We have real concerns that the effect of the new PIDR will be to continue to divert funds from frontline healthcare, especially when combined with our anachronistic civil negligence system which ignores the existence of the NHS when awarding compensation. At a time of growing pressure on the NHS, it is effectively a budget cut that the service can ill afford and which can only have a negative impact.

I fear this will lead to a growing disparity between the experience of the few catastrophically injured claimants who can prove negligence and are entitled to receive round-the-clock private care for life, and the vast majority of catastrophically injured patients, those who are equally deserving and whose needs are just as pressing but who have not been negligently harmed.

Such a two-tier system is not only unjust, it is a considerable incentive for more people to bring claims. It also risks creating a vicious circle where the small minority of successful claims deplete NHS resources further, to the detriment of patient care.

To use an analogy with which we are all now familiar, the iniquities of the civil negligence system have driven the health service towards a cliff edge. Only root and branch legal reform will truly address this crisis. Tinkering with PIDR rate has simply made matters worse.

As a doctor, it saddens me to watch the NHS damaged in this way. It is time for the government to take this issue seriously and stick to its promises.

Disappointments over the discount rate

Dr Christine Tomkins

Disappointments over the discount rate