Medical negligence in the NHS continues to harm and kill patients in England because successive governments and health service leaders have failed to act on more than two decades of warnings, MPs have said.
In a sharply critical report published on Friday, the Public Accounts Committee accused the Department of Health and Social Care and NHS England of allowing the cost of clinical mistakes to spiral to £3.6bn a year.
The committee said both organisations had taken “no meaningful action” to tackle the problem in England, despite four previous PAC reports dating back to 2002 urging reforms.
“It feels impossible to accept that, despite two decades’ worth of warnings, we still appear to be worlds away from government or [the] NHS engaging with the underlying causes of this issue,” said Geoffrey Clifton-Brown, the committee’s chair.
He pointed to what he described as “unacceptable stasis” in maternity care as a clear example of inaction that continues to cause harm and drive up costs. Since 2015, major reports have exposed failures in maternity services at Morecambe Bay, East Kent, and Shrewsbury and Telford, with a further inquiry under way into childbirth care in Nottingham.
Concerns about maternity safety prompted the health secretary, Wes Streeting, to commission a national inquiry last year, led by Valerie Amos.
The PAC report said government liability for clinical negligence had quadrupled over 20 years, reaching £60bn in 2024–25. “The PAC finds that, as government’s liability for clinical negligence quadrupled over 20 years (£60bn in 2024-25), the [Department of Health and Social Care] is unable to show any meaningful action taken to address this and the NHS has not done enough to tackle the underlying causes of patient harm,” it said.
“This is a swelling accounting of profound suffering,” Clifton-Brown added. “Each case can represent unspeakable devastation for the victims involved and the overall picture is of a system struggling to keep its patients safe from avoidable harm.”
Evidence gathered by the committee suggested the NHS had become “overwhelmed” by the volume of recommendations issued by safety watchdogs, official inquiries and coroners, many of which have gone unimplemented.
The report highlighted several key findings, including that the £3.6bn annual cost of medical negligence is diverting money away from frontline NHS care. It also found that lawsuits involving brain-damaged babies can take up to 12 years to resolve, and that some patients pursue legal action because hospitals refuse to explain what went wrong.
Helen Morgan, the Liberal Democrats’ health spokesperson, said: “These mind-boggling clinical negligence costs are a horrific symptom of an NHS that has been neglected and mismanaged for too long.”
She said Conservative policies had pushed the NHS “to the brink”, while Labour had done too little to improve services, criticising the removal of ringfenced funding for maternity care as “nonsensical”.
The PAC urged the NHS to be far more open with patients and families when mistakes occur, including apologising sooner, which it said could reduce both the number and cost of claims. It also called for an overhaul of the NHS’s “confusing and unresponsive” complaints system to create a more compassionate process that would also save money.
Separately, a report published on Thursday ranked the UK 21st out of 38 OECD countries for patient safety. The study, carried out by Imperial College London and Patient Safety Watch, raised concerns about deaths among people with severe mental illness and found the UK performed poorly on neonatal deaths and surgical complications.
A spokesperson for the Department of Health and Social Care said: “This government inherited an NHS that was failing too many people.
“We have taken rapid action to strengthen patient safety – overhauling the Care Quality Commission, rolling out Martha’s rule and Jess’s rule so patients can get a fresh clinical review, and introducing hospital league tables to drive improvement.
“We have also brought in new maternity safety measures, are conducting an urgent investigation of failings and are establishing a taskforce, so every mother can have confidence in NHS care once again.
“We know there is much more to do but we are determined to make sure the NHS is the safest in the world.”