The key clinical negligence reforms the Government must address

The current system in place to compensate those who suffer harm through clinical negligence is flawed and in need of urgent reform.

David Lock KC was appointed by the UK Government in June 2025 to provide expert legal advice on the rising costs of clinical negligence claims, improve patients’ experience and reduce the financial burden of litigation on the NHS.

However, responding to the Public Accounts Committee’s inquiry on clinical negligence, the Government announced that it has no plans to publish Lock’s review. Instead, the Government will write to the Committee by this Autumn “to set out the case for change, and its workplan including to describe key milestones, and the likely areas of focus for reform.”

MDDUS has backed calls by the Shadow Health Secretary for the publication of Lock’s review. Stuart Andrew MP said it was “difficult to understand” why the Government was delaying a report which “would have allowed Parliament, clinicians and the wider public to engage properly with the evidence”.

Chris Kenny, chief executive of MDDUS, said: “In common with Mr Andrew and his colleagues, we urge the Health Secretary to rethink his decision and to publish the review by David Lock KC as a matter of urgency.”

We look here at the current clinical negligence system and its flaws, before proposing the reforms the Government must consider to bring this broken system back to working order.

The current system

It is generally agreed that when a patient suffers harm because of treatment provided, there should be a clear avenue for them to seek and obtain equitable and timely compensation.

However, the current system has lost its way and become an inefficient process that causes undue stress to both patients and healthcare professionals. Basic clinical negligence claims fall into a lengthy litigation process, which is costly and has become financially unsustainable for the NHS. We are continuously seeing taxpayers’ money spent on high legal fees, rather than on supporting the vital services the NHS provides.

It’s become a system that encourages a ‘blame-game’ culture, adding excessive stress to healthcare professionals who are working within an already demanding environment. What’s left is a reactive system with little opportunity for NHS workers to learn from mistakes and an over-stretched NHS continuously picking up the bill at the end of it all. We can do better than this.

Reform Proposals

To see beneficial changes to the clinical negligence framework, it is critical that the Government address the following:

1. ‘Cut the lengthy litigation’

Introduce the ‘Fixed Recoverable Costs scheme’ to cap legal fees and create a more efficient process for low-value claims. This would help resolve cases more quickly, reduce unnecessary delays and ensure that legal costs are proportionate. Implementation would stand as a clear statement of intent from government.

This would allow low value claims to be dealt with more efficiently and provide patients with compensation faster to fund the treatment they need. 

2. Appeal s.2(4) of the Law Reform (Personal Injuries) Act 1948

This assumes that when compensation is awarded for someone’s future care, it will be provided privately rather than by the NHS. In practice, this means the government has to pay twice – once through compensation, and again when the person receives NHS treatment. Removing this rule would make the system fairer and free up funds to be reinvested into vital NHS services.

3. Damages ‘Cap’

There needs to be a ‘damages cap’ for future losses, and in particular on loss of earnings. This would make a considerable difference in high value claims and go some way to address longstanding inequality. For example, currently the assessment of the future earnings potential of a child injured at birth is based predominantly on the earnings of their parents and/or their social demographic.

4. Investigation Committee

To properly fix the system, we need to investigate the errors made in clinical care and ensure they do not repeat themselves. A national investigation committee should be set up to investigate clinical errors and system failings before providing its recommendations, to ensure these unfortunate events do not repeat themselves and assure patients of the service health professionals are providing.

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