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Paul Sankey weighs up NHS reforms: health inequalities and lowering standards?

Should decisions be made locally or by central government? We all like the idea of localism in theory but are annoyed when it leads to a ‘postcode lottery’ – different outcomes in different areas. One of the pillars of the proposed NHS reforms is that more decisions will be made locally. This will inevitably lead to varying standards of care in hospitals across the country, an issue which is particularly worrying the Royal College of GPs at present. Further some of the government’s critics argue that hospitals will find it more profitable to provide services for the wealthy and care in poorer areas will worsen.
At the same time less may be legally expected of doctors. It is likely to become harder to meet the legal test of negligence. For an act to be negligent there must be no responsible body of doctors of a particular type who would have done the same. That often makes it hard for the victims of medical accidents to succeed in claims. If it would have been wise to x-ray a patient’s chest to look for early signs of lung cancer but there is a body of doctors who would not – perhaps in a small district hospital struggling to meet its budget – the failure to x-ray will not have been negligent.
In effect the law accepts the lowest standards across the country as being reasonable. To show negligent you need to prove that care fell below even the lowest standards.
But with increasing inequalities across the country the minimum standard is likely to fall. Aside from the government’s assault on Legal Aid and funding of claims – making it much harder for accident victims to access justice – inequalities in the NHS may make it harder to show that poor care is negligent.Paul Sankey is a solicitor specialising in clinical negligence. If you or a member of your family have a clinical negligence enquiry please call our expert clinical negligence solicitors on 0800 916 9049, fill in our short online claim form or email and one of our specialist clinical negligence team will be in touch.