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own lifestyle; should she be forced to undergo invasive proceduresfor the benefit of her unborn child; should she face contemptproceedings if she does not comply with a court order? If

jurisdiction were to extend to fetuses who were not viable thenproblems could be created within the abortion framework.

Irt re F (in utero), Court of Appeal: May, Balcombe, and Staughton LJan 17 and Feb 4, 1988.

’Opren’ Case Arbitration

SEVERAL plaintiffs, undecided whether or not to accept Eli Lilly’ssettlement terms in their actions for compensation over adversereactions to benoxaprofen (’Opren’) (announced on Dec 9, 1987)1,2sought clariflcation of the arbitration process. Mr Justice Hirst toldthem that it would be inappropriate to incorporate any right ofappeal. Exclusion of appeal was not unusual in arbitrations, andappeals on questions of fact, such as might arise in this case, wouldnot have been allowed anyway. The judge said he himself wouldconduct the arbitrations, with assistance from another High Courtjudge; the proceedings would be in private and open to everyplaintiff who had joined the coordinated arrangements except forthose who had rejected the offer and those who had already settled.The arbitrations would be based on written submissions andevidence. Any dissatisfied plaintiff would then have the right to anoral hearing, after which a further reasoned award would follow.Damages would be subject to reduction of one-third.

Comment

The legal maxim "a bad settlement is better than a good action"reflects the uncertainties, delays, and expense of litigation, and itmust be in the parties’ interests to end this unproductive andexpensive litigation, even though many questions remainunresolved. One positive thing to emerge from this litigation andother recent disaster cases may be the lifting of the prohibitionagainst "class" actions. An amendment to the Legal Aid Bill hasbeen tabled in the House of Lords, and the Law Society, with theNational Consumer Council and the Consumers’ Association, haslaunched a campaign for a non-means-tested legal aid scheme tofund "lead" plaintiffs. Issues affecting many plaintiffs could then beconsidered as one, without the fear of costs deterring or delayingaction. A better way forward, in my view, remains a no-faultcompensation scheme such as Sweden’s.

Randall v Eli Lilly and Others. QBD, Hirst J, Feb 3, 1988.

DIANA BRAHAMS,Barrister-at-law

1. Anon. No breach of solicitors’ rules in Opren settlement. Law Soc Gaz 1988(Jan 20): 3.

2 Levin J. The Opren Litigation Lancet 1988; i: 133.

International Diary

1988

Conference on Computer Science and Life-Medical Imaging andExpert Systems Applied to Medicine: Lyon, France, March 10-12(Marie-Pierre Challier, 9 Rue Chavanne, 69001 Lyon).’

2nd international symposium on Safety in Health Care Institutions:Paris, France, April 12-14 (Centre National De Prevention et de Protection, 5Rue Daunou, 75002 Paris).

International symposium on Acid-related Disorders--a Decade afterthe Introduction of Hz-receptor Antagonists: Amsterdam,Netherlands, April 15-16 (PAOG-Commitee for Postgraduate MedicalEducation, Tafelbergweg 25, 1105 BC Amsterdam).

Meeting on Breast Imaging and Ultrasound: California, USA, July6-13 (Alaska 88, Medical Seminars International Inc, 21915 Roscoe Blvd,Suite 222, Canoga Park, California 91304).

Notes and News

FUNDING THE NHS

THE King’s Fund Institute has drawn up a paper on the fundingof the National Health Service. The document,’ which has beensent to the Social Services Committee, sets out three suggestionswhich would maintain the status quo, move in the right direction, ortransform morale in the NHS. The first, which would cost the sameas last year, would ignore the 1980s shortfall, provide nurses with amodest (6%) pay award, and finance estimated demand (2%). Thesecond, which would cost jC250 million extra in 1988-89, would alsoignore the 1980s shortfall, but would provide nurses with a

satisfactory pay award (9%), and finance estimated demand. Andthe third, which would cost an extra £ billion in 1988-89 wouldrestore the 1980s shortfall, provide nurses with a generous payaward (12%), and finance estimated demand. The King’s FundInstitute recommends the second option, favouring a pay award tonurses of around 10 % and urging sufficient resources to finance the2 % real growth needed to keep pace with demand from

demographic trends, technological change, and key service

developments. However, the Institute proposes that a further sumof money, roughly equivalent to the cumulative real shortfall sincethe early 1980s, should be released to secure improvements inpatient care. This proposal amounts to a sum of about £400-450million, taking the total cost of the King’s Fund Institute’srecommendations to approximately )C700 million.

FOOD IRRADIATION

DESPITE the approval given to irradiated food by the expertcommittee report2 on the matter, the Government has decided tocontinue to ban the irradiation of food. The Government seemed atone time determined to press ahead with the process, but a massivemistrust among consumers has effectively stopped its introduction,for the time being at least. In answer to a Parliamentary Question,Mrs Edwina Currie, Parliamentary Secretary for Health, reportedon Feb 4 that 6000 letters had been received from members of the

public, interested organisations, and MPs. Further advice had beensought from the Advisory Committee on Irradiated and NovelFoods, which reiterated3 that the irradiation of food was a safe anduseful method of food processing. The committee did acknowledge,nevertheless, certain practical issues relating to the monitoring andcontrol of irradiated foods and enforcement. Mrs Currie declared inthe House of Commons that prohibition of food irradiation wouldcontinue until such a time as effective regulation was possible.Controls must include assurance about the quality of foods to beirradiated, requirements to maintain records, the licensing ofpremises and inspection of operations, the availability of detectiontests, and adequate labelling of irradiated foods and food ingre-dients. It was probably the retailers who, aware of popular mistrustof irradiated food, moved the Government. Mrs Currie warned,nevertheless, that the issue would resurface via EEC tradingpractices, since food irradiation is currently permitted in some EECcountries and not in others.

OBSTETRIC INFECTION

A SURVEY carried out by the National Childbirth Trust has foundthat of 1528 women 21 9 % suffered some infection of the pelvic areapostnatally. The NCT does not claim that its survey reflects thenational obstetric infection rate for 1986, but does emphasise in itsreport’ an apparent difference between infection rates at home and

1. Health Policy Options for 1988-89. Memorandum to the Social Services CommitteesKing’s Fund Institute, 126 Albert Street, London NW1 7NF (01-485 9589)

2 See Lancet, April 19, 1986, p 9263 Response of the Advisory Committee on Irradiated and Novel Foods to Comments

Received on the Report on the Safety and Wholesomeness of Irradiated FoodsAvailable from DHSS Stores, Health Publication Unit, No 2 Site, ManchesterRoad, Heywood, Lancs OL10 2PZ.

4. Postnatal Infection. A survey conducted by the National Childbirth Trust Available(£1.50 including postage) from the NCT (Maternity Sales), 9 QueensboroughTerrace, London W2 3TB