Hip and knee specialist struck off for dishonest conduct following surgery

A doctor specialising in hip and knee replacement surgery, has been struck off after giving a patient the wrong knee prosthesis during surgery at Peterborough City Hospital.

Dr Emyr Abdul Hafiz Chowdury, who worked at Peterborough City Hospital was referred to the Medical Practitioners Tribunal Service (MPTS) after carrying out a revision left total knee replacement surgery on a patient in April 2016.

A hearing last month resulted in Dr Chowdury being struck off for his dishonesty following the incident.

Disciplinary proceedings

55-year-old Dr Chowdury, from Lincolnshire was an experienced surgeon specialising in knee and hip surgery. He dealt with patients with complex problems requiring primary joint replacement of the hip and knee, as well as revision joint surgery for failed hip and knee joint replacements.

During surgery in April 2016, he had used a left sided knee prosthesis in the patient’s right knee in error.

Although fitting the wrong knee was treatment below the reasonable standard, the MPTS accepted that incorrect labelling may have contributed to the error. They confirmed that the surgery alone would not have warranted disciplinary proceedings but it was his dishonesty in attempting to cover up the mistake which led to him being struck off.

This included emailing a colleague stating that the correct prosthesis had been used, giving false information to the patient, failing to tell the patient’s GP about the error and not reporting the packaging issue. All this amounted to a fundamental breach and left the Tribunal with no other option but to strike him off.

It is further alleged that his actions were dishonest in relation to discussions he had with the patient.

Patients to come forward

Senior Medical Negligence Solicitor, Emma Semwayo, said: “This is a shocking breach of trust by an experienced and respected surgeon which is reflected in the sanction applied.

“Things can and do go wrong in surgery, but, clinicians have a duty to inform their patients how and why this has happened, whether or not this will lead to a claim in negligence. Knee and hip replacements can offer a new lease of life and conversely, complications following surgery such as this can be devastating, leading to a loss of mobility and independence.

“If you think that you have been treated negligently, or have concerns about any procedures you have had, then we would urge you to speak to our medical negligence team to discuss your rights to pursue a legal claim.”

 

Negligent use of forceps results in long-term Erb’s Palsy injury

The Incident

In September 2009, our client, a baby girl, was delivered with the use of forceps at North Middlesex University NHS Trust which resulted in an Erb’s Palsy injury.

Following instruction to use forceps, it was later documented in the records “mild difficulty” was encountered during the birth.

On delivery, the child was delivered in good condition, but it was noted that her left arm was floppy and weak.

Subsequent examination confirmed a left-side Brachial Plexus Palsy injury, more commonly known as an Erb’s Palsy injury, and our client was referred for physiotherapy.

The case

In May 2014, the mother of our client contacted Fletchers Solicitors.

We accepted the case in view to assessing whether North Middlesex University NHS Trust were accountable for birth injury negligence, specifically relating to Erb’s Palsy.

As our client was a child, our team informed the family that although we would investigate further, the cause could not settle until our client reached skeletal maturity.

In addition to this, any future settlement would also need to be approved by the court at an approval hearing.

In total, Fletchers spent four years investigating further. We obtained important medical records and supporting medical evidence from a range of experts ahead of serving a Letter of Claim, which was completed in 2018.

Within that time, the Defendant, North Middlesex University NHS Trust, responded reasonably promptly with regards to the care provided.

They also admitted that their care did cause the client to suffer a right sided Erb’s palsy injury.

Despite this, however, we still needed to quantify the claim and required further expert reports and advice from Counsel.

The aftermath

Following her birth, our client’s Erb’s Palsy injury continued into childhood.

As time went on, her family found that she was unable to flex her forearm, extend her wrist or supinate her forearm.

Following further physiotherapy and exercises, our client underwent surgery for release of upper portion of subscapularis tension and coracoidectomy. The coracoid is a stout strong bone that connects the cranial edge of the sternum to the shoulder joint complex.

