Hysterical, but not in a funny wayPosted: 28 September 2013
A new and aggressive business has emerged in recent years – the business of stoking compensation culture hysteria. We see evidence of it in the press and, more worryingly, in government policy-making fuelled by a hatred of lawyers. It reminds me of the ‘PC gone mad’ hysteria that was so lively in the 1990s and still rears its unlovely head now and again. Like most hysterias, neither of these – the PC gone mad and the compensation culture – is rooted in an evidence base. Why, then, do they have such hold on the public, and political, imagination?
One example is a report published last year by the Centre for Policy Studies, a thinktank that describes its aim as advocating ‘a distinctive case for smaller, less intrusive government, with greater freedom and responsibility for individuals, families, business and the voluntary sector’. The Social Cost of Litigation by Frank Furedi examines two areas, health care and education, and argues that the fear of litigation is affecting the way professionals practice and, as a consequence, producing damaging outcomes.
In particular, Furedi focuses on what he calls ‘demand for recompense for accidents’ – presumably accidents which, in the good old days, would have been chalked up to experience, with no one to blame. Rising compensation levels, he suggests, lead people to make financial claims against public bodies, and the fear of such claims makes professionals risk averse, which in turn ‘erodes professional autonomy, stifles innovation, leads to defensive practices in both hospitals and schools and encourages greater bureaucracy’.
Anecdote as evidence
The paper has so many holes ripe for picking that it’s difficult to choose which to write about. To call this report an ‘investigation’ into litigation in education and health care is farcical. First and foremost, it refers to new research – but what this ‘research’ amounts to is a series of anecdotes with unidentified individuals who seem to have have been selected on the basis of sharing the hysteria brief of the author.
This evidence includes, for example, an account by an unnamed headteacher of the damaging effect of a parent asking questions: every time the school gets a request for a copy of policies and risk assessments, it’s a week’s work to fulfil the request. The question crying out to be asked is – how can it take that much time, unless you don’t already have policies in place and have to write them from scratch?
It is a truism that one person’s bureaucracy is another’s transparency, or accountability – but possibly a truism unfamiliar to this headteacher.
I can do anecdote, too. I mediated a disability discrimination claim brought against a private nursery by parents of a toddler with autism. The boy had been excluded from his nursery for biting another child. The nursery had struggled to balance his needs with its duty of care to staff and other children. In six months there had only been this one recorded incident. The nursery staff claimed he had been biting them many times in that period. There were no records of this, nor any records of what steps had been taken to address his behaviour. A child who could not speak and who in frustration used biting as a means of communication was labeled bad and excluded. Only by starting a legal challenge could the parents get the head of the nursery to agree to meet in a mediation and discuss what impact this had on them as a family. What came out of it was a clear way forward in terms of improving the procedures for logging incidents and enhanced training for staff – and yes, financial redress, but in this case it was in the form of fundraising for an autism charity.
I agree wholeheartedly with Furedi’s statement that ‘…we need to challenge the expectation that professional best practice in the public sector should be measured by the absence of complaints or litigation’. But this is followed by the rather chilling statement: ‘A genuine return to respecting the principles of professional judgement would have a humanising effect on public services.’ In other words, let’s turn the clock back to when people respected doctors and teachers and didn’t ask questions or make demands. Doctor, after all, knows best.
There is more than cosy nostalgia at work here. It is essentially an attack on access to justice, an attack on rights – the extension, awareness and enforcement of rights. Furedi writes that ‘professional autonomy is being increasingly challenged by its confrontation with an agenda of consumer rights’. Nothing says more than his use of the word ‘agenda’, a term laden with disgust and dismissal.
The source of ‘evidence’ on the rising culture of naming, blaming and claiming in education are articles from the Telegraph and the Daily Mail on outrageous sums awarded for ridiculous injuries. For more robust evidence, see the speech given in March this year by the Master of the Rolls, Lord Dyson (“Compensation Culture: Fact or Fantasy?“). He shatters myths around court decisions that gave rise to hysteria in the popular press, and he concludes that there have been no developments in substantive law encouraging a compensation culture.
