The NHS bill to pay solicitors acting for patients in compensation claims has more than doubled in four years.
The annual bill in England now tops £90m - a 122% increase in four years, despite the fact the number of cases has remained similar.
The NHS Litigation Authority (NHSLA) told the BBC the rise was due to an increase in no win, no fee claims, which has led to some solicitors doubling their rates to £600 an hour.
About half of the cases the NHSLA sees now are brought by solicitors on a no win, no fee basis as opposed to under a fifth in 2000.
Chief executive Steve Walker said the trend had been caused by the tightening eligibility criteria for legal aid. Only children or those cases deemed in the public interest get state funding.
He told the BBC: "Solicitors are not doing anything illegal, but it is pretty unattractive that these fees are being charged. There is no reason why they should be vastly different from what we pay our own legal teams, but they are.
"Their argument is that they have a higher mark up because there is a risk they will end up with nothing, but in reality they cherry-pick the cases they are most likely to win."
Four years ago, the NHS paid out £40.9m to the solicitors of patients in costs under the clinical negligence scheme for trusts, but by 2007/08 that had risen to £90.7m. In comparison, the fees charged by the NHS's own lawyers was £29.3m in 2003/04, but had only risen by 48% to £43.3m last year. The number of cases resolved each year has stayed at around 6,000.
Jonathan Fielden, chairman of the British Medical Association's consultants committee, criticised the solicitors.
"These organisations are encouraging a compensation culture and making a lot of money out of it. All the money that is going to lawyers is money being taken away from patient care. Obviously there is a need for the system, it is just that solicitors should do more to keep their costs in order like the NHS is doing."
Can't the NHS just be less negligent in the first place and stop treating their patients so appallingly so that compensation claims wouldn't be necessary? If you didn't need to pay compensation for mistreating your patients then you'd have more money to spend on saving lives instead of letting them die. It works both ways.
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