Defending claimants’ rights: why amending the Law Reform (Personal Injuries) Act risks undermining justice in medical negligence cases
Last week, Catherine McKinnell MP presented the Clinical Negligence Bill in the House of Commons, proposing amendments to the Law Reform (Personal Injuries) Act. The bill has reopened a long‑running debate about fairness, proportionality, and access to justice in medical negligence claims.
Although reform is often framed as a way to reduce costs and improve efficiency, from the perspective of a claimant who has suffered harm through medical negligence, these proposed changes risk eroding fundamental protections that sit at the heart of tort law.
Medical negligence litigation is built on a simple principle: those who suffer injury because of substandard medical care should, as far as possible, be restored to the position they would have been in but for the negligence. Over time, the statutory framework has evolved to reflect this principle, balancing evidential burdens, compensation mechanisms, and procedural safeguards. Any reform that places cost‑saving above claimant recovery risks destabilising that equilibrium and should be approached with extreme caution.
In her address to Parliament, Ms McKinnell argued: ‘There is also a long-standing anomaly in how compensation is calculated, dictated by a law predating the NHS that prevents consideration that the NHS may be the best place for claimants to access ongoing care… To ensure that every pound is focused on improving care and preventing harm, we must finally amend and update this law – this 1948 relic – to reflect modern-day reality.’
These reforms appear to target section 2(4) of the LR(PI)A, which currently allows claimants to disregard NHS provision when assessing the reasonableness of damages for future treatment.
A key concern is the potential restriction on the damages claimants may recover. Medical negligence cases frequently involve individuals with catastrophic, life‑changing injuries and complex, multi‑disciplinary care requirements. Limiting their ability to recover full compensation, whether through caps, altered discount rates, or constraints linked to state‑funded care, effectively shifts the financial responsibility for negligence away from those who caused the harm and onto victims and the already-strained healthcare system.
Any amendment would also need to guarantee, with absolute certainty, that a claimant’s lifelong needs could in fact be met by the NHS. NHS provision can be very variable, especially for complex or specialist care. Provision remains subject to postcode disparities, resource constraints, and operational pressures. Moreover, it is not clear why one NHS trust or ICB should be expected to absorb the cost of long‑term care needs arising from another trust’s negligence, whilst diverting funds from treating patients who have not suffered avoidable harm. The feasibility of the NHS absorbing a sudden influx of high‑dependency, complex care packages must also be questioned.
Proponents of reform frequently cite the need to control litigation costs and safeguard public finances. These goals are legitimate, but they must not be pursued at the expense of justice. The costs of medical negligence litigation arise not because claimants bring claims, but because negligent care occurs in the first place. Addressing the root causes, such as staffing issues and failures in reporting or learning from incidents, would be a far more effective and equitable way to reduce costs than restricting the rights of injured patients.
Reform should not be equated with restriction. There is genuine scope to improve efficiency, streamline processes, and reduce delay in medical negligence litigation without diminishing substantive rights. Indeed, many claimant practitioners actively support reforms that facilitate earlier resolution while preserving full, fair compensation.
While the intention behind amending the Law Reform (Personal Injuries) Act may be to modernise and rationalise the system, any changes must be made with great care. From a claimant’s perspective, the priority must remain clear: ensuring that those harmed by medical negligence retain meaningful access to justice and adequate compensation. Reforms that compromise these principles risk doing more harm than good, not only to those individuals it is there to protect, but to the integrity of the legal system as a whole.
The second reading of the Clinical Negligence Bill is scheduled for Friday 17 April 2026.