NHS compensation is rightful and necessary

Last Monday I saw an article in the Times in which a woman called Susanne Cameron-Blackie, who it turns out was the writer behind the now-removed Anna Raccoon blog (see earlier entry; she was a great supporter of Mark Neary when he was trying to get his autistic son home in 2010), who is calling for people injured by NHS treatment to stop suing it for compensation (paywalled) as it only takes away money that could be used on other patients. Ms Cameron-Blackie has terminal soft-tissue cancer which has left her “virtually paralysed”, and “is determined to spend her final weeks battling to cut the spiralling costs of litigation against the NHS”; last year, such litigation cost the NHS £1.5bn. She was given a hysterectomy without her consent after an out-of-wedlock pregnancy in the 1960s; more recently, she was given someone else’s medication, leaving her in agony.

She says:

“But I didn’t sue,” Cameron-Blackie said. “The money from the original operation would have made no difference, I just got on with my life. The second time, I would not have got anything — the money would have gone to my husband in a few years’ time. What good would that do?

“Even the valid claims where somebody gets £6m and it’s entirely justified, that money goes into the court of protection and all their needs are met by the NHS.

It’s simply inaccurate to suggest that someone who receives a large payout then has “all their needs met” by the NHS. The NHS meets healthcare-related needs; social services meet other needs, and the inujred person or their family will need to meet other needs; the NHS will not buy them a wheelchair-accessible house, or refit or extend an existing house to accommodate a wheelchair user. It does supply wheelchairs, but it might not supply the one that would best suit the user (this may be a more sophisticated model, or a more reliable and long-lasting one than the NHS prefers, or one that is lighter in the case of manual chairs). Large compensation payouts, such as those following birth-time brain injuries, also reflect the fact that the victim’s earning potential is reduced, and will have increased living costs as they need, for example, to hire carers. And the money only goes into the Court of Protection in the case of people with brain injuries that leave them unable to handle their own finances; otherwise, it may go into a trust fund, or be invested, or whatever the recipient wants.

Picture of Stella Young, a white woman of short stature in her 30s in a powered wheelchair, wearing a black dress that comes down to just below her knees, holding a microphone, against a purple backgroundCameron-Blackie was not the only woman given an involuntary hysterectomy or sterilisation just because a consultant thought they shouldn’t be having children. Sometimes this was for ‘moral’ reasons, other times because the mother had a disability, even if she was still perfectly capable of making decisions. In Australia, it was standard practice until recently to perform hysterectomies on young girls who were disabled, even if the impairment was only physical; the late disability activist Stella Young (right) said that her parents were asked to subject her to this ‘routine’ operation when she was four, though they refused. This stopped because people campaigned to stop it, and because the victims sued, both for compensation and to argue that these operations violated the law or human rights conventions. It was, and is, important for consultants in particular to realise that they are not gods, that they do not know what is best for everyone and have no right to impose their will on another person by removing or disabling part of their body, and money is an important and necessary deterrent; it is not just what the money can do for the injured person.

It is not just injuries during surgery that may merit compensation; the mental health sector has a long record of appalling abuses, from involuntary electric-shock treatment (not all of it beneficial) to housing male and female patients on the same ward for ideological or budgetary reasons, sometimes resulting in harm to the women and sometimes distress to those abused by men in the past, to denial of family visits, privacy, clothing and sanitary protection (as in this recent case and another that I know of involving a teenage girl in a Manchester Priory unit), unnecessary and sometimes unlawful denial of liberty, and so on. A large section of today’s mental health care is done by private companies such as Cygnet and the Priory Group, but the same argument might be made that hitting them for compensation (say, for prolonged mental illness, and prolonged detention caused by the conditions of detention) leaves them less money to care for patients. Like physical injuries, these acts — often motivated by arrogance or prejudice — are wrongs, and the victim is entitled to redress.

The Times suggests that “Cameron-Blackie is likely to find widespread support for her campaign”. I don’t think so; this is not the sort of issue that could start a mass campaign, though it could attract funding from a lobby group which could give the impression of a popular movement and it could attract the support of a tabloid or two. The NHS is a publicly-funded institution and as with all the other supposed “inefficiency” or “underperformance” of some NHS trusts, the root of the problem is underfunding from government; these claims should not really be detracting from healthcare. I do agree that people should not sue the NHS for hurt feelings or anything else trivial, but without the threat of litigation, some NHS (and private healthcare) staff would be a lot more arrogant and a lot less careful. Remember that consultants in particular are highly-paid people who stand to benefit from very generous pension schemes; if they make mistakes, they can have devasating and lifelong consequences, and like any other organisation, they should have to pay for them. As it’s our public health service, we all have to pay.

Image source: Wikipedia; contributed by Young herself, Public Domain.

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