MedCo was created following a belief that the obtaining of medical reports was bringing the industry in to disrepute. There was a concern about the quality of some reports and a concern that the content of some reports were influenced more by cosy commercial relationships rather than the reality of the injury that was suffered.
MedCo is being seen as an integral part of the process post law reform. At the moment solicitors can often work through the issues presented and the instances of poor quality reports to achieve the right outcome. Post law reform litigants in person will be left in no-man’s land where a doctor has failed to provide an adequate service or report
The ills that MedCo originally sought to resolve were complex and numerous but its creation has been the subsequent source of many of its problems. The role of the Ministry of Justice has always been opaque, wanting to be hands off in terms of accountability but wanting to be a puppet master when it suited. This has resulted in MedCo having the de facto brief of a regulator without being constituted as a regulator.
It is important to remember that much of the work undertaken by MedCo is undertaken by volunteers – volunteers with otherwise very full day jobs. From the outset most of them were handed the task of working with an imperfect solution without being given the time or means to create something which could materially improve the claims process and the public’s perception of that process.
There is little doubt that we are now eventually seeing, some years after its creation, some of the benefits of MedCo. Some of the data analytics is starting to shine a light on doctors who don’t understand the importance of what they do and some solicitors have started to recognise that attempts to “game” the randomisation can have serious adverse consequences for their business. However, given the cost to consumers of MedCo, (to date it has been funded by the ABI which means it has ultimately come from premium income) has enough progress been made?
The proliferation of new medical agencies immediately following the creation of MedCo was never contemplated. How those new agencies and established players then sought to achieve or retain market share has created a significant distraction for the MedCo board. The inappropriate speed of implementation may create a good reason for the initial distraction but we are still in a position where the status of some agencies is not settled and the distraction continues. This obviously has continued cost (to consumers) and also means that some agencies are focussed on battles with MedCo rather than optimising the service they provide. There are anecdotal stories about the approach to audit of some agencies which suggests that the purpose of MedCo has been somewhat forgotten in the audit. Equally there are anecdotal stories about some poor agency behaviours as well.
Ultimately this distraction means that the obtaining of good quality independent objective medical evidence in a timely manner is not being progressed in the way it should. Whilst data is helping, practitioners still know that the quality of too many reports is simply not up to scratch.
So why is this important?
Post law reform whilst the litigant in person can raise a complaint with MedCo in most instances they will not know how to do that or feel that they cannot challenge a doctor further. Whilst reporting of bad reporting is not as high as it should be by many solicitors this does at least happen at the moment and investigations are undertaken by MedCo.
There is industry chatter about the remit of MedCo being extended to cover EL/PL claims and also rehabilitation. There are many arguments why each of this extensions would not be appropriate but the fact that MedCo is essentially still struggling with its own teething problems means that extension could only be viewed as premature.
Before there is any extension of the remit of MedCo the Ministry of Justice needs to take some responsibility for facilitating a solution that works for the current purpose. At the same time MedCo itself needs to ensure that audit is focussed on achieving good quality medical reports.
At the same time practitioners need to take responsibility for identifying bad reports and doctors who do not understand their duty. More reporting to MedCo of instances of poor reporting can only help MedCo to focus their audit and training.
Ultimately the whole industry still needs to work together to make sure that MedCo is working for the consumers who pay for it.