Advising with empathy and experience

Mediation suggested for medical disputes.

The NHS could save millions of pounds if families and doctors were offered mediation when they disagreed on treatment, a leading consultant has proposed.

An anaesthetist at Royal Berkshire Hospital, Reading, Dr Chris Danbury, said it should be made a legal requirement in England and Wales.

He suggested that examples of when mediation should be used included disagreements in whether to turn off life support and this would avoid a case going to the Court of Protection, he said.

Another instance was when a mentally competent patient did not want to accept a treatment they which medically required.

Dr Danbury, a consultant intensive care physician, said it is not just the cost of going to court that is problematic but that resorting to legal proceedings can have a damaging effect on the relationship between the medical team and the family involved.

Speaking at Euroanaesthesia 2016, Mr Danbury said: "Mediation can be done informally, perhaps by getting another clinician within the institution to act as an 'honest broker'. If this fails, then a formal mediation process can be initiated with legal representation on both sides.

"Mediation costs a great deal less than going to court and often preserves the relationship between clinical team and their patient and their representatives, which can otherwise be severely damaged by the rigors of court proceedings.

"Sometimes misunderstandings can occur very easily. One doctor may not explain something very well to a family, but once a colleague intervenes, the situation can be calmed down very quickly.

"However, if this should fail, then the default option should be to go to formal mediation by an independent third party. It's never too late to talk, and the cost savings to the UK NHS, or any other country adopting this, would be immense."

However, Debbie Whiteley, whose son Tom died from a brain tumour when he was nine years old, said parents of seriously ill children in hospital were very vulnerable.

She said: “At such times, you become very institutionalised and it's a really vulnerable time. I worry about mediation because it's fine as a form of explanation but not as a form of persuasion. Whatever the outcome you have to life with it for the rest of your life."