Fixed payments plan for victims of NHS errors

Fixed-rate payments for victims of medical negligence are to be proposed in a white paper later this year as ministers struggle to contain the mounting legal costs of compensation claims against the NHS.

Alan Milburn, the health secretary, will tomorrow announce proposals to speed up payments to patients injured by medical blunders or accidents in NHS hospitals and GP surgeries.

Although patients will remain free to litigate if they think the offered settlements are insufficient, Mr Milburn believes most will prefer the speed and certainty of a fixed tariff of payments appropriate to the injuries caused.

They are expected to include non-financial compensation such as daily nursing visits, as well as cash awards. The Department of Health said it could not give examples of the amounts at this stage.

The plans were disclosed as Mr Milburn prepared to publish the final report of an inquiry into the deaths of babies undergoing heart surgery at Bristol royal infirmary between 1984 and 1995.

Ian Kennedy, the inquiry chairman, has delivered what is understood to be a hard-hitting report to Mr Milburn and the document is due to be published later this month.

The department denied any link between the timing of its announcement on medical negligence compensation and Professor Kennedy's report. But it was clear last night that ministers were trying to do all they could to avoid stoking public disenchantment with standards of medical care.

They want to foster a "no blame" culture in the NHS, encouraging doctors and nurses to admit mistakes as a first step towards improving clinical practice.

Pressure to improve the system of clinical negligence compensation was increased in May by a national audit office report that estimated that the cost of settling outstanding claims could reach £3.9bn.

Settlements cost about £400m a year in compensation payments and legal fees. Ministers have been concerned that in some cases the lawyers took a larger share of the proceeds than the patients did.

"We are trying to reform clinical negligence so people don't feel they need to go to court. We are looking for ways to stop costs spiralling out of control and at the same time give people justice," a senior department source said.

"We need to establish a system in which medical staff feel able to point out when things go wrong without fearing someone else's lawyer is looking over their shoulder."

There were no official estimates last night of how much the reforms might save the NHS. The source said: "If we are trying to get people to choose not to go to court, we have to have a system that is perceived to be more generous than the proceeds of litigation.

"This is not about restricting justice. It is about producing a more transparent system so we can address systemic failures by changing the system instead of blaming the doctors."

The Bar Council said Mr Milburn was proposing a cut in medical compensation similar to the reduced criminal injuries compensation introduced by the last Tory government and opposed by Labour. Ministers were trying to contain NHS costs behind a smokescreen of blaming lawyers.

The Patients Association welcomed plans to speed up compensation and move away from a confrontation culture in the NHS.