Throughout our client’s young life, she has had to adapt to her circumstances and requires assistance with washing her hair, when showering and lifting objects above her head.

She has previously struggled with PE classes at school, including some dance classes and with swimming; all the practical elements of being a young child and wanting to enjoy life are all the more difficult.

As well as this, our client has a cosmetic 4cm scar on her weaker arm and continues to have marked functional disability in the left upper limb.

The reality of this means that she has reduced muscle bulk in the left shoulder girdle elbow, forearm and hand. There is also evidence of muscle imbalance in the ulna nerve distribution.

Our client is unable to fully raise her left arm above her head and is unable to fully abduct the left arm away from her body and above her head.

Furthermore, due to a soft tissue contracture at the elbow, our client cannot fully straighten her weaker arm and has reduced power in the left upper limb. She has since been informed that reduced sensory awareness will affect her functional capacity, meaning that she will have difficulty identifying objects held in her left hand.

The case outcome

In May 2021, a final settlement was approved by the Court and our client was awarded £320,000.

At the approval hearing, she was given permission to obtain a payment from the agreed damages to buy a laptop. The remainder was lodged into the Court Office Funds and the client will be obtaining the damages when she is 18 years old.

In total, the damages covered an element for her injuries, which include:

  • Permanent impairments affecting the whole shoulder complex
  • Elbow
  • Forearm
  • Wrist and hand function

Whilst part of the settlement goes towards previous care costs provided by the family, including bringing her to doctor appointments, a large sum relates to our client’s future care.

In terms of general living, she will require help with washing, putting extensions in her hair and tying her hair each day. As well as this, she struggles with opening anything with tight lids and tops, or anything that requires reasonable force in her hands.

The reality of our client’s injuries mean she will require physiotherapy throughout her life.

After the settlement was confirmed, our client’s mother commented:

“I cannot even begin to express my feelings on how Fletchers and Niall handled this case, I will forever be grateful. The whole process, from start to finish, has been remarkable. I was never shut out from the process, and if I didn’t understand a letter, Niall would always call me and explain it in a way I could then understand.

“All the assessments we attended, both at home and out, everyone was great. They took time to listen to our daughter’s voice which was very important. Everyone I know, I have told them how fantastic Fletchers were, they followed up this case more in the interest of C first before anything else.

“I just want to say thank you so much on behalf of C. The whole process and how it was handled from the beginning made C want to study Law.”

“I can finally have closure and stop beating myself up every day. C will be able to have all the help she needs in future and it’s all thanks to Fletchers.”

GPs stretched by record appointment numbers

NHS England data has shown that 28 million GP appointments were booked in March 2021. These figures are amongst the highest ever recorded.

This may seem surprising on the face of it. The pandemic, whilst still present, is slowly being brought under control and the vaccination programme in England continues to administer amongst the highest volume of doses in the world. So, why the increase in demand on GP services?

15% reduction in cancer referrals

There are potentially several reasons. The number of patients who were referred by GPs for urgent cancer check-ups reduced by 15% in 2020/21, in comparison to 2019/20. It would not be realistic to suggest that 15% fewer people had cancer symptoms year on year.

The government messaging during the pandemic was “stay at home, protect the NHS, save lives”. The figures suggest that many patients stayed away from their GP, even when they had concerning symptoms. Perhaps they feared they would add a burden to an already overstretched NHS. Others may have been fearful of attending their GP surgery or hospitals at a time when coronavirus transmission was rife.

It’s clear that in cases involving cancer, the earlier the problem is dealt with, the more likely an individual is to have a positive outcome.

Hidden wave of patients

The Health Foundation data shows that individuals who stayed away from primary care in the past year, for whatever reason, are now presenting. With patients now reporting problems in record numbers (and potentially later than they otherwise would have), the burden on primary care and hospitals increases.

Dr Dean Eggitt, from Doncaster, told the BBC that it is not necessarily the patients that he now sees which are his greatest concern. Dr Eggitt stated that he worried most about the “hidden wave of patients who don’t get through”.

