The department of health has established a Clinical Negligence Working Group to draft a white paper on medical errors and liability. There are many indicators that the current system of dealing with so-called adverse events within the NHS is not working well.

According to an Audit Commission Report of last year, the costs of litigation to the NHS in the vast majority of cases exceeds the value of the settlements reached. This means the NHS spends for example £10,000 on a case that is subsequently settled for £5,000 compensation.

The Health Select Committee found in 1999 that 70 per cent of claimants came out of litigation feeling dissatisfied. In particular, they felt that many of their questions remained unanswered. Remedies other than financial compensation, such as prevention of recurrence or apologies, are hard to obtain under the current system. The system is also characterised by long delays. Medical negligence cases take longer than any other in the High Court.

The threat of litigation has profound effects on staff morale and on the culture of clinical institutions as a whole. Professor Ian Kennedy in his Report on the Bristol children's surgery scandal clearly points out that what is needed is a culture change. A culture of openness and cooperation will not be achieved in the shadow of an adversarial and defensive legal system.

It is difficult to make exact statements about how often things go wrong and patients get harmed within the NHS. One study conducted in two London hospitals found that about 10 per cent of patients admitted to acute hospitals experienced an adverse event, about half of which were preventable with current standards of care.

We need to try to do several things; prevent mistakes and resulting harm wherever possible; help those who have suffered through a medical error quickly, pro-actively and cost-effectively; and find a way of doing this which does not demoralise and undermine health professionals and their work.

This government has done a lot to start implementing a proper patient safety agenda, with its creation of CHI, the Patient Safety Agency, the Council for the Regulation of Health Care Professionals and its implementation of national service frameworks. All these moves concern the level of prevention, of designing health care in a way that is safe and satisfying for patients. They are all fairly recent and a lot more needs to be done.

I am going to focus just on one example of where lack of investment puts patients at risk and makes the work and life of health care professionals ridiculously difficult: the NHS patient record system.

Too many accidents happen because a practitioner does not have or cannot find information that is theoretically available. Anyone who has ever seen piles of patient notes, unconnected heaps of paper floating around in cardboard files, cannot but be shocked. Essential, life-saving information is hidden away amongst stacks of irrelevant - at times decades old - correspondence. It is astonishing that a safety critical process such as healthcare depends on a documentation system which has changed little in two centuries.

What is needed is a huge investment in information technology for the NHS. A functioning electronic patient record is essential to the reduction of clinical misjudgement caused by lack of information. One of the longest running Electronic Patient Record systems is in the oncology department at the Norfolk and Norwich Hospital. It has served the clinicians there for at least eight years now. It has been demonstrated twice to the Department of Health, without a flicker of interest from them. We cannot afford to ignore the under-investment in information dissemination systems in the NHS any longer.

In fact the solution lies not with small scale EPR systems, but with the development of a National Medical Records system, maintained on a secure backbone, and using common and non-proprietary datasets and application through the wired NHS. There is a NHS IT strategy, it needs to be urgently implemented.

I hope this is not the only argument that will be listened to in the Department of Health, but nevertheless: there also is a strong economic incentive for bringing the NHS up to speed and into the age of information technology. It is obvious that the NHS cannot afford things to go wrong as often as they do. Medical errors are hugely expensive. According to Department of Health figures, the NHS spends £400 million a year in settling claims for negligence. The money spent on negligence cases alone would be enough to fund the work of a large health service trust for an entire year.