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Medico-Legal News, Issue 26

Lisa Cheyne, Medico-Legal Manager, SpecialistInfo 

APIL calls for Compensation for all Victims of Dog Attacks 

Since the covid lockdowns, there has been an increase in dog ownership, and an alarming rise in the number of people injured or killed in dog attacks in England and Wales. 

Unfortunately, many people badly injured in dog attacks are not eligible to claim compensation from the Government Criminal Injuries Compensation Scheme (CICS), which pays damages to victims of violent crime, who suffer physical or mental health injuries.

The current CICS rules state animal attacks do not fall within the definition of a crime of violence, unless the owner intentionally uses or causes the animal to attack an individual.

However, it is a criminal offence to have a dangerously out-of-control dog anywhere, including in a public place or in the owner’s home. A criminal court can impose unlimited fines or prison sentences on dog owners who break the law.

The Government has recently added the American XL bully to the list of dogs banned in England and Wales under the Dangerous Dogs Act 1991.

APIL has told the Government that the scheme also needs updating, so that victims of all criminal dog attacks are eligible for compensation.

Read more: https://www.apil.org.uk/blog/Time-to-treat-all-victims-of-dog-attacks-with-compassion

Medico-legal Agency Fee Disclosure Rule

Claimant costs could be significantly reduced unless they reveal details of fees paid to the medico-legal agency handling their report.

In Parsons v Stevens, an RTA claim which had settled for £25,000, Deputy District Judge Fentem concluded that ordering a reply to the Part 18 request for a breakdown of costs from the defendant was ‘reasonably necessary and proportionate’ and that commercial sensitivity was not a good enough reason to refuse.

Claimant lawyers had wanted to recover the £5,880 (plus VAT) cost of a pain management report fee, but without a breakdown of what was paid to the agency, Premex. The judge reduced this to £1,250 for the doctor’s fee and £250 for the agency’s costs after the breakdown was not disclosed.

County courts in different parts of the country have reached different verdicts in similar cases, with calls growing for guidance from a higher court or the Civil Procedure Rule Committee.

Read more: www.lawgazette.co.uk/download?ac=117050

Faculty of Expert Witnesses FAQs – Claimant Surveillance 

Mr E. Witness completed a report for a law firm representing the defendant in an RTA and was subsequently sent surveillance tapes of the claimant by the law firm and was asked to review these and comment.

Would he first need a court direction/instruction to review any surveillance tapes?

Should he also request that the solicitors tell him the specific issues they want dealt with regarding the footage?


Jonathan Dingle, Barrister, Mediator and Lead Expert Witness Trainer at SpecialistInfo replies:

An expert may be instructed to consider surveillance.  This may be directly from the original solicitors/agency pre-litigation or sometimes after the claim has been issued, or it could be following a court order which should be provided to the expert. In both cases it is proper to prepare an addendum report. 

When this happens, first they should consider how long it is likely to take to prepare an opinion and report and give a quote for cost and an estimate of when they can deliver the report – if there is any difficulty complying with any court order they should immediately say so.  If the matter is requested by a solicitor or agency then they should await acceptance of their fee quote. If there is a court order, then they should comply and render a fee note.

When they consider the video, they should consider first whether the subject is definitely the Claimant.  If there is any doubt they should say that their opinion is based on the presumption that the subject is Claimant but obviously if that is incorrect then the materials are of no value.

Then they should consider from the perspective of their own area of expertise only what if anything the video can assist them with: the expert should not speculate about matters outside their own area of expertise.  

Sometimes video surveillance is thought by experts to be of no value at all; sometimes it is thought to be important.  Where it raises questions about what the expert has recorded they were previously told about the ability of a person to do certain things then the expert can of course highlight the disparity but in every case they should also indicate (a) how and  of at all it changes their opinion on any issue and (b) whether there would be a range of reasonable opinion on the issue as between experts of the same discipline.

Finally, they should prepare the report under the usual declaration and addressed to the court in the usual way, and then send it to the person who originally instructed them with a fee note requesting conformation of receipt.  