GP delays

The British Medical Association has warned that the GP workforce, including non-clinical staff, is simply not growing fast enough to meet current or future demand. Many will be able to relate to the frustration of attempting to make a GP appointment, only to be met with a distinct lack of appointments and inconvenient hold time.

We are now faced with a situation where record numbers of patients are presenting, combined with a workforce of GPs which is not sufficiently equipped to meet demand.

The logical assumption to reach would be that as the pandemic eases, the pressure on the NHS would reduce. But the reality may prove to be very different.

(Sources: https://www.bbc.co.uk/news/health-57229848 & https://www.gponline.com/gps-per-patient-down-10-just-five-years-nhs-data-reveal/article/1715127 )

Chris Marsden is a Solicitor within Fletchers’ Medical Negligence Serious Injury Team.

Ian Paterson Compensation Scheme Confirmed

A new compensation fund and claim scheme has been approved and set up to deal with new claims against surgeon Mr Ian Paterson, who was jailed in 2017 for 20 years after being found guilty of intentionally injuring patients by carrying out unnecessary surgical procedures.

A recent recall of hundreds of new patients by Spire Hospitals had led to the scheme being set up to fast-track claims. Fletchers Solicitors represent a number of patients of Mr Paterson and are one of the few firms to have registered with the scheme, having also recently took part in a conference to discuss the details.

It is anticipated that claims will be submitted to the scheme and will be considered quickly, with Lizanne Gumbel QC approving offers of compensation to victims.

Once a claim is submitted to the scheme, an offer could follow in as little as 2 to 3 months.

If you think you have a claim for negligent treatment carried out by Mr Paterson, or if you received a recall letter from Spire earlier this year, please contact our expert team without delay. We will advise on the process and guide you through it.

More information on Ian Paterson: 

New compensation scheme set up

Recall of 5,500 patients

Should GPs have NHS indemnity?

Christian Beadell a senior solicitor in the medical negligence department considers the difficult issue of rising GP indemnity costs.

A recent report from the MDU (here) noted the spiralling costs of professional indemnity was putting primary services at risk.

Currently, private GPs are currently not covered under NHS indemnity. NHS indemnity only provides cover for the actions or omissions of staff during the course of their employment (extended to vicarious liability for work done by university medical staff or research workers under honorary contracts).

Private GPs believe this should be extended to them also as their indemnity costs are rising and this could lead to increased drop-out rates from the profession.

The MDU has promised to get to the root causes of the indemnity rises. Similarly, NHS England has commenced wider work to address increasing costs and the RCGP also announced a new GP indemnity scheme with an estimated cost of approximately 33 million per year.

Much of the blame has been placed upon the Government decision to reduce the discount rate  from 2.5% per annum to -0.75% which came into force on 20 March 2017.  The discount rate serves to preserve the principle of 100% compensation for those injured to ensure that lump sum awards of compensation that they receive now for future losses, if invested appropriately, will be sufficient to pay for those costs which will arise in the future.  The recent review was based upon three year average yields on index-linked gilts and given the low investment return, led to the reduction from the previous rate. The last time the discount rate was reviewed was in 2001 when we were in a very different economic climate and some would say that this had given a significant windfall to the insurance industry over the years when lower damages awards were made despite them being insufficient to cover against all future losses.

At the time  the Discount Rate was introduced the then Lord Chancellor Liz Truss said, “as lord chancellor, I must make sure the right rate is set to compensate claimants. I am clear that this is the only legally acceptable rate I can set.”

The Government has bent to pressure from the insurance industry to review the discount rate again and as claimant lawyers we can only hope that the principle of full and fair compensation will be paramount to their considerations.  Nevertheless, if we want a system that respects such a fundamental principle,  due consideration needs to be given to the ability of private insurers to  indemnify such claims.  If GPs are driven away from the profession due to rising costs then the will be to no-ones benefit.

There is some merit to the MDU approach. It was stated by the Government at the time of the rate change that there would be appropriate funding to cover hospitals Clinical Negligence costs as well as meeting additional costs to GPs.

