In the first part of this paper, Dr. Goldberg examines the context in which medical malpractice liability is operating in the UK. The fact that the state-run National Health Service (NHS) is the major healthcare provider in the UK has several implications, since funding for medical malpractice compensation in the NHS comes from the taxpayer. The most recent empirical evidence on the incidence and funding of claims in England and Scotland is assessed, to show a trend of expenditure on clinical negligence increasing, particularly in England. This is followed by an examination of the statutory framework for the empowerment of some of the Chief Medical Officer's recommendations in his report, Making Amends in the NHS Redress Act 2006. In Scotland, while medical negligence remains the primary route to bringing a claim for compensation for medical injury, no-fault compensation is now the favoured way forward of the Scottish Government for the NHS. A No Fault Compensation Review Group has recently been reported and Dr. Goldberg explores its recommendations, which provide a radical development in the field of compensation for medical malpractice.

The heart of the paper examines the existing basis of medical liability, with particular emphasis on the problems in establishing negligence and factual causation. The paper concludes with a review, in the context of clinical negligence claims, of both the recommendations for reforming the costs of civil litigation in England and Wales and the dramatic changes being introduced to the Legal Aid system, in particular the abolition of legal aid for clinical negligence cases.