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Economics - National Health Service 5

Britain's motorists face soaring insurance premiums under plans to allow hospitals to reclaim more money for treating accident victims. Ministers were last night accused of imposing a 'stealth charge' to raise money for the ailing NHS, following rule changes which have left the insurance industry facing an £18 million bill. Since 1988 hospitals have been encouraged to reclaim the cost of medical care for victims where drivers are at fault - if, for example, the driver hit a pedestrian while drunk or speeding. But until now the maximum they could recoup was £10,000. New regulations recently came into force increasing that figure to £30,000. Charges levied for patients who need treatment but do not stay overnight have also risen by 13 per cent, from £354 to £402, while daily 'hotel' charges for keeping a crash victim in hospital have risen by 13 per cent, from £435 to £494.

The Department of Health insists that it is only responding to the spiralling cost of drugs - and the real cost to the NHS of lengthy treatments for badly injured patients. But the Liberal Democrats have accused the Government of raising cash through the back door to keep the NHS afloat. The Association of British Insurers warned that the change could only put more pressure on insurers to raise premiums at a time when costs were already rising swiftly, though it had not yet worked out the full impact. In 1999, legislation made it easier for hospitals to claim money through a central recovery unit. This raised around £75m for the NHS in 2000, the last year for which figures are available. A spokeswoman for the Department of Health said the charges had not been raised since and the rise only reflected the cost of inflation, which runs at about 6 per cent in the NHS because of the rising price of drugs.

Patients whose lives are wrecked by doctors' blunders will be offered more NHS treatment instead of big payouts as ministers want to stop the £476million paid every year in compensation. But blunder op victims who accept the deal will give up their right to sue for more. Patients will get £30,000 tops and it will be paid monthly for mistakes made during surgery. Brain damaged babies will get up to £100,000 a year for lifetime care.

Victims will also be offered treatment at a different NHS hospital from the one that botched their op. The new scheme also means doctors will no longer have to accept the blame for mistakes as long as they say sorry. Government Chief Medical Officer Sir Liam Donaldson said, "For many it is not the size of any compensation that matters so much as an apology." His spokesman added, "If the NHS makes a mistake, then the principle is that the NHS repairs that harm."

There were 135 drug errors a week at a single UK hospital and a quarter were "potentially serious", a study discloses. Pharmacists at a London teaching hospital recorded details of prescribing errors in all patients over a four-week period. During this time 36,200 drug orders were written at the 550-bed hospital, which amounts to almost 1,300 a day. Mistakes were made in 1.5% of these orders which is the equivalent to 135 drug errors a week. Of these, one in four was "potentially serious" and would have resulted in significant harm to the patient had they not been intercepted, according to the study authors.

The research, led by Dr Bryony Dean of London University's School of Pharmacy, is published in the journal Quality and Safety in Healthcare. The study found errors were more likely to be made during hospital stay (44%) rather than at the point of admission (32%) or discharge (15%). Senior house officers made 56% of the mistakes and junior house officers were responsible for one in three. Paracetamol, morphine, diamorphine, metoclopramide and beclomethasone were the drugs most likely to be the subject of error.

Almost four out of 10 of the errors involved the choice of drug while almost two thirds (61%) concerned the dose and or timing of the medication. At the moment, information on errors is only fed back to the prescriber which means it is not shared across the team nor used to inform hospital-wide policy. The study's authors conclude that this policy should be changed.

 

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