Whether some form of joint indemnity between the NHS and private insurers is the way forward is a matter of discussion, but my view is that we should start such debates from the position that the victims of medical accidents should always receive the compensation they deserve.

GP negligence to be part indemnified by the Government

In July of this year, I blogged about the proposals at the time that GPs should have the benefit of government backed indemnity similar to the Clinical Negligence Scheme for Trusts which covers Hospital treatment.

It appears that behind the scenes, intense talks between the various GP defence organisations and the Department of Health have resulted in  an agreement that part of the GP indemnity will now be covered by a government backed scheme and this was announced by Jeremy Hunt, the Secretary of State for Health at the RCGP conference last week.

The scheme will not come into place for another 12-18 months and cover will only be for work provided under an NHS contract.  It will not cover certain work such as complaints, GMC proceedings or inquests but it is designed to cover risks from clinical negligence claims arising from the provision of services to the NHS.  This does reflect the increasingly blurred lines between primary and secondary healthcare , but some would say that for GPs to have the benefit of such a scheme, belies their status as individual profit making organisations that should cover their own risks, rather than the tax payer.

The background to the scheme is the increasing indemnity costs  which are purportedly pushing GPs to reduce sessions and in turn inhibit recruitment of new GPs to practices. BMA figures for 2016 suggested that indemnity premium costs were on average £8000 per year. By comparison, the average premium for a solicitor’s firm in 2016 was £4737.50 (Professional Indemnity Insurance Research report 2016-17, 18 July 2017), 1.3% lower than the previous year. However, in the case of law firms, premiums have been falling due  a reducing number of negligence claims.

If the GP scheme does indeed result in a reduction of the indemnity premiums payable by practices and allows them to expand their service then it will be  a success.

However, it is important that defence organisations pass on a real reduction in monetary terms and that this is not at  the expense of full and fair compensation for victims of medical negligence.  The misguided recommendations from the MPS in their paper on Striking  a Balance aims to limit compensation levels and does not recognise the full compensation scheme that has been embedded in UK law.  I would hope that by the government stepping in to relieve the pressure on the insurers this aim will now be abandoned.

Blog: NHS funding pledge, is this a matter of too little, too late?

Written by Assistant Litigation Executive, Nina Taylor

 

A&E waiting times have risen by a third since last July, new figures published on last Thursday show.

 

This is a disturbing trend that highlights the blurring between the winter crises and ‘quieter’ summer months. While the current government has pledged £1.8bn to upgrade the infrastructure and equipment, is this a matter of ‘too little, too late’?

 

Dame Donna Kinnair, Chief Executive and General Secretary of the Royal College of Nursing said:

 

Cash for new buildings is always welcome, but the NHS desperately needs more staff to cope with these peaks in demand.

 

Whereas, Dr Rob Harwood, Chair of the British Medical Association Consultants Committee said:

 

The recently announced spending for the NHS is welcome, if that indeed represents new investment. But frankly, these figures suggest that much more is needed if the performance of the NHS is to be restored.

 

While the NHS say they see on average 2,300 people a day within 4 hours, official figures say differently. The number of patients waiting more than 4 hours rose by 35% to 57,694.  Moreover, Patients waiting more than 12 hours almost tripled from 149 to 436.

 

Attendances at A&E are also up by 4% from last year with 2.7 million attendances. As the UK’s population ages, experts believe that by 2040 nearly one in seven people will be over 75.

 

Do we need to look elsewhere for a viable solution?

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Northern Ireland’s figures (March 2019) show on average that almost two thirds of patient treatment / discharge /admittance fell within 4 hours. As a result, 95% saw their care needs assessed for the first time by a medical professional within 36 minutes of arrival.

 

Clearly in cases where early diagnosis is key (such as sepsis and cauda equina), we know from experience that these delays can have catastrophic consequences for our clients. The sooner the diagnosis, the better their outcome.