For upcoming expert witness training dates with Jonathan Dingle and colleagues from Normanton Chambers see: https://www.specialistinfo.com/course-calendar-2024

Report by The All-Party Parliamentary Group on Birth Trauma Published

The All-Party Parliamentary Group (APPG) on Birth Trauma report was published this May, and has suggested several major recommendations, including:

∙ Recruit, train and retain more midwives, obstetricians and anaesthetists to ensure safe levels of staffing

∙ Roll out and implement, the OASI (obstetric and anal sphincter injury) care bundle to all hospital trusts to reduce risk of injuries in childbirth

∙ Respect mothers' choices around giving birth and access to pain relief

∙ Commitment to tackling inequalities in maternity care for ethnic minorities, particularly black and Asian women

∙ Universal access to specialist maternal mental health services to end the postcode lottery across the UK

A new maternity commissioner, who would report directly to the prime minister, is a key recommendation in the inquiry's report, along with ensuring safe levels of staffing.

NHS Resolution has announced a collaboration with THIS Institute (The Healthcare Improvement Studies Institute) at the University of Cambridge to support the evaluation of its two maternity safety programmes: the Early Notification Scheme and Maternity Incentive Scheme.

The dissolution of parliament took place on Thursday 30 May 2024, until after the general election on 4th July 2024. 

Other all-party parliamentary meetings were due to take place in May on historic and ongoing harms in women involving mesh, and drugs Valproate and Primodos, which can cause birth defects. Ongoing APPGs campaigns will now be paused until after
the GE.

Read more: https://www.theo-clarke.org.uk/birth-trauma

BMA Announces Junior Doctors Strike in June/July and Possible GP Collective Action in August

In May, following the Government’s refusal to meet their demands for a roadmap to restore pay lost over the last 15 years in England,  junior doctors announced new strike dates, just before the general election, involving a full walkout beginning at 7am 27th June and ending 7am 2nd July 2024. 

This follows a BMA referendum in March asking GP members whether they accepted the changes to the 2024/25 contract. More than 19,000 GPs took part and almost 100% voted ‘no’. The Government has so far failed to make any changes to the contract, prompting the committee to launch a ballot on collective action. The ballot is open to all GP contractors/partners from Monday 17 June and closes on Monday 29 July ahead of action commencing from Thursday 1 August, depending on the result.

Read more: https://www.bma.org.uk/our-campaigns

Early-Bird Medical AI, Robotics & Technology Conference 2025 - Bookings are Open!

Now in its third year, the SpecialistInfo Medical Al, Robotics & Technology Conference brings together healthcare leaders, doctors, practitioners, tech innovators, and experts who are at the forefront of a changing healthcare system, who wish to enhance their knowledge in this fast-developing field, and showcase new technology in the world of healthcare. It will feature talks by some of the industry's most knowledgeable speakers with first-hand experience of developing and implementing these techniques and devices.

Confirmed 2025 Speakers include:

∙ Mark Slack, CMR Surgical

∙ Mark Wilson, Founder of the GoodSAM app

∙ Omer Karim, Intuitive, Consultant Urologist

∙ Amrita Kumar, Consultant Radiologist – named 2022 Top 50 Innovator & Top - 50 Influential Woman in the UK for leading innovation in the use of AI within the NHS

Congress Centre, London, 4th March 2025

Read more and book: www.medical-ai-and-robotics.com

Supreme Court Backs Claimants in Hybrid Injury Test Case Hassam and Another v Rabot and Another [2024] UKSC 11

Personal injury lawyers have won the right to claim extra damages for claimants’ non-whiplash injuries, despite Insurers submitting that separate compensation for the other injury should only be added if the claimant could establish it was different to the pain, suffering and loss of amenity (PSLA) covered by the whiplash injury.

The Supreme Court dismissed insurers’ appeals in the joint cases of Hassam and another v Rabot and another in a long-running dispute over so-called hybrid claims.

The decision means that litigants using the Official Injury Claim portal for low-value RTA claims can be compensated for bodily injuries as well as for soft tissue injury, although the court must still decide if deductions should be made to avoid double payments for the same consequences.

Lord Burrows, giving the lead judgment, said at the outset that while the sums involved were small, thousands of cases were potentially affected by this decision. 

This judgment of the Supreme Court concerned Part 1 of the Civil Liability Act 2018 and the Whiplash Injury Regulations 2021 (SI 2021/642).

The act sets a statutory tariff for whiplash-type injuries, but many claimants suffer other types of injury in addition. A court dealing with multiple types of injury would consider the various injuries and fix a particular figure as reasonable for each. It would then consider whether the award for PSLA should be greater to reflect the combined effect of all the injuries upon the injured person’s recovering quality of life, or smaller in order to remove an element of double recovery.