The Furedi report argues that claims ‘inexorably’ lead to a diminishing of the public services and decline in the quality of education. Tell that to the young people with special educational needs who have had to fight for inclusion in mainstream schools. Those with behavioural difficulties face a constant struggle against being labeled bad. A survey conducted by the National Autistic Society (NAS) found that some 21% of children with autism are excluded, permanently or otherwise, from both mainstream and special schools, the most common reason given being that the school was unable to cope with the child.
Others find that without legal challenges, schools and local authorities won’t make the physical changes needed so that children with mobility impairments or cerebral palsy can attend mainstream schools. Let’s follow Furedi’s lead and use anecdote here – but from a named individual who went public with his struggle. In April 2010 Jonathan Bartley, a parent of a child with cerebral palsy, confronted David Cameron about his claim that there has been a ‘bias towards inclusion’:
‘We personally had to battle for two years to get our son into our local school, which his two sisters attend. It cost us thousands of pounds to go to a tribunal, which we then won. The local authority then said they would appeal against the decision to the high court. At that point, the secretary of state intervened, and paid for some modifications to the school. Samuel now attends the school.’
Instead of discouraging challenges, we need instead to encourage smarter complaining and better handling of complaints. Late settlements by local authorities is a constant problem with the SEN and disability tribunal. Whether it’s a tactic or it merely reflects departments under pressure, such settlements have a disproportionate cost for both parents and local authorities. The latter is, as Furedi would be the first to point out, public money being misused.
‘This is the perverse outcome of the modern fantasy of redress through litigation: every time we bring a claim against our health or education services, we are in effect suing ourselves. And every time we are encouraged to ‘name, blame and claim’ as an act of responsible citizenship, to stop other people sharing our bad experiences, we end up contributing to the worsening of these very services.
Where’s the evidence for that? This confused argument – that public services suffer when public bodies pay financial redress – has no foundation. The former Parliamentary Ombudsman Ann Abraham was straightforward in her condemnation of such an outdated approach: ‘Much work still remains to be done on the issue of financial redress. I’m still bewildered by the different attitudes to redress across the public sector: from local government where it appears to be understood and accepted; to central government where it is accepted – but somewhat grudgingly much of the time; to the NHS where it feels like pulling teeth… .’
Complaints aren’t the enemy
An interview with Furedi allowed him to elaborate on his views:
“In conversation, Furedi is steadfast: ‘There shouldn’t be compensation claims for financial reward in the public sector. It is a completely irrational process because who pays for it? It is not the nurse or the teacher or the doctor who is found liable. No, it’s the taxpayer, the public purse – that is what pays for it. It leads to an irrational use of resources. People talk about the postcode lottery. This is even worse because resources are distributed according to whether you have a good lawyer or a bad one.’ “
What better argument for encouraging a culture where complaints are welcomed and efforts are made not just to resolve the individual grievance (which, yes, sometimes requires financial redress) but also to learn from complaints and improve? One way to do this, and to save public money in the bargain, is to encourage earlier use of mediation – independent, rights-based mediation to help resolve the complaint and identify what needs to change.
Where a complaint has no merit, mediation offers a cost-effective way to identify what has led to it – a misguided sense of justice, an unreasonable demand for cash, or – far more likely, in my experience – a breakdown of trust and communication. Trust is rightly cited by Furedi as a key issue – but trust isn’t earned by virtue of a degree certificate on display in the headteacher’s office.
The report suggests that it’s misguided to think that complaints foster greater accountability. Why? It argues that the institutionalisation of a culture of complaint has caused a rise in complaints. How do we know that complaints aren’t on the rise because of a decline in services or, more optimistically, a sign of progress and greater awareness? Show me the evidence.
 Barnard et al, Inclusion and autism: Is it working? (NAS, 2000).
 From “The role of the independent scrutineer: ensuring effective accountability”, Ann Abraham’s Annual Lecture to the Centre for Public Scrutiny, Feb 2005.