 

While pledging £1.8bn is a start, it is hopefully not a one off payment and instead the start of a reinvestment scheme into our NHS following over 10 years of austerity and budget cuts.

Blackpool Hospital worker held over poisoning claims

A health care professional at Blackpool Hospital has been arrested over the alleged administration of poison or a noxious substance to patients.

Lancashire Police have reported that concerns were raised over the alleged mistreatment and neglect of some patients on the stroke unit at Blackpool Teaching Hospitals NHS Foundation Trust.

The employee has been suspended from duty and bailed until December 6.

Police were contacted by Blackpool Teaching Hospitals NHS Foundation Trust on November 8 after concerns were raised about the care provided to some patients earlier this month.

The allegations relate to the alleged mistreatment and neglect of patients on the stroke unit in November 2018. The woman was arrested on suspicion of administering any poison or noxious thing with the intent to injure and ill treatment or wilful neglect. The healthcare professional has been suspended.

Officers are at the very early stages of their investigation and are working closely with Blackpool Teaching Hospitals NHS Foundation Trust.

Detective Chief Insp Jill Johnston, of Lancashire Police said: “This arrest is part of an on-going investigation into allegations of mistreatment of patients by a healthcare professional at Blackpool Victoria Hospital.

“The inquiry is complicated and we have a team of specialist detectives working on this case who are also offering support to those families who have had loved ones identified as potentially being involved.

“Our priority and the priority of Blackpool Teaching Hospitals NHS Foundation Trust is to ensure the safety of patients. We are working closely with the Trust as part of the investigation.”

If you are affected by this story and would like a confidential discussion with a solicitor then please get in touch by calling 0330 013 0245.

Supreme Court find A&E receptionist negligent in brain damage case

Written by Jennifer Hales, solicitor in the medical negligence department at Fletchers

Michael Darnley v Croydon Health Services NHS Trust:  Organisations can now be held liable for the actions of non-medical staff, if misleading information is provided which causes injury.

In May 2010 Mr Darnley attended the A&E department of Croydon Health Services NHS Trust with a head injury. he should have been told that he would be assessed by a triage Nurse within 30 minutes. Mr Darnley was however incorrectly told by reception staff that he could wait up to 4-5 hours for medical treatment.

On the basis of the information provided by the reception staff, Mr Darnley decided to go home after 19 minutes.

At home, Mr Darnley’s condition deteriorated and by the time he had been readmitted to hospital he had suffered permanent brain damage.

It was alleged by Mr Darnley that if the reception staff had provided the correct advice (assessment within 30 minutes) he would have remained in hospital and received treatment thus avoiding permanent brain damage.

The High Court and Court of Appeal initially dismissed Mr Darnley’s claim on the basis that the Hospital Trust and reception staff did not have a duty of care to provide Mr Darnley with the appropriate waiting times.

Lord Justice Jackson in particular argued that to hold the reception staff responsible would open the floodgates and that Litigation about who said what to whom in A&E waiting rooms could become a fertile area for claimants and their representatives.”

NHS Resolution also commented that although this was a ‘sad case’ the ‘novel’ claim was resisted in the interests of the NHS, and that ‘opening up receptionists to negligence claims of this kind would have had very serious consequences’.

However, the recent ruling by the Supreme Court has overturned the previous judgements. The Supreme Court set out that it is well established that healthcare providers owe a duty of care to their patients and this includes the actions of Reception staff. There is no distinction between medical and non-medical staff.

The effect of the judgement is that organisations can now be held liable for the actions of non-medical staff. In the case of Mr Darnley, the misleading information provided regarding A&E waiting times caused him to suffer brain damage and long-term disability (for which Croydon Health Services NHS Trust will now have to compensate him).

This decision has implications for all healthcare providers, including GP, Dental receptionists, A&E and Ambulance services where employed non-medical staff provide advice on which patients rely.

Organisations must now take steps to ensure that non-medical staff understand the implications of their actions and that they have a duty to provide reasonably accurate and non-misleading advice.

