UK Supreme Court backs GP who refused to pay £10 000 compensation to patient’s widow

Claire Dyer reports in The BMA News reports that UK Supreme Court backs GP who refused to pay £10 000 compensation to patient’s widow (BMJ 2016;353:i2743 ). This is important as some GPs have paid small sums after these hearings only to find that their insurance premiums are loaded severely. The ruling means that GPs will refuse whenever possible, and reconciliation will be less likely: litigation more likely. Insurance companies view paying such a fee as admission of liability…

The Northern Ireland complaints commissioner was acting beyond his powers when he recommended that a GP give the widow of a patient who died from a heart attack a consolatory payment of £10 000, the United Kingdom’s Supreme Court has ruled.

The unnamed GP apologised but refused to pay the £10 000, even though the commissioner threatened to lay a special report about the case before the Northern Ireland Assembly if he failed to pay.

The GP mounted a legal challenge to the commissioner’s decision, which initially failed but was successful in the Northern Ireland Court of Appeal in 2014. The appeal court judges ruled by two to one that, although the commissioner had power to recommend that a public body such as a health trust pay a sum of money to a complainant, there was no such power in the case of GPs.

The appeal court judgment has now been upheld unanimously by the UK Supreme Court. The five judges in the country’s highest court held that the complaints commissioner had no power either to recommend that the GP make the payment or to lay a report before the assembly in default of payment.

The commissioner’s powers were laid down by legislation in 1996. The role has now been abolished and taken over by a new Northern Ireland public services ombudsman, who was given specific powers in a law enacted in February 2016 to recommend payments by GPs.

A spokesperson for the ombudsman was unable to provide figures for the number of GPs who had been asked to make a payment in the past but said that no special reports had been laid before the assembly because the doctors had always complied with the recommendations.

Annual reports published on the ombudsman’ s website, which cover 2012-15, give details of only two GPs who were asked to make a payment, one of £2000 and another of £500.

In the case that went to the Supreme Court the commissioner found that the GP’s practice had failed to provide a reasonable level of care and treatment and was guilty of maladministration. The patient, at that time without symptoms, had been referred by the GP for an electrocardiogram in July 2008, which was reported negative for ischaemic heart disease.

The patient complained of chest pains to a locum doctor on 10 December 2008. He was referred to a chest pain clinic, which refused to see him because of the earlier negative test and sent a report to the practice on 20 December, which was not marked urgent or reviewed. The patient asked on 6 January why he had not received an appointment and was referred for another electrocardiogram but died of a heart attack later that day.

The GP apologised to the patient’s widow and changed procedures at the practice, as recommended by the commissioner, but refused to make the payment. Not only was there no power for the commissioner to recommend it, said the Supreme Court judge Jonathan Sumption, delivering the judgment, but the figure of £10 000 seemed “to have been plucked out of the air.”

 

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This entry was posted in A Personal View, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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