Select Committee on Public Accounts Minutes of Evidence

Examination of Witnesses (Questions 140-159)



  140. They would say "Here's 2,000 for your toe" and I would not have to get a lawyer and all that and take years.
  (Mr Walker) No, there is another step. We should strongly recommend that you then went to get legal advice which we should pay for, so there was no question of you being ripped off.

  141. This is one of the key issues here about the lengthy bureaucracy, the legal costs and all the rest of it.
  (Mr Walker) This is not bureaucracy, it is purely to prevent any perception that the trust is trying to deny someone their legal rights.

  142. But even in this simple example there is a notional value which is tabulated for the cost of a toe, is there not?
  (Mr Walker) Yes.

  143. So you could say a toe is 2,000 and you could go to a lawyer, spend a lot of time, but really just get 2,000 and that would be reasonable advice, would it not?
  (Mr Walker) Yes, that would be reasonable advice.

  144. You are saying you would not give that advice, you would want me to run off and employ a lawyer.
  (Mr Walker) I would offer you the 2,000 and I would tell you I would pay maybe another ten per cent if you wanted to get legal advice so there was no perception of your being ripped off by the NHS. The interesting bit is that a solicitor rang me yesterday, having been offered that for his client. He thought it was a con trick. He thought they were trying to rip him off locally when they said that if it went to the Litigation Authority it would take time.

  145. The reason I ask this is not because I have a toe missing, it is because there are people who come to me who have been given the impression by lawyers and others that it is not really worth spending years on these small claims. They are up against a faceless bureaucracy of enormous power and they are not going to get anywhere; all they do is get a lot heartache sending lots of letters and nothing ever happens. That again is borne out by the statistics which show that the average claim takes five and a half years. This is for the not so serious cases. Do you think there is any truth in that?
  (Mr Walker) We are not disputing those figures; those are the cases we inherited. That is why we are proposing that after 1 April we can offer a fast-track system so that your constituent with the lost toe can have the claim settled very quickly but still with the guarantee of their legal rights. We are very keen not to erode people's legal rights. That is not how the NHS works.

  146. We have these 22,000 people waiting in a queue, taking an average of five and a half years. Do you know the cost of these delays? Each of them must have a file, there must be someone going to the file every few months, pulling it out and all this sort of stuff. There must be an enormous bureaucratic cost to this backlog. I know when we looked at immigration it was very costly. Do you know what the cost of the delay is as opposed to the cost of the claims? Does anybody know?
  (Mr Walker) The delays have mostly been incurred before the claim goes to the Litigation Authority.[13]

  147. Running 23,000 files for five and a half years.
  (Mr Walker) Remember that most of those claims are still with trusts and health authorities.

  148. Is there any way we could be given an evaluation of that delay? What would you say if you could get the backlog down to 1,000 for example?
  (Mr Crisp) We have not done that and Mr Walker has made the point that some of these are inactive.

  149. But there are not costless, are they? These files bubble up from time to time.
  (Mr Crisp) They may well bubble up from time to time or not over a period of years. Let me have a look at that and see whether there is a significant cost there.

  150. That would be very kind. A point was made about the people who die while they are waiting. Then Mr Walker said only one has died. It struck me that there are 23,000 of these and ten per cent must be old age pensioners over 70 and that is 2,300 and at least ten per cent of them must be dying every year. It is absurd to say that only one died.
  (Mr Walker) That is not actually what I said. The question was expressly about cerebral palsy children who were taking a long time.

  151. How many do die each year overall who have not been processed?
  (Mr Walker) Impossible to tell. The claim would just be withdrawn. We would never know.

  152. So you do not know how many die waiting for legal justice. Is it possible to do an estimate on that?
  (Mr Walker) We could look. I should be very surprised if we could find that out. We just would not know if a claim were withdrawn.


  153. Do you have that information or do you think you do not have it?
  (Mr Walker) We do not.

Mr Davies

  154. Sir Hayden, do you know how many die waiting for legal wheels to turn?
  (Sir Hayden Phillips) You would have to get behind the figures of claims which are withdrawn, which would frankly be a mammoth undertaking.

  155. Can no sort of estimate be done or does no-one care?
  (Mr Walker) No, it is not that we do not care.

  156. There is a big issue about huge public sector bureaucracy rolling very slowly. Do you think, given that amount of delay and the number of cases, that this is a case for public/private partnership where we could actually ask people to do something within a cost and they might speed things up?
  (Mr Crisp) Let me answer that in two ways. Firstly, we have specifically set up our own internal agency and—if this is public/private partnership—brought in a highly specialist person, the man sitting to my left, who used to work within the private sector, to run this organisation as a public agency.

  157. I am just thinking of a system of incentives so we do not have these enormous costs and people saying that is the way it is and we are doing better than France.
  (Mr Crisp) We do indeed have a system of incentives which is the system of incentives for trusts to pay into the scheme in proportion to their rating and record, which actually gives precisely the point about giving an incentive.

  158. Obviously there is an incentive to delay the older people because they are more likely to die, are they not? Or do you do it the other way round and think that because they are getting on a bit you had better sort it out before they die? Is there any system of encouragement to prioritise or deprioritise old people?
  (Mr Walker) No —

  159. So it makes no difference. So if I came along and said my father was 80, he had cancer and had three years to live, had an outstanding claim and could it not be sorted out, you would just say no, he was in the list.
  (Mr Walker) No, I would invite you into my office to settle it, if you told me that.


13   Ev 23, Appendix 1. Back

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