Select committee: Public Accounts Committee

Recommendation 6

64th Report - Costs of clinical negligence Published 30 Jan 2026 Addressed to HM Treasury
Recommendation (the committee's words)
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 of claims. It is not clear the extent to which the taxpayer is paying twice for clinical negligence – once through compensation for injury 6 and then again by providing subsequent health and social care. A law from 1948 states that damages must be calculated on the presumption that care will be provided by the private sector and not the NHS or local government. NHS Resolution identified this as a major contributory factor to the increasing cost of very high-value cases (£1 million or more), where about 60% of the damages relate to future care. Although claimants can be asked to declare in court if they plan to use the NHS for treatment, this rarely happens in practice and cannot be mandated. NHS Resolution is unable to ask successful claimants for information on how they spend their award or whether they subsequently access state funded services to manage their condition. Local authorities are also not able to consider clinical negligence compensation awards when assessing eligibility for publicly funded social care. recommendation The Department should develop, within six months, proper estimates of the impact of assuming health and social care for clinical negligence victims will be provided exclusively by the private sector. It should by the same deadline set out additional measures—including any requiring changes to legislation—which it judges would effectively guard against the risk of paying twice for the care of those it has harmed and an indicative timeline for their potential implementation. 7 1 The rising costs of clinical negligence Introduction

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.

Read the government's response ↗ Report an error