Surgery carried out on wrong part of breast

A 51 year old woman has been awarded £8,000 due to a medical procedure being carried out on the wrong part of her breast.

The claimant attended Queen Elizabeth Hospital and was advised that she had grade two breast cancer in the left breast.  On March 21, 2017, she underwent an operation within Queen Elizabeth Hospital Birmingham which entailed removing the nipple and then going in from where the nipple was removed and investigating where the cancer was. The client was discharged the same day.

In mid-April 2017, she received a telephone call from the Hospital asking her to attend an appointment. The client attended the Hospital and was advised that the wrong part of the breast had been operated on. The client was advised that the area under the nipple did not need to be examined and that a further operation would be required.

On April 20, 2017, the client underwent the second operation at the same hospital and the operation entailed operating underneath the left breast where the cancer was located. During the operation the cancer was successfully removed.

Fletchers Solicitors pursued the case against the defendant for the negligence in relation to the failure to carry out surgery on the affected breast tissue on the March 21, 2017 leading to the requirement of further surgery on the April 20, 2017.

Following Fletchers’ investigations a Letter of Claim was sent to the defendant and liability was admitted in this case. An out of Court settlement was reached of £8,000.

Priscilla Marfoa, litigation executive in the medical negligence department at Fletchers Solicitors, dealt with the case against the Queen Elizabeth Hospital.

Priscilla said: “I am happy that the Trust admitted to this negligence which  ensured a smooth settlement process.”

The duty of candour – slow and steady progression

By Andy Tindall, Litigation Executive in the Medical Negligence team

After the publication of AVMA’s report on the inspection and regulation of the duty of candour earlier this month, the NHS’s ability to implement one of the fundamental standards of care and the CQC’s ability to ensure compliance, was once again put under the microscope.

The report can be accessed by clicking the following link:

https://www.avma.org.uk/

In a sector which, largely in the past, has been considered by some to be rather ‘paternalistic’ in its handling of patient transparency, the findings of this report are encouraging and show NHS Trusts increasing overall willingness and adherence to their duty to be open and honest with their patients when mistakes occur.

However, the report does also highlight inconsistencies amongst Trusts’ implementation of the duty, especially when it comes to complete compliance and knowledge/ awareness amongst staff and patients.

In order to completely adhere to the duty of candour, the following must occur:

  1. The victim of the incident must be notified as soon as practically possible
  2. An apology must be offered
  3. The victim must be provided with support after the incident and they must be included in the incident investigation

A written notification must then be provided in person, including an apology, with an accurate and comprehensive account of the incident and the victim must also be advised of the relevant enquiries that can be taken regarding the incident as well as any results from the investigation.

In a number of the CQC reports that were analysed by AVMA, it was identified that certain Trusts failed to adhere to all aspects of the duty of candour requirements; for example conversations with individuals were not recorded or there was evidence of an apology but not a written one. This is something which I have personally come across when reviewing medical records as part of my role as a Litigation Executive. The clinical notes may include reference to a ‘duty of candour conversation and apology given’ but a written apology is then not provided.

The importance of a full and frank apology, both verbally and then followed up in written format, cannot be underestimated and is often a source of comfort and appreciation for victims of medical mistakes. By adhering in full, not only do Trusts prevent themselves from regulatory action but it also ensures that the public can have confidence in an open and transparent system.

A further issue that came out of AVMA’s research into the CQC reports was lack of staff knowledge and training. This is concerning, especially given the varying amounts of knowledge between different Trusts.

It would seem that the most appropriate solution to this problem would be to ensure that universal and mandatory duty of candour training is provided to each Trust to ensure a consistent understanding of the meaning and importance. In addition, regular refresher sessions and information leaflets for both staff and patients (which it must be noted has been implemented by a number of Trusts) would also ensure a full and up-to-date knowledge.

It is important to reiterate, that despite the areas that require improvement, a large percentage of Trusts follow good practice and implementation of duty of candour awareness in an environment with increasingly stretched resources. However, consistent application amongst all Trusts is the key to ensuring overall public confidence and allowing lessons to be learned from when mistakes are made, resulting in future prevention.

