The NHS’s total liabilities for medical negligence have hit an “astounding” £58.2bn amid ministers’ failure to improve patient safety, an influential group of MPs have warned.
The Commons public accounts committee (PAC) said the “jaw-dropping” sums being paid to victims of botched treatment and government inaction to reduce errors were “unacceptable”.
The Department of Health and Social Care (DHSC) has set aside £58.2bn to settle lawsuits arising from clinical negligence that occurred in England before 1 April 2024, the PAC disclosed.
The sum is so huge that it is the second-largest liability across the whole of government, with only nuclear decommissioning costlier, the committee said in a damning report.
“The fact that government has set aside tens of billions of pounds for clinical negligence payments, its second most costly liability after some of the world’s most complex nuclear decommissioning projects, should give our entire society pause,” said Sir Geoffrey Clifton-Brown, the PAC chair.
“This is a sign of a system struggling to do right by the people it is designed to help,” he added.
The PAC urged ministers to take urgent steps to reduce “tragic incidences of patient harm” and to also end a situation where lawyers take an “astronomical” 19% of the compensation awarded to those who are successful in suing the NHS. That amounted to £536m of the £2.8bn that the health service in England paid out in damages in 2023-24 – its record bill for mistakes.
“Far too many patients still suffer clinical negligence which can cause devastating harm to those affected,” and the ensuing damages drain vital funds from the NHS, the report said.
A DHSC source accepted the PAC’s findings, saying: “The cost of clinical negligence claims is rising at an unsustainable rate, eating into resources available for frontline care. Annual cash payments have more than doubled in the last 10 years and quadrupled in the past 17 years to £2.8bn.”
The PAC criticised the department for not yet having explained why patient harm occurs and devised a strategy to overhaul patient safety, despite the committee in the last parliament asking the DHSC do so by last summer. The DHSC “has only recently written to us in response” to that recommendation, the PAC said.
“It is unacceptable that the department is yet to develop a plan to deal with the cost of clinical negligence claims and so much taxpayers’ money is being spent on legal fees,” the report says.
Paul Whiteing, the chief executive of patient safety charity Action Against Medical Accidents, said that lawsuits arose over errors by NHS staff in every area of care. “But the largest sums are awarded to families of babies that are left with lifelong disabilities, such as brain damage, through negligence at birth.”
The NHS has faced a series of maternity care scandals in recent years that have left mothers and babies dead or badly injured. In 2023 the Care Quality Commission, the health service care regulator, said that two-thirds of maternity units provided substandard care.
The NHS would face fewer lawsuits if it was more open when mistakes happen, Whiteing added.
“We see many people who only litigate because the NHS ‘pulled down the shutters’, by which I mean failed to properly look into what went wrong, offer a meaningful apology for their mistake and involve the family in the investigation. If steps such as these were followed, many fewer people would resort to litigation,” he said.
Jess Brown-Fuller, a Liberal Democrat health spokesperson, said the huge cost of NHS medical negligence payouts are “symptomatic of a health service that simply is not functioning. The Labour government’s embrace of dither and delay on social care, maternity reforms and rebuilding our hospitals is prolonging the misery.”
In its analysis of the DHSC’s annual report and accounts for 2023-24, the PAC also revealed the cost of building long-planned new high containment labs in Harlow, Essex, to help protect the UK against infectious diseases, had spiralled from £530m to “an eye-watering projected £3.2bn”.
And it criticised the government for not spelling out what impact its decision to abolish NHS England and axe tens of thousands of health service managers would have on patients and staff. It voiced concern about cuts to dentistry, GP services and health prevention.
Matthew Taylor, the chief executive of the NHS Confederation, echoed the PAC’s unease. “While many leaders understand the need for change, the lack of detail on how the national shake-up will be taken forward, the pace of this restructure, and how it connects to the ambitions of the 10-year plan are a cause for concern among staff,” he said.
A DHSC spokesperson said: “Patient safety is the bedrock of a healthy NHS and social care system. This government will ensure the country has the best system in place to keep patients safe by overhauling the overly complex bureaucracy of healthcare regulation and oversight and we will examine the drivers of costs, how to manage spending on clinical negligence and the potential merits of reform options.”
