We are concerned only with the dynamics of the legal market in so much as they affect the ability of injured patients and their families to access compensation, and the system to learn and improve safety. However, we note that those that gain most from the present system are its most staunch defenders and the greatest critics of any administrative alternative. The evidence than an administrative system would open the floodgates to new and expensive claims is patchy at best and any examination of the impact on costs must be undertaken with the knowledge that, left unchecked, the cost of settling clinical negligence cases will more than double in the next ten years.