Government and NHS fail to take ‘any meaningful steps’ to tackle spiralling medical negligence costs

The government and NHS England have been sharply criticised by MPs for their failure to take "any meaningful steps" to slash the rising costs of clinical negligence in England, despite two decades of warnings.

The Public Accounts Committee (PAC) branded this "lack of action" as "especially disappointing" amidst widespread budget cuts and redundancies across the health service.

This comes as figures reveal total liabilities for medical negligence have quadrupled to £60 billion since 2006-07, while annual settlement costs have more than tripled to £3.6 billion.

These alarming figures paint a picture of "a system struggling to keep its patients safe from avoidable harm", the PAC stated.

Its new report highlighted that while the committee and its predecessors "have examined the issue of clinical negligence many times", the Department of Health and Social Care (DHSC) "cannot provide reassurance that it has taken any meaningful action to address clinical negligence to date".

The report further added that the DHSC would "not commit to any new improvement activity" until an ongoing review of clinical negligence was completed, for which there is no expected completion date.

Elsewhere, the PAC said the NHS "has not done enough to tackle the underlying causes of harm to patients", and that the approach to patient safety by NHS England and the DHSC "lacks co-ordination".

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MPs also raised concerns about a lack of data on the factors behind clinical negligence.

Sir Geoffrey Clifton-Brown, chairman of the PAC, said: “Clinical negligence is the second-largest financial liability across government, but represents to our committee a different matter entirely from other large items like nuclear decommissioning or pensions.

“This is a swelling accounting of profound suffering.

“Each case can represent unspeakable devastation for the victims involved, and the overall picture is of a system struggling to keep its patients safe from avoidable harm.

“Indeed, the rising costs of such claims are diverting resources away from frontline care badly in need of them.

“That is why it feels impossible to accept that, despite two decades’ worth of warnings, we still appear to be worlds away from government or NHS engaging with the underlying causes of this issue.”

Sir Geoffrey added that “tragic failings” in maternity care are one driver of this trend, and “one of many problems within this system which we can see government has failed to address”.

In 2024-25, costs for claims involving brain injury at birth were more than £1.5 billion, with the total cost of claims for paediatric failings reaching £325 million.

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Earlier this week, Baroness Valerie Amos launched a call for evidence for the National Maternity and Neonatal Investigation which will examine failings at 12 trusts.

The PAC called for the DHSC to publish the Amos Review within two months along with a response that sets out how it plans to reduce harm and the costs of claims in maternity care.

It is also seeking a plan from the Government to tackle clinical negligence, a national framework to improve patient safety with clear annual targets, and a national system for sharing data between NHS trusts.

Sir Geoffrey said: “Whatever happens next, government has been in unacceptable stasis on the issue of clinical negligence for the majority of my political life, as numbers have continued to creep up.

“For those harmed by the outcomes of this system, the time for change has long since come and gone.

“We hope our recommendations, and those of other forthcoming reviews, help government and NHS carry out their duties to prevent future harm.”

A DHSC spokesperson said the Government “inherited an NHS that was failing too many people”.

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“We have taken rapid action to strengthen patient safety – overhauling the Care Quality Commission, rolling out Martha’s Rule and Jess’s Rule so patients can get a fresh clinical review, and introducing hospital league tables to drive improvement,” they added.

“We have also brought in new maternity safety measures, are conducting an urgent investigation of failings and are establishing a taskforce, so every mother can have confidence in NHS care once again.

“For the first time in years, we’ve put the NHS back on firm financial ground – meeting its 2.7% productivity target, cutting waste, and getting patients seen faster as waiting lists come down.

“In the Ten Year Health Plan, to tackle the rising costs of clinical negligence and to improve the system, we asked David Lock KC to carry out a review, so every penny can be spent on patient care.

“We know there is much more to do but we are determined to make sure the NHS is the safest in the world.”

An NHS spokesperson said its staff “work incredibly hard to keep patients safe” but “there is more to do to tackle safety issues and improve care for many families”.