Select committee: Public Accounts Committee
Recommendation 5
64th Report - Costs of clinical negligence
Published 30 Jan 2026
Addressed to HM Treasury
Public Accounts Committee Costs of clinical negligence All items in this report Report on parliament.uk ↗ Inquiry on parliament.uk ↗
Recommendation (the committee's words)
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 £538 million in 2024–25. At 19% of total settled claim costs it is unacceptable that so much taxpayers’ money continues to be spent on legal fees. NHS Resolution has worked hard to increase the number of claims resolved without litigation (83% in 2024–25, up from 66% in 2006–07). It has also expanded its use of alternative dispute resolution and mediation. There are considerable financial benefits to these approaches which have been well received by the legal sector. However, we are extremely concerned that low-value clinical negligence claims (damages of £25,000 or less) cost far more in legal fees than victims receive in damages, with a 3.7:1 cost-to-damages ratio. The Department’s previous plans to limit the amount paid to lawyers in lower-value cases were not implemented as planned in April 2024 and remain under review. recommendation The Department should a. develop alternative dispute mechanisms to speed up decisions and reduce costs for less complex cases. As part of this, the Department should look at international examples (such as in New Zealand and Sweden) of non-adversarial and ombudsman models and assess how our ombudsman system could be improved; and b. clarify its position on a fixed recoverable costs scheme for lower-value clinical negligence cases at the earliest opportunity.
From: Public Accounts Committee, 64th Report - Costs of clinical negligence (HC 1234), 30 January 2026
Government response
The government responded to the whole report on 7 April 2026 (deadline 30 March 2026).
Summary written by Accountability Index from the government's response. It is not the government's own words.The government agrees with the Committee's recommendation to set out an operational plan on clinical negligence, disagrees with others, and has some recommendations "under consideration".
- It agrees to write to the Committee "by this Autumn" with its workplan, key milestones and likely areas of focus for reform, but "disagrees" with publishing David Lock KC's review, saying it has "no current plans" to publish a separate report.
- It "disagrees" with estimating and tracking the costs of treating avoidable harm, stating it "would not be financially or logistically feasible", and "disagrees" with a new national data-sharing system, saying "there is already data sharing arrangements in place".
- On maternity, it agrees with the recommendation to learn lessons. Baroness Amos has confirmed the independent investigation will publish its final report in June 2026, and a National Maternity and Neonatal Taskforce will develop a national action plan.
- Alternative dispute mechanisms and fixed recoverable costs are "under consideration", and the government is "unable to commit" to the six-month timeframe for double recovery estimates. It will write to the Committee by Autumn 2026 on each.