Medics fight back in whiplash debate

Last night's meeting of the All Party Parliamentary Group on Insurance & Financial Services was rather more tense than is usually the case as doctors and medical reporting agencies battled to get their views on the seemingly uncontrollable surge in whiplash claims across to MPs.

"Don't blame us" was the essence of their message which clearly wasn't what the members of the group, led by chairman Jonathan Evans, wanted to hear.

To be fair to both Donald Fowler, the managing director of the Premex Group and Dr John Canning, chair of the Professional Fees Committee of the British Medical Association, they set out to create some balance in a debate that, certainly within in the All Party Group, has been tilted towards the insurer perspective. In attempting to do this they at least flushed out some of the areas where Parliamentary opinion is beginning to firm up on this issue, although that wasn't necessarily what they wanted to hear.

The medical profession came under fire, especially from Lord Hunt, for submitting medical reports based on telephone consultations, a practice that Jack Straw is gathering evidence on. While Dr Canning was able to quote alot of fine words from General Medical Council guidance on writing reports about the need for honesty and completeness, he found himself struggling to defend the submission of reports where the patient hasn't been seen. This is something that is permitted under the GMC guidance and Dr Canning outlined some types of cases where it might make sense but he failed to convince Lord Hunt and his colleagues in the group that this was acceptable.

Mr Fowler tried to provide some context to the work of medical reporting agencies such as Premex and made a bold attempt to challenge the terms in which the debate is being conducted: "What is whiplash?", he asked, "It is hard to understand the figures without having a clear view of what whiplash is in the context of soft tissue injury", he told the group. The figure he was referring to is the one that is now uppermost in the minds of MPs: 1600 new whiplash claims every day. It was a bold attempt but one that was doomed to fail because this figure has shocked MPs and is now firmly fixed as their principal reference point for this debate.

What MPs want is answers to the simple question: Why are there 1600 new claims every day? They believe that this is an unacceptable figure and that there must be a substantial amount of fraud for it to be so high. They had hoped to find that the medical profession and medical reporting agencies were making a significant contribution to this deluge of claims but both Dr Canning and Mr Fowler at least managed to escape being saddled with that responsibility. Instead they presented themselves as the innocent but honest parties in a flawed system.

So, where do the flaws lie?

Clearly, referral fees are a significant culprit. They force claims into a system where there is too much money to be made by lawyers. At the end of the process is the money paid to claimants, another incentive to turn relatively minor injuries into claims. I don't know the answer to this but I suspect that one of the reasons we have more claims most European countries is that the compensation we pay is much higher. I say this because one point that struck me yesterday and has had me wondering in earlier presentations is why, if we use the same diagnositic tools as the rest of the world (which we were reassured that we do) do we have so many more claims? Surely, it can only be because our legal system puts a higher value on the pain and suffering of relatively minor soft tissue injuries than elsewhere? Does this make our system better or worse? That is a question that the insurance industry could very usefully invest in some proper research to help find answer.

The other challenge to the insurance industry has to be to stop paying all referreal fees immediately. We know they are a significant contributory factor and a real incentive to creating claims where none would exist otherwise. Why wait for the legislation to ban them? Some insurers have already banned them – what is stopping the rest?

This issue is not going to go away. It is on the Prime Ministerial agenda, the Transport Select Committe is due to return to this topic shortly and Jack Straw is in no mood to let it drop. Solutions have to be found. They will be better solutions for being better informed and yesterday's meeting was another small step in that direction. It did, however, yet again highlight what we don't know as much as what we do know.