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UK Court of Appeal orders rise in awards for “catastrophic injuries”
POLICY AND PEOPLE
UK Court of Appeal orders rise in awards for “catastrophic injuries” n March 23, the Court of Appeal in London, in the landmark judgment of Heil v Rankin and others, said that damages payable for pain and suffering and loss of amenity in England, Scotland, and Wales were too low and should be increased by a maximum of about a third. Led by Lord Woolf, the instigator of the major procedural law reforms implemented in April, 1999, the five-judge court said that the maximum awards (currently £150 000 for catastrophic injuries) should increase by 35%. Awards below the maximum should be increased by smaller amounts, and those below £10 000 should remain unchanged. The Court’s compromise package falls far short of the Law Commission’s recommendations for achieving fair and reasonable com-
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pensation for claimants. However, it follows in the wake of the House of Lords’ judgment in Wells vs Wells in July, 1998, whose requirements for higher multipliers for future financial losses have already cost the NHS Litigation Authority, doctors’ defence societies, and the insurance industry a reported £128 million. Although there is clear evidence that claimants were routinely undercompensated, damages paid out annually for personal injuries have continued to sky-rocket. The Court must have been alarmed to learn that during 1996–97 the NHS paid out £11 million on clinical negligence claims, but that by 1997–98, the figure was £66 million and was expected to spiral up to £278 million for 1999–2000, presumably excluding any uplift ordered by the Court of
Appeal. It is uncertain how far the government’s planned end to Legal Aid for personal injury (but not yet clinical negligence) claims on April 1 will affect the number of claims and total payout. What is certain is that commercial insurance premiums will increase. The Court’s increases reflect the longer life expectancy of seriously injured claimants. Among the eight cases before the Court were two cerebral-palsy birth claims. Lord Woolf remarked: “Their loss endures from birth until well into middle age. Had we been asked to assess in percentage terms the degree of their deprivation, we would have placed it at 85-90%.” Both awards of £135 000 were increased by £50 000. Diana Brahams
News in brief
Concern over supermarket sales of drugs in Spain
Trends in drug-resistant TB A WHO report released on March 24 provides the first worldwide data on trends in anti-tuberculosis drug resistance. Among new cases, a significant increase in resistance to any drug was found in Estonia, Latvia, Denmark, Germany, New Zealand, and Peru. Only Estonia reported a significant increase in cases of multidrug-resistant tuberculosis (MDR-TB, resistance to at least isoniazid and rifampicin); however, Henan (China), Latvia, and Ivanovo (Russia) continued to have MDR-TB prevalences of 9% or more among new cases.
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UK drug study A 2-year study by the UK’s Police Foundation released on March 28, suggested that prison should no longer be a penalty for possession of drugs such as methylenedioxymethamphetamine (ecstasy), lysergic acid diethylamide (LSD), and cannabis. The study was partly funded by the government’s Home Office.
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Health, said that drugs have to be sold only in pharmacies, since such establishments “have always been regarded as health centres”. He said that the sale of drugs in supermarkets would mean “loss of medical and pharmaceutical advice, which is the added value that pharmacies bring forward”. The General Council of Pharmaceutical Colleges has also denounced the proposal, and noted that “between 15 and 20% of visits to hospital emergency departments are due to drug side-effects or interactions”. The Council added that: “WHO considers the pharmaceutical advice as a necessity and an aid to following the treatment prescribed by a doctor.” But CEDAC replied that the opposition to its proposal stemmed from the fact that the “pharmaceutical sector does not want to lose its monopoly”. The introduction of breastmilk substitutes to supermarkets caused a sharp decrease in the price of these products. Prices are up to 30% lower than those of the same products in pharmacies. AP
Tougher rules for UK doctors On March 24 UK Health Minister, John Denham, outlined proposals to widen the powers of the UK’s General Medical Council. The regulations could include the power to strike a doctor off the medical register for life, save in the most exceptional circumstances, if found guilty of misconduct.
