The medicolegal landscape through the lens of COVID-19: time for reform

The COVID-19 pandemic has brought out the best of the health and social care workforce globally, as acknowledged by the public. But the clapping has now stopped. Over 50,000 people who tested positive for coronavirus in the UK have died, a tragic figure that is more than double the UK Government's early ‘best case scenario’ estimate. Each death represents a life lost too soon, leaving behind grieving family and friends. At the same time, doctors and other healthcare professionals are exhausted and anxious, fearing both the implications of a second wave, and possible repercussions from decisions made under the strain of the pandemic.There has been polarised debate around whether doctors should be granted immunity from civil and criminal negligence claims and regulatory proceedings arising from treatment provided during COVID-19.1,2 Here, we argue that this focus on temporary statutory immunity is a distraction from pre-existing concerns that several aspects of the current medicolegal system are not fit for purpose – for doctors or for patients. Areas where there is no ‘quick fix’ include: the need for reform of the clinical negligence system; concerns in relation to regulatory proceedings; and the potential for BAME (black, Asian, and minority ethnic) doctors (and patients) to be disproportionately impacted in both areas. These issues are critical, since they each have a direct impact on multiple stakeholders, including on those who deliver and receive healthcare. However, there has been a tendency for these to be considered from single-minded viewpoints; accordingly, we aim in this paper to provide a more holistic view. Rather than pursuing immunity legislation, we say that the time is right for more comprehensive action, including an independent Public Inquiry to scrutinise these issues, taking into account all of the interests engaged (Figure 1).