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When are paediatricians negligent?
  1. Harvey Marcovitch
  1. Editor, Clinical Risk, Royal Society of Medicine Press Ltd, 1 Wimpole Street, London W1A 0AG
  1. Correspondence to Dr Harvey Marcovitch, Honeysuckle House, Balscote, Oxford OX15 6JW, UK; h.marcovitch{at}btinternet.com

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In 2009/2010, the National Health Service Litigation Agency (NHSLA), a Special Health Authority responsible for handling both clinical and non-clinical negligence cases on behalf of the NHS (in England only), spent £787 million ($1244.5 million; €923.5 million) dealing with 6652 clinical negligence claims. The cost is increasing by about 10% annually. Paediatrics is not a high-risk specialty, in terms of the number of claims, although some of the largest financial payouts have been for multiply disabled children, whose injuries were perinatal and whose life expectancy is long.

First European data

Until publication of the data from France in this month's ADC,1 information in journals on paediatric malpractice claims has been available exclusively from the United States. Indeed, the French group have reported previously a systematic review of six such studies.2 In this first European series of paediatric negligence claims, they interrogated the database of the French national insurer, Sou Médical-groupe MASCF, and discovered 228 claims from 2003 to 2008 involving children, where the defendant was coded as a paediatrician or general practitioner.

The English experience

Claims involving paediatricians employed by NHS Trusts are defended by the NHSLA in England, with similar bodies in Scotland, Wales and Northern Ireland. The latest factsheet from NHSLA3 does not include paediatrics in its comparative claims data (see figure 1).

Figure 1

NHSLA: total number of reported clinical negligence scheme for Trusts (CNST) claims by specialty as on 31 March 2010 (since the scheme began in April 1995, excluding ‘below excess’ claims handled by trusts).

However, from April 2003 to March 2008, NHSLA specialty coding listed 992 claims as paediatric and 87 as paediatric surgical. (Personal communication, NHSLA). It is not clear whether children might also be coded elsewhere—for example, under general practice, anaesthesia, accident and emergency (or obstetrics when perinatal claims are considered), so it is not …

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