n March 28, the President of the Spanish Organisation of Official Medical Colleges stated on March 28 lent support to Spain’s pharmacists, who are trying to stop supermarkets from selling nonprescription drugs. Last week’s proposal by the Catalonian Council of Food Distribution Companies (CEDAC) to sell non-prescription drugs in supermarkets prompted a heated debate. CEDAC argued that non-prescription drugs have a similar status to breastmilk Drugs for sale? substitutes, the sale of which was liberalised in 1994, mainly as a result of pressure from large food-distribution companies. Spain’s Ministry of Health said on March 22 that CEDAC has little chance of success, since the sale of drugs in general stores, with or without prescription, is forbidden in two separate pieces of legislation. “Dispensation of drugs can only be done by a pharmacist”, confirmed a ministry official, adding that “drugs that do not require prescription are not similar to breastmilk substitutes which are in fact consumption products”. Eduard Rius, head of Catalonia’s Department of
Xavier Bosch
THE LANCET • Vol 355 • April 1, 2000
UK Court of Appeal orders rise in awards for “catastrophic injuries” n March 23, the Court of Appeal in London, in the landmark judgment of Heil v Rankin and others, said that damages payable for pain and suffering and loss of amenity in England, Scotland, and Wales were too low and should be increased by a maximum of about a third. Led by Lord Woolf, the instigator of the major procedural law reforms implemented in April, 1999, the five-judge court said that the maximum awards (currently £150 000 for catastrophic injuries) should increase by 35%. Awards below the maximum should be increased by smaller amounts, and those below £10 000 should remain unchanged. The Court’s compromise package falls far short of the Law Commission’s recommendations for achieving fair and reasonable com-
O
pensation for claimants. However, it follows in the wake of the House of Lords’ judgment in Wells vs Wells in July, 1998, whose requirements for higher multipliers for future financial losses have already cost the NHS Litigation Authority, doctors’ defence societies, and the insurance industry a reported £128 million. Although there is clear evidence that claimants were routinely undercompensated, damages paid out annually for personal injuries have continued to sky-rocket. The Court must have been alarmed to learn that during 1996–97 the NHS paid out £11 million on clinical negligence claims, but that by 1997–98, the figure was £66 million and was expected to spiral up to £278 million for 1999–2000, presumably excluding any uplift ordered by the Court of
Appeal. It is uncertain how far the government’s planned end to Legal Aid for personal injury (but not yet clinical negligence) claims on April 1 will affect the number of claims and total payout. What is certain is that commercial insurance premiums will increase. The Court’s increases reflect the longer life expectancy of seriously injured claimants. Among the eight cases before the Court were two cerebral-palsy birth claims. Lord Woolf remarked: “Their loss endures from birth until well into middle age. Had we been asked to assess in percentage terms the degree of their deprivation, we would have placed it at 85-90%.” Both awards of £135 000 were increased by £50 000. Diana Brahams
News in brief
Concern over supermarket sales of drugs in Spain
Trends in drug-resistant TB A WHO report released on March 24 provides the first worldwide data on trends in anti-tuberculosis drug resistance. Among new cases, a significant increase in resistance to any drug was found in Estonia, Latvia, Denmark, Germany, New Zealand, and Peru. Only Estonia reported a significant increase in cases of multidrug-resistant tuberculosis (MDR-TB, resistance to at least isoniazid and rifampicin); however, Henan (China), Latvia, and Ivanovo (Russia) continued to have MDR-TB prevalences of 9% or more among new cases.
O
UK drug study A 2-year study by the UK’s Police Foundation released on March 28, suggested that prison should no longer be a penalty for possession of drugs such as methylenedioxymethamphetamine (ecstasy), lysergic acid diethylamide (LSD), and cannabis. The study was partly funded by the government’s Home Office.
1166
Health, said that drugs have to be sold only in pharmacies, since such establishments “have always been regarded as health centres”. He said that the sale of drugs in supermarkets would mean “loss of medical and pharmaceutical advice, which is the added value that pharmacies bring forward”. The General Council of Pharmaceutical Colleges has also denounced the proposal, and noted that “between 15 and 20% of visits to hospital emergency departments are due to drug side-effects or interactions”. The Council added that: “WHO considers the pharmaceutical advice as a necessity and an aid to following the treatment prescribed by a doctor.” But CEDAC replied that the opposition to its proposal stemmed from the fact that the “pharmaceutical sector does not want to lose its monopoly”. The introduction of breastmilk substitutes to supermarkets caused a sharp decrease in the price of these products. Prices are up to 30% lower than those of the same products in pharmacies. AP
Tougher rules for UK doctors On March 24 UK Health Minister, John Denham, outlined proposals to widen the powers of the UK’s General Medical Council. The regulations could include the power to strike a doctor off the medical register for life, save in the most exceptional circumstances, if found guilty of misconduct.
n March 28, the President of the Spanish Organisation of Official Medical Colleges stated on March 28 lent support to Spain’s pharmacists, who are trying to stop supermarkets from selling nonprescription drugs. Last week’s proposal by the Catalonian Council of Food Distribution Companies (CEDAC) to sell non-prescription drugs in supermarkets prompted a heated debate. CEDAC argued that non-prescription drugs have a similar status to breastmilk Drugs for sale? substitutes, the sale of which was liberalised in 1994, mainly as a result of pressure from large food-distribution companies. Spain’s Ministry of Health said on March 22 that CEDAC has little chance of success, since the sale of drugs in general stores, with or without prescription, is forbidden in two separate pieces of legislation. “Dispensation of drugs can only be done by a pharmacist”, confirmed a ministry official, adding that “drugs that do not require prescription are not similar to breastmilk substitutes which are in fact consumption products”. Eduard Rius, head of Catalonia’s Department of
Xavier Bosch
THE LANCET • Vol 355 • April 1, 2000