During this period (1992-5) I also started to prepare medico-legal reports, initially for Clinical Negligence cases, but then for Personal Injury also.
As well as preparing reports for litigation, I also assessed medical records for signs of practitioner competence (or otherwise!) for disciplinary hearings.
I served on the Medical Negligence Expert Panel of St Paul's Insurance Company, 1999-2001, when, following losses sustained in '9/11' it decided to restructure and withdraw from the UK Professional Indemnity market.
My LAMP course stimulated an interest in Public Law and Medical Ethics.
I served on the Multi-Centre Research Ethics Committee (MREC) for the Northwest, from August 1997-August 2000. Aspects of both Public Law and Medical Ethics have formed part of my work for the Royal College of Ophthalmologists on various committees since 2004.
Expert Witness work.
I have been preparing reports for 17 years. I am accredited by APIL, and was previously by the Law Society (when it used to do this). I have always been happy to accept instructions from either Claimant or Defendant. I felt mildly slighted when Lord Woolf's CPR reforms introduced the various statements about 'Duty to the Court' and 'Statement of Truth', as 'a truly independent opinion' was already my philosophy and practice.
Personal Injury instructions are 70% Claimant (including many where my instruction has been agreed with the Defendant), 20% formal joint instructions, and 10% Defendant.
Clinical Negligence instructions are 45% Claimant and 55% Defendant, with the occasional Joint instruction.
Charges. Currently just under the VAT ceiling, but I presume this will change in the near future. I charge £250 per hour, (£25 per 6 minute unit), whether for perusal of records, preparation of report or examination of the client.
In practice, a straightforward personal injury report, where the effects of the injury on lifestyle have not been catastrophic, and the volume of records small, is likely to cost £250 - £350.
Costs for Clinical Negligence cases are more difficult to estimate but an average Condition and Prognosis report, including examination costs £300- £400, and an average Causation and Liability report £1250 - £1500, depending obviously on the complexity of the issues.
No Win; No Fee?
Clearly as an independent expert I cannot enter into such an arrangement.
In PI cases, where outcome of the case is more predictable, I am willing to consider deferment of payment, but not to reduction of fees for 'unsupportive' reports. Instructing Solicitors must be ultimately responsible for payment of agreed charges.
Proposed actions for suspected Clinical Negligence are less predictable, and if the claimant is not covered by insurance or legal aid, cases should be discussed on an individual basis. I will consider providing 'limited advice' for an agreed fixed fee of between £400 - £500 for clients who wish to investigate the possibility of Clinical Negligence, but who have limited funds. Such advice will be given after perusal of the records, and will not include a detailed chronology, for instance. The explanation as to why the medical actions are, or are not, deemed to be negligent may also need to be curtailed for reasons of cost containment. This aspect highlights one of the reasons why such an approach is often unsatisfactory; a client who wishes to pursue an action against, say, a hospital generally wishes to have a full explanation of what has happened, especially if the conclusion of the investigation is that a case for negligence would be difficult to prove.
Court attendance.
I have attended court to give evidence on several occasions, but not in the last five years. Most matters now seem to resolve after discussions between Experts. My charge for Court attendance is currently £1500 per day, plus reimbursement of travelling costs, and overnight accommodation when necessary. Late cancellation of proposed Court hearings can be a problem so instructions for court attendance are accepted on the following understandings:
cancellation of these arrangements within three working days of the court date will incur full payment of my daily court fee, currently £1500.00
cancellation between three and five working days previous will incur a fee of half my daily court fee, £750.00
cancellation prior to one week, no charge incurred.