who is AvMA?
I clearly remember my first week as a trainee
in my then firm's Clinical Negligence team. I was given
a breakdown of who was important, what my resources were and who
was who, and it was made absolutely clear to me that Action against Medical Accidents
(AvMA), was one of the most important groups with
which I would work as a Claimant lawyer. This was because of its
role in representing patients who had been injured by medical
accidents, which meant that they had a central role in monitoring
and developing the expertise of claimant clinical negligence
lawyers, accrediting their work as specialists, providing some of
the best available training in medical law, and a forum in which to
meet other clinical negligence practitioners. AvMA could
refer cases and it operated a lawyer service that gave us access to
an expert database. It was a fact of my professional life
that AvMA provided the tools to assist me in my work, and it was an
organisation to respect and assist.
Over the years, as I have got to know many
other clinical negligence claimant practitioners, that view of AvMA
as being at the forefront of providing training and expertise in
pursuing clinical negligence claims has not changed. The
clinical negligence litigation picture has changed immensely since
I entered the profession only 14 years ago and has shifted beyond
belief I suspect from the time when practitioners first began to
test pursuing claims against the NHS and private doctors.
AvMA has moved with that changing landscape and over 26 years since
it was set up by Arnold Simanovitz it is thriving in its role.
AvMA is the independent charity that promotes
better patient safety and justice for people who have been affected
by a medical accident. A 'medical accident' is where
avoidable harm has been caused as a result of treatment or failure
to treat appropriately. AvMA believes that whatever the cause
of a medical accident, the people affected deserve explanations,
support, and where appropriate, compensation, and that the public
deserves to know that the necessary steps will be taken to prevent
similar accidents being repeated.
As part of that remit, AvMA responds to key
consultations about law and regulatory reform, on medical issues
and proposals for change and provides free and confidential advice
and supports people affected by medical accidents, via their
telephone helpline and casework service. This recently
included supporting families affected by the Stafford Inquiry in
providing evidence. It also maintains a panel of specialist
clinical negligence solicitors to whom patients can be referred if
they wish to litigate, or if they need help with inquests or
complaints.
my involvement with AvMA
Over the last four years, I have increasingly
interacted with AvMA on policy issues. One particular
interest of mine, following the Government's proposal to introduce
a no fault Redress Scheme for lower value claims, has been how to
ensure that lower value negligence claims were still pursued by
specialist lawyers, notwithstanding the risks of poor costs
recovery. AvMA welcomes the proposed Redress Scheme as long
as it provides equality of arms and there is a real concern, that I
shared, that lawyers will not see that they can act for those with
lower value claims who choose not to follow the Redress Scheme, as
they will be unable to act in accordance with their professional
duty and do the cases economically. Typically it is claims
for the elderly, mentally ill, and long term disabled (especially
fatal claims) that fall into this category.
I also used to send members of my team to AvMA
to help with the helpline. Its advice service runs a daily
advice helpline that anyone can call for immediate advice on, for
instance, making a complaint, pursuing a claim or trying to obtain
medical records. When a member of my team who held that role
left our firm, I then took their slot for around nine months.
Arising out of that contact, an opportunity
then arose for me to offer my services to AvMA on a regular basis,
one day a week, to help it develop some of its policies and
campaigns. I had a particular interest in fatal accident
claims on behalf of the elderly, mentally ill and neo-natal deaths
and as a consequence of that also had a fair amount of experience
in inquest work. In the course of my discussions with Peter
Walsh and the then legal director, Fiona Freedland, I agreed with
them that I would spend one day a week at AvMA, initially working
on developing its inquest work for families where there is no civil
claim, and that work would be done under the leadership of its new
legal director Catherine Hopkins.
This was a tremendous opportunity for me as it
was very exciting to work with a charity whose work I have watched
and respected over the years, particularly at a time of change in
our profession. When I started with AvMA, the Jackson costs
review was under way, we were awaiting details of the new proposed
LSC tender, changes were being proposed to the inquest system, and
to the valuation of fatal accident claims, which would have great
impact on our practice. Furthermore I was at the stage in my
career where I wanted to broaden the impact of my work beyond
bringing compensation claims to encompass some input into long term
change in the provision of medical care in the UK.