The impact of cuts to legal aid on access to justice

Written by Eliza Esiategiwa, Assistant Litigation Executivat Fletchers Solicitors. 

The legal aid funded civil law sector has been plagued by funding cuts since the mid-2000s. Between 2006 and 2009, legal aid was imperilled to a new fixed-fee system by the government. This was followed in 2011 by a 10% cut in fee rates across all legal aid services .  The cuts enforced by the Legal Aid, Sentencing and Punishment of Offenders (LASPO) Act 2012 came into effect on the 1st April 2013.[1] The introduction of this Act was aimed at cutting the legal aid budget by £350 million mainly in areas of clinical negligence, immigration and family law. The cuts were announced despite opposition from the public, the legal profession, law society and the House of Lords.   In addition, it added that in no win, no fee agreements the losing side no longer pays the success fee, claimants would now pay it out of their damages.[2]

21st century Britain has a growing number of people who are unable to defend themselves; between 2009 – 2010, more than 470,000 people received advice or assistance for social welfare services issues, but by 2013 – 2014, after the government’s reform to legal aid, the number of people seeking legal advice had fallen to less than 53,000 – a drop of nearly 90%. [3] It is apparent after the enactment of this Act that the cuts were neither beneficial nor proportionate and it has hindered access to justice for a large group of people who are mostly vulnerable.  The government is currently undertaking a review into the effects of LASPO into the legal aid system, which is expected to be published by the end of 2018; we look forward to this review.

Britain’s most senior judge Lord Thomas of Cwmgiedd stated recently  “our justice system has become unaffordable to most.”[4]  Therefore, the notion of access to justice seeks to emphasize that it is an imperative that the system needs to be challenged. The system has shifted to economic needs i.e. the narrative that legal aid cuts are unavoidable rather than focussing on the narrative that legal advice/aid is a necessity in a civilised society. [5]

According to a recent BBC investigation, it has found that up to a million people live in areas with no legal aid provision for housing, with a further 15 million in areas with one provider. Richard Miller, head of justice at the Law Society, states that legal advice across England and Wales was “disappearing, creating legal aid deserts.”[6]

The impact of the cuts to legal aid involves the shift in government policy – the decline in social regard for the welfare of the community and individual needs. Policy restrictions in legal aid, changes in government policy combined with punitive law and order agendas will damage the fundamental understandings of due process and the rule of law – the underlying basis of access to justice.[7]  The conservation of the rule of law rest on the power of all people to have basic equality of access to the law. “If some cannot access justice because it is beyond their means, then the rule of law everywhere suffers.”[8]

To conclude, the impact of cuts to legal in aid has led to a mounting crisis in our justice system. The importance of legal aid to access to justice was captured by Amnesty, “Legal aid gives a voice to the unheard and light to those overlooked. Without legal aid the marginalised are kept in the shadows. They cannot be seen and they cannot be heard.”[9]

 

[1] Legal Aid, Sentencing and Punishment of Offenders (LASPO) Act 2012

[2] Access to Justice: A Comparative Analysis of Cuts to Legal Aid

[3] https://www.theguardian.com/commentisfree/2016/jan/16/legal-aid-review-lack-of-access-to-justice

[4] https://www.theguardian.com/commentisfree/2016/jan/16/legal-aid-review-lack-of-access-to-justice

[5] Access to Justice: A Comparative Analysis of Cuts to Legal Aid

[6] Legal aid advice network ‘decimated’ by funding cuts

[7] Access to Justice: A Comparative Analysis of Cuts to Legal Aid

[8] https://www.thejusticegap.com/2016/11/labour-lambasts-government-access-justice-crisis-following-legal-aid-cuts/

[9] Sarah Sadek of Avon and Bristol Law Centre: https://www.thejusticegap.com/2016/11/labour-lambasts-government-access-justice-crisis-following-legal-aid-cuts/