Opinion

No-one wins in our system of dealing with medical negligence - Deirdre Heenan

A better way is needed, for healthcare professionals as well as patients

Deirdre Heenan

Deirdre Heenan

Deirdre is a columnist for The Irish News specialising in health and social care and politics. A Professor of Social Policy at Ulster University, she co-founded the Northern Ireland Life and Times Survey.

The Freedom to Speak Up guardian role was created in 2016
Things can and do go wrong in hospitals. Patients and healthcare professionals would benefit from remedies that don't involve being locked in years if costly adversarial legal battles (Peter Byrne/PA)

Last week our health and social care system was again in the spotlight for all of the wrong reasons. The Western Health and Social Care Trust paid out almost £21 million to the family of a Derry girl who suffered brain damage during an emergency caesarean section.

The family solicitor lambasted the trust for prolonging this case for almost 13 years. Just weeks before the trial the trust finally accepted full liability. Delays and prevarication meant that the girl’s family had to look after her complex medical needs with limited financial support.

One can only imagine the suffering faced by this family in their quest for justice. Admiration for their tenacity and resilience is combined with hope that we never find ourselves in a similar position.



Coming to terms with devastating life events, whilst being dragged through the courts, multiplying trauma and distress. After a protracted and exhaustive fight, they must now try to rebuild their lives.

Cases of medical negligence within the NHS have risen exponentially over the last decade. Medical errors have serious consequences for those injured and their families, healthcare professionals and the financial viability of the system.

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Against a backdrop of an underfunded, struggling health system, with reduced staff numbers, existing staff stretched, poor communication and delayed treatments, mistakes, miscommunication, and oversights are inevitable.

However, rather than acknowledge errors and accept the learning from them, a culture of ‘say nothing’ and ‘close ranks’ pervades the system. Requests for information are met by a wall of silence.

Instead of a system of denial and avoidance which seeks to pin the blame on individuals and frustrates grieving families, the focus could be on learning and support. Organisations and companies that learn from mistakes do better

Frequently, it is the system rather than an individual professional that is to blame. A response which focuses on identifying and blaming individuals is counterproductive can detrimental to open and honest patient-professional relations.

Inevitably lawyers are depicted as the villains of the piece, ambulance-chasing in the hope of getting an easy win. Driven by the lure of a large pay day, greedy leeches terrorising the hard-working staff in the NHS - but this is not only inaccurate but also grossly unfair.

Frustrated by a lack of communication, delays, and denials many patients are forced to turn to the legal system. The courts are often their last resort.

Medical negligence litigation often runs for years, adding to the distress of families and healthcare professionals. The focus on the financial implications of acknowledging that mistakes were made has resulted in a defensive, adversarial approach. Full disclosure is resisted at every turn.

It doesn’t have to be like this. There is widespread agreement that the current system lacks coherence and is not fit for purpose. It meets neither the needs of the injured nor the healthcare professionals.

A better, fairer approach is possible. Medics are human beings, and they will sometimes get things wrong. Medical errors are inevitable, and we need to find ways to reduce them.

Instead of a system of denial and avoidance which seeks to pin the blame on individuals and frustrates grieving families, the focus could be on learning and support. Organisations and companies that learn from mistakes do better.

An independent administrative body or committee could be established to investigate individual cases and ascertain if avoidable harm has been done. If this is the case, they would agree compensation in a timely manner. Pay outs would be fair and proportionate. The focus in this type of system would be to ensure justice through openness and accountability.

Learning from mistakes would enable the development of preventative strategies to protect future patients. We need to move away from the blame culture towards a learning one, focused on systems and processes. Blame and looking for scapegoats means lost opportunities to improve and share learning.

This type of process has been adopted in New Zealand and Scandinavia, among others. Compensation is considerably lower and patient satisfaction is higher. Many of those who have been injured often just want an explanation as to what happened, someone to listen to their concerns, reassurance that what happened to them cannot happen to others and acknowledgment of their physical and mental distress.

Money paid out in compensation is taken directly from health and social care funds. It is not like suing a private company that has insurance cover.

The NHS belongs to all of us, we have a collective duty to ensure that money is well spent. The public don’t like to see the NHS out of pocket but also acknowledge the devastating impact of medical negligence. Both healthcare professionals and patients urgently need a fairer system.