Patients are remarkably patient – and as a general rule seem to tolerate far more than they should, not least because patients are far too grateful for the treatment they receive from the  NHS. We as taxpayers in the UK pay a commercial rate for healthcare, that provides universal coverage, and free at the point of delivery. Yes the staff work hard under unenviable pressure, and often in difficult conditions but wages are as good or better than elsewhere in Europe and as a nation we pay overall as much as most other Western nations.

Unfortunately, despite massive increases in spending, results have not kept pace with the rest of the world and there are many league tables showing  that the  UK gets less bang for our buck than many other countries*.

What does this mean for the patient on the ground? On the one hand, patients are worried that if they complain about their doctor or their treatment, they will be penalised. Given the precarious state of the NHS, this is not an unreasonable fear. I have seen direct evidence of this, where a patient has either made a complaint or refused to follow  a recommended line of treatment.

The worst nightmare of most patients is to be the victim of a medical mistake where a patient has no choice but to complain. Yet, in my experience, the desire for financial compensation rarely drives such complaints. Most people want to understand what happened and why, and want to prevent what happened to them, happening to someone else.

The NHS has a single NHS Litigation Authority that deals with all cases of medical negligence. Yet once someone has lost faith in the hospital and the NHS it is very difficult to trust NHS lawyers employed to defend the NHS. All too often doctors and hospitals still try to cover up what has happened and avoid blame and responsibility. Unfortunately it is human nature, and it is very difficult for anyone to admit that their actions  have damaged someone else. In addition, it is rare for a single person or process to be responsible for a tragedy. Instead it is almost always the culmination of a series of errors that lead to medical errors. It is as often a failure in processes, system management and inadequate  safeguards as much as human error.

Independent mediation can gain the trust of both sides to reach a solution, which can involve both transparency and reform and ensure that essential questions are answered. Only at this stage can compensation claims be reasonably assessed. Even where diagnosis and treatment were not well managed,  medical negligence is a high bar  to cross. Nonetheless fully understanding what happened is vital so that people can move on with their lives and come to terms with what has happened.

* www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror