64th Report - Costs of clinical negligence

Select Committee
Public Accounts Committee HC 1234 30 January 2026
Report Status Government responded
Conclusions & Recommendations 27 items (18 recs)
Source View on Parliament website
Government Response (AI assessment · 27 of 27 classified)
Accepted 10
Accepted in Part 2
Acknowledged 2
Deferred 10
Not Addressed 1
Rejected 2
Government response
Treasury minutes: Government response to the Committee of Public Accounts on the Sity-fourth report from Session 2024-26 · published 7 Apr 2026
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Recommendations & Conclusions

10 results
5 Recommendation Deferred
Develop alternative dispute mechanisms to speed up decisions and reduce costs for less complex claims.
Recommendation
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 Summary
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
Develop estimates and set out measures to prevent double payment for negligence care.
Recommendation
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 Summary
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
Department unable to discuss policy due to ongoing clinical negligence review.
Recommendation
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 Summary
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
Claimant legal fees for clinical negligence have significantly increased as a proportion of total.
Conclusion
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 Summary
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
Alternative dispute resolution successfully increases claims resolved without litigation, saving significant legal costs.
Conclusion
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 Summary
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
Legal costs for low-value clinical negligence claims are disproportionately high compared to damages.
Recommendation
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 Summary
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
Plans to limit lawyer fees for low-value clinical negligence claims are stalled.
Recommendation
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 Summary
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
Presumption of private care in clinical negligence awards leads to double public payments.
Conclusion
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 Summary
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
No clear data on clinical negligence claimants accessing public services post-compensation.
Conclusion
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 Summary
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
Debate over 1948 Act's private care presumption requires dedicated inquiry into double recovery.
Conclusion
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 Summary
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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