THE law firm Irwin Mitchell has topped a league table of clinical negligence lawyers paid the most by the NHS, picking up almost £11m in fees and costs last year from compensation claims by patients.

The health service paid out more than £35m in total in 2007-8 to the top 10 law firms, which are accused of charging excessive rates in many cases.

Steve Walker, chief executive of the NHS Litigation Authority (NHSLA), said it was unacceptable that firms could demand as much as £800 an hour in “no-win, no-fee” cases. He is calling for the hourly fees to be reduced significantly in a review of civil litigation costs.

Walker said lawyers on so-called conditional fee agreements should not be able to claim a 100% extra success fee on cases in which the authority admits liability early in proceedings. “They are paid too much to begin with and the fact they can double the rate is outrageous,” he said.

Law firms say success fees reflect the substantial risk they face of losing cases. They are paid no fees in unsuccessful claims.

Last year the clinical negligence scheme paid out £264m, of which £90m was for claimants’ legal fees and costs. One in four NHS trusts paid out more in legal costs than in compensation. In some cases the legal costs have been 10 times greater than the damages paid out.

Irwin Mitchell, which has seven offices across Britain, accrued £10.7m in claimant costs, including lawyers’ fees and other legal costs. It won £58m in damages for clients.

Two other legal firms that specialise in clinical negligence, Leigh Day and Pannone, claimed £4.9m and £4.8m, respectively. McMillan Williams solicitors, which has offices in Surrey, claimed £3m in costs. Irwin Mitchell and Pannone said they took only a limited amount of no-win, no-fee work and the hourly rates were subject to court approval. “The vital thing is not to lose sight of the need for people injured by negligence to be rightfully compensated,” said Emma Holt, head of clinical negligence at Pannone.

Colum Smith, head of personal litigation at McMillan Williams, said cases that went to trial accounted for the most costs and the NHSLA should settle legitimate claims earlier.

Peter Walsh, of Action Against Medical Accidents, a patients’ charity, said the compensation scheme was in need of a review but the NHS should do more to deal with the cause of the legal actions. “The biggest scandal is the rate at which perfectly avoidable negligent harm continues to be caused in the NHS,” he said.

Des Hudson, chief executive of the Law Society, said: “No fees are payable if a claim against the NHS is unsuccessful. Fees are recovered only when the NHS is at fault and if the court is satisfied that the fees claimed are appropriate. There is ample opportunity for any party, including the NHS, to challenge the fees if they choose to do so.”

The top 10

NHS legal payments

Irwin Mitchell £10.75m

Leigh Day £4.87m

Pannone LLP £4.83m

McMillan Williams £3.01m

Kingsley Napley £2.96m

Gadsby Wicks £2.40m

Russell Cooke £1.86m

Challinors Lyon Clark £1.58m

Keeble Hawson £1.55m

Withy King £1.53m

Total: £35.34m

Source: NHSLA 2007-8

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