Is risk management necessary?

During the last 25 years, medical negligence claims in the United Kingdom have become increasingly frequent and problematical. In 1990, the Department of Health announced that district health authorities would assume vicarious liability for negligent acts by doctors in the course of their work for the National Health Service. A study of claims closed in the region covered by one Regional Health Authority shows that over a five-year period there were 7.8 claims per 100,000 population, levels in some other Regions ranging from 4.5 to 20.5 claims per 100,000, with a progressive increase. Obstetrics/Gynaecology and Anaesthetics are prominent areas for claims. It has been suggested that by the mid 1990s some 12% of the United Kingdom's National Health Service Budget might be absorbed in indemnity payments. Negligence litigation provides signals to health care providers about where they should invest in risk reduction rather than in bearing the cost of successful claims. At the national level it can be of value to create computerized data bases' of medical mishaps. Among the various types of activity which seem more practicable and worth exploring at the local level are the positive development of a "culture of safety" in health care, the creation of risk management teams to examine and document medical misadventure, and the establishment of health care organizations which do not feel threatened by their failures but which can respond in a caring, compassionate and concerned fashion to patients' distress and deal fairly with economic losses.