I read with great interest the article written by Bob O'Connor on UK Medical Negligence (30 May, Insurance Times). I spent many years as a broker placing various US domiciled medical malpractice programmes in the London Market and take issue with a number of comments made in O'Connor's article.

First, lets be clear that the Medical Defence Union (MDU) does not insure anyone as it is a defence mutual and not an insurance company and is not subject to the same financial controls as an insurance company.

Second, he states there is a worsening problem in the US. This is not correct. Since the severe crisis in the early 1970s, when no insurance company would touch medical malpractice, the picture has improved mainly as a result of strict risk management programmes.

In my opinion this is the only sensible answer to the problem in the UK.

The reason birth injuries have increased in the UK is due to the advancement of medical technology such as foetal monitoring equipment. This allows a doctor or nurse to respond to a distressed foetus whose brain has either been starved of oxygen or blood, due to a complication in the womb.

Twenty years ago this would have been a still birth, but in the 21st century we have the technology to extract the baby from the womb, usually ending with a brain damaged child.

Regarding the St Pauls, I would not have thought that it could be used as a barometer for the insurance industry. Historically, its track record for long-term investment in any class of business is not lengthy , having been in this class only for a few years.

In conclusion, medical negligence litigation will continue to run away unchecked unless the appropriate authorities start to address the root of the problem.

It will not be solved by throwing money at it, but by sponsoring a UK wide risk management programme within the NHS.

Kevin Dower
Insurance Consultant

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