From the point of view of an expert, the legal aid cuts are affecting us in a number of different ways. Firstly 10% of the Consortium of Expert Witnesses to the Family Courts have closed down their offices already. Secondly we can expect a significant number of experienced experts to cease work over the next 4 years as they cannot be bothered to jump through what they see as the rather insulting hoops of GMC revalidation. Of course we are currently suffering from a double whammy already; firstly the hourly rate was artificially lowered last year (and by much more than 10% in the vast majority of cases) and this October’s cuts will undoubtedly see more experts leaving the field.
But most lawyers will not notice because of the other half of the equation which is that judges in Family cases, in particular, are exercising their muscle and refusing psychiatric and psychological reports. Now far be it from me to criticise, but I have been in this game long enough to realise that judges are actually fallible. Many do understand the fundamentals of addiction, but I have observed one judge who believed that a positive hair strand test for alcohol was evidence of ‘low use’ and another who refused to believe experts who told them that sexual abuse was occurring.
Simplistic ideas seem to have developed a currency of their own; for example that a liver function test is a measure of how much someone drinks – particularly the dangerous folly that a negative test is proof of something. Equally some people seem to be of the mindset that the only way to terminate an addiction is to abstain for x years, ignoring the fact that ‘reinstatment after abstinence is one of the central tenets of Alcohol Dependence Syndrome.
Add to this a climate where government ministers show no understanding of professionalism and rubbish lawyers and experts on a regular basis and you have a situation which is pretty much akin to an accident waiting to happen. In exactly the same way that work slackened off at the point the PLO was introduced, only to skyrocket post Baby P, I fear a similar tragedy will be the only thing which makes courts sit up and notice that experts really do know things they don’t.
Expert psychiatric testimony has a 200 year history, so the idea that this generation of lawyers is that much more informed than their predecessors, is really hard to credit, especially as expert work in criminal and personal injury cases carries on more or less unabated. The sting in the tail, though, will be when we are needed again and the courts discover that the seasoned experts, trained and experienced in the sort of psychiatry needed for family cases, have diversified or retired and are no longer available. Because the truth is, that much of what we do in our clinical work is unrelated to the sorts of questions asked of us in court cases. You cannot pluck a young consultant out of the outpatient clinic and expect them to know the answers to the sorts of questions routinely posed by family lawyers.
The government’s fantasy that psychiatrists don’t need an infrastructure to do medico-legal work and that £108 an hour is sufficient pay when they can charge between £200 and £300+ to see private patients will be tested when someone discovers that they need experts again. I dare say psychiatrists will come forward to do the work but will they be experts as we understand the term today? I fear not. As more and more is expected of us in terms of training and as our medical defence premiums rise in response to the perceived risk of being sued, my prediction is that there will be precious few of us left when the call comes.