UK Inquiry Tracker

Costs of clinical negligence

Public Accounts Committee Open Inquiry

Opened: 10 Jul 2025 Parliament page

The PAC in its 2025 scrutiny the Department of Health and Social Care’s (DHSC) annual report and accounts 2023-24 called on government to reduce tragic incidences of patient harm. The PAC found it unacceptable that DHSC had yet to develop a plan to deal with the cost of clinical negligence … Read more The PAC in its 2025 scrutiny the Department of Health and Social Care’s (DHSC) annual report and accounts 2023-24 called on government to reduce tragic incidences of patient harm. The PAC found it unacceptable that DHSC had yet to develop a plan to deal with the cost of clinical negligence claims, with so much taxpayers’ money being spent on legal fees. Its report found that £58.2bn had been set aside to cover the potential cost of clinical negligence events in the 2023-24 accounts – the second largest liability across government after nuclear decommissioning. 19% of money awarded to claimants in 2023-24 went to their lawyers (£536m of the total £2.8bn paid out that year), on top of the fees payable for the Government Legal Team. The PAC last scrutinised the topic of clinical negligence in 2017 , saying at the time that bold action was required to address the impact of claims on resources available for frontline care and patients. Its report urged government at the time to end its complacency over the cost of clinical negligence, with the annual amount paid out having quadrupled over the preceding decade from £0.4 billion in 2006–07 to £1.6 billion in 2016–17. The National Audit Office reports on clinical negligence costs in 2025, with an investigation setting out the scale and drivers of changes to the value of long-term liabilities for clinical negligence claims and associated in-year payments, and likely future projections. Following the NAO’s report, the PAC will take evidence from senior DHSC and NHS officials . Likely topics will include what is being done to reduce patient harm and improve patient safety across the NHS, and the effective management of costs, including the reduction of legal fees. If you have evidence on these issues, please submit here by 23:59 on Thursday 6 November 2025. Please look at the requirements for written evidence submissions and note that the Committee cannot accept material as evidence that is published elsewhere. You can request anonymity or confidentiality when you send evidence, but it is the Committee which decides what information to publish and how. It may treat submissions confidentially, even where you have not requested this. Please note that the Committee’s inquiry cannot assist with individual cases. If you need help with an individual problem you are having, you may wish to read the information on Parliament’s website about who you can contact with different issues . Show less

18 Recommendations

9 Conclusions

1 Report

1 Oral session

4 Letters

1 Event

Activity timeline 8 events

21 May
2026

Correspondence

Letter to the Permanent Secretary at the Department for Health and Social Care relating to Cost of clinical negligence, 21 May 2026

7 Apr
2026

Report published

Treasury minutes: Government response to the Committee of Public Accounts on the Sity-fourth report from Session 2024-26

30 Jan
2026

Report published

64th Report - Costs of clinical negligence

12 Jan
2026

Correspondence

Letter from the Chief Financial Officer at NHS England relating to the Committee’s evidence session into Costs of Clinical Negligence on 20…

15 Dec
2025

Correspondence

Letter from the Permanent Secretary at the Department for Health and Social Care relating to the Committee’s evidence session on 20 Novembe…

15 Dec
2025

Correspondence

Letter from the Permanent Secretary at the Department for Health and Social Care relating to the DHSC-NHSE Transformation programme, 11 Dec…

20 Nov
2025

Oral evidence

Oral evidence session

20 Nov
2025

Formal meeting (oral evidence session) · Room 8, Palace of Westminster

Committee event

Oral evidence sessions 1 session

20 Nov 2025

View on parliament.uk

Elizabeth O'Mahony · Department of Health and Social Care Helen Vernon · NHS Resolution Professor Aidan Fowler · NHS England Samantha Jones · Department of Health and Social Care

Reports 1 report · click to expand

Title	HC No.	Published	Items	Response
64th Report - Costs of clinical negligence	HC 1234	30 Jan 2026	27	Responded

Recommendations & Conclusions

10 results

5 Recommendation Deferred

64th Report - Costs of clinical ne…

Develop alternative dispute mechanisms to speed up decisions and reduce costs for less complex claims.

Legal costs in clinical negligence claims are disproportionate for medium and low volume claims. Legal costs in clinical negligence claims have risen sharply, with claimant legal fees increasing in real terms from £148 million in 2006–07 (in 2024–25 prices) to … Read more

Government Response

The government states the recommendation is under consideration and it is exploring international examples and policy proposals for reducing legal costs in clinical negligence. It will write to the Committee by Autumn 2026 to provide further information on its intentions, including a fixed recoverable costs scheme.

HM Treasury

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6 Recommendation Deferred

64th Report - Costs of clinical ne…

Develop estimates and set out measures to prevent double payment for negligence care.

Clinical negligence claims are settled on the basis of costs of care in the private sector and yet there is nothing to stop the claimant using the NHS or publicly funded social care in the future, potentially inflating the costs … Read more

Government Response

The government acknowledges the concern of 'Double Recovery' and states it is under consideration. However, due to limited data, it cannot commit to providing estimates within the six-month timeframe and will provide further information on its intentions by Autumn 2026.

HM Treasury

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9 Recommendation Deferred

64th Report - Costs of clinical ne…

Department unable to discuss policy due to ongoing clinical negligence review.