The problem for the Supreme Court was the approach to be used where the injuries included a fixed tariff whiplash and other types of injury, which were subject to a common law assessment.  

In the first test case, for example, the claimant suffered whiplash injuries to his neck and back. He also suffered non-whiplash soft tissue injuries to his knees. At an assessment hearing, the tariff amount for the whiplash injuries was assessed at £1,390 and the common law damages for PSLA for the knee injuries at £2,500, resulting in an overall figure of £3,890. The court then reached a final figure, by making an appropriate deduction and identified a ‘clear overlap’ between the PSLA from the different types of injury. The overall award was therefore assessed down to £3,100.

Read more: https://www.supremecourt.uk/cases/uksc-2023-0025.html

GMC Consultation on Regulation of MAPs Closed on 20 May 

The GMC has closed its public consultation on its rules, standards, and guidance for physician associates (PAs) and anaesthesia associates (AAs), collectively known as Medical Associated Professionals (MAPs).

MAPs are currently working in the NHS in a variety of roles across primary and secondary care. They complete a two-year postgraduate course (1,600 hours of clinical experience and teaching) but are increasingly being employed in the NHS in roles that had previously been reserved for doctors, and in many cases as direct substitutions for doctors, working on doctors’ rotas. They do not have a medical degree and must always be supervised by a doctor.

The consultation addresses concern that registration with the GMC blurs boundaries with doctors, and that the GMC is not an appropriate choice for regulator of PAs and AAs. The BMA opposes regulation by the GMC and states the Health and Care Professions Council is more appropriate.

Read more: https://bma.org.uk/media/wjnmmbsu/bma-gmc-maps-consultation.pdf

Mandatory MOJ Mediation Scheme in Civil Cases

The Ministry of Justice is piloting a new requirement to mediate in low-value money claims from this May.

MoJ head of dispute resolution policy, Kim Wager, pointed to the success of a Canadian mandatory mediation model.

‘We haven’t ruled out mandatory referral to mediation for higher value claims in the county courts, so those over £10,000. It seems to work well in Ontario in Canada; they have had it in place for over 20 years now [for] all cases that go to the court… including personal injury… That remains of interest as a potential model to develop a mandatory mediation arrangement in England and Wales.’

Money claims worth under £10,000 filed on or after 22 May, will include a requirement for parties to attend a free, one-hour telephone mediation arranged through the small claims mediation service (SCMS) before the claim can then proceed to court if no settlement is reached. 

The number of claims dealt with by the SCMS is expected to grow from 20,000 annually under the current voluntary service to 92,000 per year, with 39 new mediators already recruited.

Wager said: ‘We concluded that the only way to move the dial on this and drive take up would be to require it; to make mediation an integrated step in the resolution journey, which includes penalties for non-compliance.’

‘The impact assessment that we published modelled a 15 - 55% settlement rate… and we estimate this would free up between 1,400 and 5,200 sitting days; between 9% and 32% of all county court sitting days. So, it would release a significant amount of resource for those cases that do need to go before a judge.’

Wager said the MoJ welcomed the Court of Appeal's ruling in Churchill v Merthyr Tydfil Council last November that a court can lawfully stay proceedings and order parties to engage in non-court dispute resolution. 

‘This is an area that requires extensive further consideration to strike the right balance in the public interest.’

More recently in the decision HHJ Mithani KC in Conway v Conway & Anor (Rev1) [2024] EW Misc 19 (CC) at the end of May, costs were reduced following refusal to mediate.

The defendant’s costs in this case were reduced by 25% because they rejected the claimant’s offer of mediation, despite having a strong case and ultimately succeeding. The judge found that mediation would probably not have succeeded; however, to reject an offer of mediation out of hand was unreasonable conduct.

Read more: https://www.lawgazette.co.uk/news/moj-moves-the-dial-on-mandatory-mediation/5119687.articlehttps://www.bailii.org/cgi-bin/format.cgi?doc=/ew/cases/Misc/2024/19.html&query=(Mithani)stand

Infected Blood Final Report 20 May

Following publication of the final report on the infected blood scandal by Sir Brian Langstaff in May, the Government has announced further details of compensation arrangements for those infected and/or affected by contaminated blood.

At the time of going to press, this includes details of the expanded groups that will be eligible for compensation and a commitment that further interim payments of £210,000 will be paid within 90 days to living infected beneficiaries ahead of the establishment of the final scheme.

Read more: https://www.infectedbloodinquiry.org.uk/reports/inquiry-report