Stuart Hislop has been involved with medico legal work for 23 years and works both for the prosecution and defence. He carries out between 30 and 35 reports per year and attends court less than once per year as an expert witness; he speaks with Lawyer Monthly about the cases he often sees and what could be done to avoid lawsuits.
What are common cases you are instructed on as an expert witness and why do they arise so often?
The most common cases I receive are trauma cases but also cancer cases where the initial cancer has been missed by the relevant clinical practitioner. They tend to arise because there seem to be a lack of education for primary care practitioners particularly medical practitioners. Cancer awareness and diagnosis is now core clinical professional development for the dental team, however there have been several cases where cancers have been missed by dentists. There is occasionally a problem with the practitioner not believing patients symptoms or not having the clinical acumen to detect the clinical problem.
How has the medical profession changed over the years, and how have these changes affected lawsuits?
The biggest change in medico legal practice for me has been the introduction of the duty of candour and the involvement of patients in their own treatment. The duty of candour should reduce the number of lawsuits as should the patient involvement. One way of improving the candour would be to have no fault compensation.
With cancer being so common, do you think any changes could be made to avoid lawsuits involving the conditions?
There needs to be more education for primary care professionals, but also more time for consultation in primary care to help elucidate the complexities of the problem. It is a balance because now we are seeing a lot of trivial conditions being referred to secondary care because of the worry of missing something. We also need to improve our communication with patients as I see some lawsuits due to poor communication with the patients and a misunderstanding of prognosis, side effects and complications.
If you could alter one thing about the process you undergo as an expert witness, what would you change?
Generally, I think the system works well. I would like to see improvements in the time the legal aid board pays for cases, but I think generally I have no real problems.
Stuart Hislop
01563 527488
stuart.hislop@aaaht.scot.nhs.uk
My name is Stuart Hislop and I am a consultant oral and maxillofacial/ head and neck surgeon specialising in head and neck cancer and its reconstruction. My areas of expertise are oral cancer, head and neck skin cancer and salivary gland cancer. I am also part of the skull base oncology team which involves maxillofacial surgeons, ENT surgeons and neurosurgeons. I also specialise in advanced reconstruction following ablative surgery. This includes the raining of distant flaps and microvascular reconstruction. I am also involved in the treatment of facial injuries. I participate in research, audit and clinical governance.