On multiple occasions the Department told us that it was unable to comment on many aspects of current policy as a recent review into clinical negligence by David Lock KC was still being considered by ministers.9 5 C&AG’s Report, paras … Read more

Government Response

The government will write to the Committee by Autumn 2026 to set out the case for change, its workplan including to describe key milestones, and the likely areas of focus for reform in clinical negligence.

HM Treasury

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21 Conclusion Deferred

64th Report - Costs of clinical ne…

Claimant legal fees for clinical negligence have significantly increased as a proportion of total.

Claimant legal fees have increased in real terms from £148 million in 2006–07 (in 2024–25 prices) to £538 million in 2024–25 and now represent 15% of all settled costs. During the same period, NHS’s legal costs increased in real terms … Read more

Government Response

The government is considering alternative dispute resolution mechanisms to reduce legal costs, and will provide additional information by Autumn 2026.

HM Treasury

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22 Conclusion Deferred

64th Report - Costs of clinical ne…

Alternative dispute resolution successfully increases claims resolved without litigation, saving significant legal costs.

Over the last 10 years, NHS Resolution has introduced several new approaches to help keep claims out of court. These alternative dispute resolution initiatives are typically less adversarial and more collaborative than conventional litigation and provide greater opportunities for claimants … Read more

Government Response

DHSC, working with David Lock KC, is considering alternative dispute resolution mechanisms. The government will write to the Committee by Autumn 2026 to set out the case for change.

HM Treasury

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23 Recommendation Deferred

64th Report - Costs of clinical ne…

Legal costs for low-value clinical negligence claims are disproportionately high compared to damages.

Around three-quarters of clinical negligence claims settle for £25,000 or less, but the legal costs for these claims vastly exceed the damages payable to claimants. In 2024–25, there was a 3.7:1 ratio of claimant and NHS legal costs compared with … Read more

Government Response

The government is considering alternative dispute resolution mechanisms to speed up decisions and reduce costs for less complex cases, but specific policy proposals remain under consideration and will be addressed in a letter by Autumn 2026.

HM Treasury

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24 Recommendation Deferred

64th Report - Costs of clinical ne…

Plans to limit lawyer fees for low-value clinical negligence claims are stalled.

The previous government announced plans to place limits on how much lawyers receive from lower damages clinical negligence claims of under £25,000 where 85% of cases fall within this category from April 2024, but 51 Q 50 52 C&AG’s Report, … Read more

Government Response

The government will write to the Committee by Autumn 2026 to set out the case for change and provide additional information on the department’s intentions, including Fixed Recoverable Costs for lower-value clinical negligence cases.

HM Treasury

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25 Conclusion Deferred

64th Report - Costs of clinical ne…

Presumption of private care in clinical negligence awards leads to double public payments.

The government may effectively be paying twice in some instances of clinical negligence, once through the compensation given to claimants and once again through providing NHS treatment and publicly funded social care. Section 2(4) of the Law Reform (Personal Injuries) … Read more

Government Response

The government is keeping the issue of double recovery under consideration and will write to the Committee by Autumn 2026 on the case for change, after David Lock KC has focused on this in his work.

HM Treasury

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26 Conclusion Deferred

64th Report - Costs of clinical ne…

No clear data on clinical negligence claimants accessing public services post-compensation.

There is no estimate of the extent to which successful clinical negligence claimants then go on to use publicly funded health or social care services for their conditions.67 We asked NHS Resolution why there is no clear data on the … Read more

Government Response

The government is keeping under consideration the issue of clinical negligence claimants using publicly funded services and will write to the Committee by Autumn 2026.

HM Treasury

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27 Conclusion Deferred

64th Report - Costs of clinical ne…

Debate over 1948 Act's private care presumption requires dedicated inquiry into double recovery.

Written evidence from the Medical Defence Union told us that Section 2(4) of the Law Reform (Personal Injuries) Act 1948 is based on a recommendation made in 1946, two years before the establishment of the NHS, which was caveated that … Read more

Government Response

The government is keeping the matter of double recovery under consideration and will write to the Committee by Autumn 2026 on the case for change and provide additional information on the department’s intentions, including Double Recovery.

HM Treasury

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Government Response AI assessment · 27 of 18 classified

Accepted 10

Accepted in Part 2

Acknowledged 2

Deferred 10

Not Addressed 1

Rejected 2

Total 18 recs + 9 conclusions

Correspondence 4 letters

21 May 2026 From committee Letter to the Permanent Secretary at the Department for Health and Social Care relating to Cost of clinical negligence, 21 May 2026

Parliament page

12 Jan 2026 To committee Letter from the Chief Financial Officer at NHS England relating to the Committee’s evidence session into Costs of Clinical Negligence on 20 November 2025, 06 January 2026

Parliament page

15 Dec 2025 To committee Letter from the Permanent Secretary at the Department for Health and Social Care relating to the Committee’s evidence session on 20 November on Costs of clinical negligence, 04 December 2025

Parliament page

15 Dec 2025 To committee Letter from the Permanent Secretary at the Department for Health and Social Care relating to the DHSC-NHSE Transformation programme, 11 December 2025

Parliament page