Fenn P, Hermans D, Dingwall R
School of Management and Finance, Nottingham University.
BMJ. 1994 Aug 6;309(6951):389-91. doi: 10.1136/bmj.309.6951.389.
The current system in Britain for compensating victims of medical injury depends on an assessment of negligence. Despite the sporadic pressure on the government to adopt a "no fault" approach, such as exists in Sweden, the negligence system will probably remain for the immediate future. The cost of this system was estimated to be 52.3m pounds for England 1990-1. The problem for the future, however, is one of forecasting accuracy at provider level: too high a guess and current patient care will suffer; too low a guess and future patient care will suffer. The introduction of a mutual insurance scheme may not resolve these difficulties, as someone will have to set the rates. Moreover, the figures indicate that if a no fault scheme was introduced the cost might be four times that of the current system, depending on the type of scheme adopted.
英国目前用于补偿医疗伤害受害者的体系依赖于对过失的评估。尽管政府不时面临采用瑞典那样的“无过错”方法的压力，但在不久的将来，过失体系可能仍会保留。据估计，1990 - 1991年英格兰该体系的成本为5230万英镑。然而，未来的问题在于预测医疗机构层面的准确性：估计过高，当前的患者护理将受影响；估计过低，未来的患者护理将受影响。引入互助保险计划可能无法解决这些难题，因为总得有人来设定费率。此外，数据表明，如果引入无过错计划，根据所采用计划的类型，成本可能是当前体系的四倍。
