Future Healthcare

Courts are after you!

By Robin Stride

A recruitment drive is underway to find consultants and GPs who want to increase their private incomes by taking on legal work.

They are needed for often lucrative employment in writing reports and giving court evidence as expert medical witnesses.

A shortage of doctors taking on these roles was highlighted at a BMA medico-legal conference where some of the 110 specialists indicated they charged £400+ an hour for the work.

Negligence barrister Dr Simon Fox QC, who generally instructs in cases exceeding £1m in value, told attendees to ‘spread the word’ about doctor shortages in this field.

He described medical expert witness duties as ‘interesting and well paid’.

However, consultants and GPs at the meeting revealed a huge discrepancy in the fees they charge for their expertise. Of 110 present, a show of hands found most doctors charged £250 an hour or under, while others were getting £300- £350 and beyond. The survey was stopped before it revealed how much the highest earner was paid.

BMA medico-legal committee chairman Dr Jan Wise ran the ‘hands-up’ study in response to a doctor’s question about how much a ‘reasonable’ fee would be.

He suggested that doctors should factor in everything that might be relevant, such as their NHS equivalent rate, holidays and pension. They should keep a real record, like solicitors, of the time they spent on medical expert witness work. 

Dr Wise said their fee should be much closer to those in the audience who were at the higher end, adding: ‘We are probably all undercharging’.

In the light of new evidence, some doctors are now reviewing their fees. 

Dr Wise told Independent Pract­itioner Today later that the dearth of experts had a range of contributing factors. ‘While the intellectual rigour and the adversarial atmosphere of the court appeals to some, the ability of a barrister – a compelling narrator, orally articulate – deters many doctors from engaging in expert witness work. 

‘As the trained Rottweilers of our legal system, they are supremely able to persuade the listener to accept the righteousness of their cause.’ 

He said the deterrents to becoming an expert witness seemed ‘nigh on insurmountable’. 

These deterrents included lawyer intimidation, an employment regime where adjusting job plans to accommodate the work or time to give evidence was a Sisyphean task – as well as the detriment to existing patient care – and the impact of vexatious complaints to a regulator.

Medico-legal tasks help clinical work

According to Sir Martin Spencer, chairman of the Expert Witness Institute (EWI), doctors should take on expert work with a view to improving their own practice.  

He said: ‘Medico-legal work gives doctors a perspective on the work of others in their field: they see how others practise, the mistakes they make, the judgements that have to be made. Medico-legal experts, in informing the court of appropriate practice, need to update their own knowledge, for example by revisiting and reminding themselves of NICE guidelines. 

‘In considering questions of causation, they may need to review relevant studies/papers and give the court a view on the balance of probability. All this is stimulating and interesting. The work is well-paid, rewarding, invigorating and intellectually challenging.’

EWI governor Amanda Stevens said: ‘The lack of available experts in some specialist areas can cause delays in bringing cases to court. It is a sad fact that in children’s brain injury cases, experts such as paediatric neurologists and neonatologists are in such short supply solicitors can wait up to a year to secure their services.’

What should an independent practitioner take into account in arriving at a reasonable fee to charge for an hourly rate? Doctors and accountants – let’s hear what you would advise. Contact robin@ip-today.co.uk