Almost immediately after I reached this
agreement with AvMA, I was also appointed to a new position as head
of Clinical Negligence at Blake
Lapthorn in London. This position did not start until
September and Blake Lapthorn, with whom I would be working full
time, agreed to second me one day a week to AvMA from my start date
at no cost to AvMA whatsoever. This was a generous and
significant contribution by my firm.
an example of the work I have done
Working with the AVMA team has been
fascinating. I should emphasise that I had to sign a
confidentiality agreement when joining AvMA, which means I cannot
tell you how many cups of tea a day we drink, how we spend our
money at lunchtime or any other salient details that may breach
issues of confidentiality. All joking apart, however, our
commitment to confidentiality underpins the functioning of
AvMA. Recent press coverage about disclosure by the National
Bullying Helpline of the potential identity of callers to their
helpline has highlighted the importance of confidentiality to the
public who use services such as AvMA.
What I can tell you about however are some of
the issues I have been involved in whilst working at AvMA.
The issue that has most engaged me is the Inquest and Human Rights
project. Under the leadership of Catherine Hopkins and with
the support of Peter Walsh and Hugh Williams, I conducted research
amongst a broad variety of clinical negligence practitioners about
a perceived need for increased inquest representation. We
aimed to understand why families are often unable to obtain
representation for inquests and concluded that the main bar was
financial. Law firms simply cannot afford to provide
representation regularly on a pro bono basis where there is no
likely claim. In the course of our research it was also clear
that Human Rights claims arising out of medical accidents face the
same difficulties in being taken forwards. They may not generate
any or sufficient benefit in ratio to the likely costs of pursuing
a case, and require a high level of expertise to conduct those
claims. We calculated that it takes a minimum of 15 hours to
prepare and attend a simple half day inquest involving perusal of
maybe three lever arch files of records, proofing two witnesses and
attending a brief conference before the hearing. This is half
a week's work for any practitioner and in straitened economic
times, it is unrealistic to expect law firms to regularly and
continually act on a pro bono basis in inquests and/or human rights
matters.
We therefore have been working on setting up
an inquest group of panel and non-panel inquest specialists who
will, on occasion, pick up pro bono cases for us, and work with us
to provide the necessary representation. We have also set up
a counsel panel where a number of barristers chambers have very
generously offered a team of junior barristers who will carry out
pro bono inquest work. We intend expanding this to human
rights matters arising out of medical treatment as needed.
For this to work we are working with all members of AvMA's panel
and subscribers to lawyers' services who can show adequate
knowledge of inquest law and a willingness to work with us.
Some the other issues I have dealt with
include advising on and drafting initial consultations and working
on drafting leaflets and precedent letters. I have reviewed
medical records and provided a short report on them, and I have
conducted legal research and helped with the expert database.
I have also been involved in fund raising and helping them with two
applications for funding.
We wish to encourage volunteers to work with
the Lawyer Service and Catherine Hopkins on a range of issues not
simply on the helpline. We always need people to work and
help on the helpline, which is a core service of AvMA.
However, there are also other areas of work we do with which we
would welcome assistance. These include consultation
responses, training and conference planning fundraising and
preparing advice leaflets.
You can see the role is varied and very
interesting and dare I say it a great antidote to the
cut-and-thrust of my role as a litigation lawyer. Is it cost
effective? I would say "yes". It has not led to one case
being referred to me, as I am not on panel with AvMA, but I think
it has prepared me for making that application and it has enhanced
my practice, so saving the time of training. You have to be
focused about the time you give and be realistic about how much
time you can offer. However if you can, you will reap the
rewards of working with some great people, seeing claims from
another angle, and perhaps broadening your horizons.
If some of what I have described has been of
interest and you think you may have a skill that you could offer
AvMA including marketing, business development, web design as well
as legal and medical knowledge please do contact Catherine Hopkins
on 020 8686 6900.
