Sunday, 17 March 2013

A day in court

Attended Leeds Crown Court recently. First time in court as a professional taking the stand to provide witness evidence for defence (no not as expert witness).

Standing in the cold, very windy, wet pavement fully drenched in a queue to go through security to enter the court building was irritating and unpleasant start. Contrast that with the NHS, we do not keep our customers/patients/visitors on the pavement wet and soaking before they get into the hospital.

I believe there was a change of judges and our judge was given the case only at 4.30 pm on the previous day. Well, well, not so different from the NHS.

Then there was the matter of the court room itself. The judge informed us that the room was that of a criminal court whereas our case was a civil case. With some humour he added that we would find all the chairs were bolted to the floor as some people in criminal courts tended to use the chairs for purposes other than sitting. There was another attempt at humour about bowels which in my personal view did not really click as the case involved a patient who had severe complications on that subject. This would have been seen as poor taste in the NHS and it would be well possible that GMC or other authorities might take a dim view of this, if doctors were to joke about this.

Barristers, though masters in their work, seemed to show significant stress, one with furrowed brows and the other with clenched fingers to the point of blanching. It is not easy for the barristers as they stop between sentences to allow the judge to type his notes. I was particularly impressed with the claimant's barrister's knowledge of the relevant anatomy, pathology and their applications to the surgical technique. They still wear the funny wigs.

I noticed about 6 or 7 large lever arch files with identical individual copies for the judge, barristers, witness and solicitors. At least 4 large document transport boxes for the defence. Two large size luggage cases, many stroller type luggage cases, many 'pilot' boxes. If you hated the NHS paperwork you may want to change your mind and be thankful that you are not a lawyer.

It is very difficult especially for lay witnesses when the 'do you recall' question is put to them only then to be countered by 'it is not suggested in the notes' response. An expert witness was shaking his head in the yes/no directions as the witnesses were speaking – wonder if that would influence the witness responses.

If you thought NHS was hierarchy bound, think again. The court had highly defined places on who will sit where in strict order of rank with the bowing and formality. Apparently barristers who did not take toilet breaks at the right time have even gone into urinary retention. A colleague made an observation that the judges and barristers did not share the same cafeteria as the witnesses and visitors whereas in the NHS doctors shared the same cafeteria as visitors. I suppose the medical professional equivalent of the much valued water cooler conversations cannot happen due to concerns of potential confidentiality breaches; a lost opportunity.

The judge and lawyers were very polite, considerate and respectful to the doctors in room. The judge noticed that senior doctors were sitting on very uncomfortable observer benches and moved them to jury box chairs (there was obviously no jury in this case) which were far more comfortable.

In my personal view the overall customer experience is better in the NHS when compared to my one day at court but obviously you would expect me to say that. In terms of what goes on insider the court room, one clinical colleague called it daunting, another called it long drawn out and boring. Personally I found the triangulation between the witness's aim (to speak the truth, nothing but the truth and the whole truth), the lawyers aim (to get to that part of the truth which will support their client's case) and the judges aim (to constantly probe which way the balance tilted) confusing and demanding; this became particularly acute while in the witness stand.

What stuck to my mind was the judge saying in mild frustration something like 'in cases involving patient care the doctors can't agree on anything and then the lawyers can't agree on anything' and carrying on with a wry smile. Shows the importance of agreeing as the starting point of good clinical care, which incidentally is the best means of avoiding the courts in the first place.

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PS: The inability of doctors to agree is part of Clinical Wrongology. An attempt is made to resolve it by asking my 4 fundamental questions

1 comment:

Anonymous said...

I enjoyed reading your review of your day in court :) Very insightful.