are committed to boosting patient safety within the NHS, especially in maternity settings and we have made improvements in this area.

“Furthermore, we took swift action to procure PPE at the height of the pandemic and continue prioritise pandemic preparedness with UKHSA, to ensure the UK is best-placed to tackle future health emergencies.” 

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