In a recent Guardian newspaper article Richard Williams considers the legacy of the 2012 London Olympics and evokes memories of Danny Boyle’s brilliantly conceived and executed opening ceremony. In this regard I was particularly struck by the following very apt comment:-

” most unforgettably … Great Ormond Street staff reminding us of the place occupied by the NHS at the centre of our lives”. *

I am sure that many of us will entirely agree with this sentiment and that for the most part it does an excellent job in delivering healthcare of a very high standard.

However, the innumerable people who have benefited immensely from the wonderful services that the NHS provides will also doubtless agree that increasingly, it has become a political football. Some consider it to be large and unwieldy and the funding pressures on it are immense!

As well intentioned and capable as the vast majority of NHS staff undoubtedly are, many have become disillusioned. Their organisation is beset by both staff recruitment and staff retention issues. There are ongoing, often acrimonious debates and rows about possible privatisation and many within the organisation feel that they are subject to unwarranted scrutiny and intrusion. The NHS is quite rightly expected to meet high standards but even the most unastute person can see that it is beset by underfunding with many Trusts either in the red or working on the basis of negative budgets. The strike issue, which has been considered in earlier ASM blogs, is very much to the fore. All of this attracts very negative publicity, which, unfortunately, detracts from the very good service that despite all its difficulties, the NHS still manages to deliver.

The net effect of all this is unprecedented levels of discord and conflict. In an age where the British public have become increasingly litigious with aspirations fuelled by the possibilities of “no-win no fee” costs arrangements offered by lawyers, a considerable proportion of the NHS budget is put towards paying not just compensation but vast amounts of court and legal costs. For example, according to the 2015/16 NHS Litigation Authority report, “the NHS paid out more than £1.4 billion to patients and their legal representatives in 2015/16, compared to £1.1 billion the previous year”. **

In practice, individual members of staff who are often working in very difficult circumstances many well be scapegoated and effectively denied the opportunities they need to defend themselves. It seems that the organisation has become almost a hostage of the legal system and that high value compensation claims are bitterly contested simply because they are high value.

Modest compensation claims are invariably settled on what some will see as overly generous terms because it is seen as “more economic” to do so, something that tends to undermine the integrity of the system. Little thought is given to the immense amounts of probably unquantifiable hidden costs in respect of the time, money and ‘stress’ expended by administrators and medical staff in providing notes and records, attending meetings and on occasion, attending court. The litigation culture that precludes the possibility of any form of admission of guilt effectively means that what dissatisfied litigants often want most, namely an apology, is denied them.

Readers may be interested to know that  our next blog, written by David King considers how mediators can draw inspiration from the Olympics!

* Williams R (2016) Why the London Olympics were a gigantic waste of time and money, <>, published 23rd July 2016
** NHS Litigation Authority (2016) <> Accessed 25 July 2016