Medical negligence

Most doctors only want to do their very best for their patients but when healthcare mistakes do occur they usually result in little or no harm to the patient. In fact, despite an increasing openness between doctors and their patients, it's probably fair to say that in many cases the patient isn't even aware a mistake has been made.

At the other end of the scale are instances of deliberate harm, as in the case of Dr Harold Shipman. Fortunately, such cases are extremely rare and measures are being implemented to protect patients even further.

But somewhere between inconsequential mistakes and deliberate harm lie incidents where those looking after patients fail to varying degrees in their duty to do their best.

Causes

From a doctor's point of view, the reasons things go wrong are often quite understandable. Doctors are human and everyone makes occasional errors, especially when under immense pressure. Of course, gross negligence is indefensible, but illness is never totally as it appears in medical textbooks. Important things may be hidden or happen unexpectedly.

Every doctor has had times when they've found themselves saying "If only I hadn't done that..." or "If only I had intervened sooner.." They may ask themselves why they didn't ask you a particular question or why you didn't tell them the necessary information without being asked. Maybe there wasn't anything they could have done to make a difference, but maybe there was.

Despite their best intentions, doctors' personal lives have a habit of occasionally slipping into their professional lives. Doctors are human and have their own personal stresses which may affect their performance from time to time. For a doctor, the implications of such a lapse in concentration can be far more disastrous than for an accountant or a baker.

Reactions

When things go wrong, it can be hard for a patient or their loved ones to accept that human failure is a fact of life. When you put yourself and your health in the hands of a professional rightly you expect them to do their best.

So how do you deal with it when things do go wrong? The first thing to ask yourself is, what do you want to achieve in this situation? The vast majority of people want just two things: an explanation and an apology.

And how do health professionals react? They tend to react defensively and close ranks. The result is that patients and their relatives are forced to take the slow and expensive legal option to get answers and, in some circumstances, compensation.

Litigation

Medical cases can take as long as ten years to come to court, at great expense, and are notoriously difficult to win. Not only do you have to prove that the doctor was negligent, you also have to show conclusively that harm was done as a result. The courts are keen to protect the integrity of the health profession and avoid a flurry of similar claims, so it's far from easy to convince them.

Sometimes there's a very real need to seek financial compensation, especially if children lose a parent or permanent damage means the patient needs expensive care. But often a little time and a few words would have been enough.

What should you do?

Your first step should be to put your complaint in writing to focus your mind as to what the problem is, where it possibly went wrong, or what you would like explained, then ask the doctors, nurses, practice or hospital managers involved to talk your complaint through with you.

You, or someone on your behalf, can also take a complaint to the designated complaints manager in your health authority.

If you need help, you can talk to your local Patient Advice and Liaison Service (PALS), listed in the telephone directory, or Citizens Advice.

Another good source of information is the Independent Complaints Advocacy Services (ICAS), a free impartial and independent service for people who wish to pursue a complaint about the NHS.

If 'local resolution' fails, you can request an independent review. Failing this, you can appeal to the health ombudsman. However, if you're looking for compensation you may want to go directly to a solicitor specialising in medical work.