This paper examines the many events that have occurred since 2001 that have had an impact on medical litigation. There have been numerous legislative changes in NSW, including an overhaul of health care and civil liability law. United Medical Protection (UMP), the principal medical defence organisation (MDO) in NSW, has entered provisional voluntary liquidation and emerged again, the first body to do so in Australian corporate history. The debate surrounding medical indemnity insurance has become a national issue, evidenced by the development of a comprehensive rescue package by the Commonwealth Government. The Negligence Review Panel, chaired by Justice Ipp, published its review of the law of negligence in 2002, with many of its recommendations subsequently implemented by the states, including NSW. Medical defence organisations are now required to operate as insurers under the supervision of APRA, rather than as mutual indemnity societies.

This paper examines these changes, analyses the effectiveness of the reforms, and highlights the concerns that still exist.