Source · Select Committees · Public Accounts Committee
Recommendation 27
27
Deferred
Debate over 1948 Act's private care presumption requires dedicated inquiry into double recovery.
Conclusion
Written evidence from the Medical Defence Union told us that Section 2(4) of the Law Reform (Personal Injuries) Act 1948 is based on a recommendation made in 1946, two years before the establishment of the NHS, which was caveated that it “might need to be radically altered if a comprehensive health service is introduced”.70 Evidence from The Medical Protection Society and the Medical and Dental Defence Union of Scotland suggested that repealing the Act would save the NHS money that could be reinvested into frontline care.71 However, the Association of Personal Injury Lawyers raised concerns that removing the presumption of private care would force patients to return to the NHS institution which injured them in the first place.72 Action against Medical Accidents suggested to us that the issue should be subject to its own dedicated inquiry or review.73 NHS Resolution recognised that it needs to do more to understand the true extent and cost of any double recovery by claimants.74 69 Q 76; C&AG’s Report, para 2.20 70 The Medical Defence Union (CCN0004) 71 The Medical and Dental Defence Union of Scotland (CCN0009); The Medical Protection Society (CCN0019) 72 The Association of Personal Injury Lawyers (CCN0017) 73 Action against Medical Accidents (CCN0018) 74 Q 43 18
Government Response Summary
The government is keeping the matter of double recovery under consideration and will write to the Committee by Autumn 2026 on the case for change and provide additional information on the department’s intentions, including Double Recovery.
Government Response
Deferred
HM Government
Deferred
The government is keeping this under consideration. Target implementation date: to be advised. 6.2 The existing system requires judges to disregard the availability of NHS services when assessing damages for personal injury. This means claimants are able to claim damages for future care costs (for example, including private care) and then go on to use state-funded NHS and social care services too. Double Recovery, or the instance of the state paying twice, once in terms of compensation calculated on the basis of private care, and again if the recipient of the compensation then goes on to use state-funded care, is a significant concern and an area that David Lock KC will focus on in his work. 6.3 As the NAO’s Costs of clinical negligence report in October described, there is “no estimate of the extent to which clinical negligence claimants go on to use publicly funded health or social care services for their conditions, and little is known about how damages are used by claimants.” Working with David Lock KC, DHSC has sought to identify potential data sources in order to make an informed calculation and continues to do so. However, data in this area is limited, partly because there is no legal obligation for a claimant to notify the relevant service providers of their past compensation payments. DHSC is, therefore, unable to commit to the timeframe specified in this recommendation to provide estimates of the scale of double recovery. 6.4 The government will write to the Committee by this Autumn 2026 on the case for change and provide additional information on the department’s intentions, including Double Recovery.