IT IS fair to say that referral fees have become a way of life to most lawyers over last few years.

It was once unthinkable that a solicitor would pay somebody to refer an accident claim or a house-purchase.

For most firms it is now an accepted business expense. But is it time to reconsider?

This reversed the previous policy which was in favour. Whilst the Law Society cannot force abolition they are certainly an influential voice.

The argument against referral fees is that they limit choice and cannot guarantee quality.

So if somebody suffers an accident, their case could be handled by the firm willing to pay the highest fee, which does not mean that they are the ones best equipped to deal with the matter.

There is no doubt that a whole industry has grown based on gathering and selling cases.

On the other hand, there are those who will argue that they increase access to justice.

Despite statements about a "compensation culture", it is still a minority of victims of accidents who pursue claims.

This might be through fear of the legal process or ignorance of the right to claim. It is argued that a claims management company which acts as a "go-between" can increase awareness, meaning that justice becomes more widely available.

It will be interesting to see how this argument develops.

My own view is that banning of referral fees is unlikely in the short time.

In 2011 we will see the arrival of Alternative Business Structures under the Legal Services Act 2007.

This means that major corporations can own law firms - so called Tesco Law. Won't they see the buying of work as part of the normal world of business? Or does the very thought of that make us want to get rid of referral fees as soon as possible??

Discuss!

* Steve Cornforth is deputy managing partner of EAD Solicitors

I READ last week in the Daily Post that scores of Liverpool women are dying needlessly from breast cancer every year because their condition is diagnosed too late.

The city was found to have one of the worst survival rates anywhere in England, with almost 7% of women dead within one year of being told they have the condition.

Health experts believe the high death rate is explained by a failure to diagnose the cancer early enough.

This report was compiled by the Care quality Commission and I understand they are there to alert the primary care trusts to the problems, but the trusts will face no punishment for their failings which I believe does not seem right.

Professor Mike Richards who was appointed as the first National cancer director at the Department of Health said Liverpool's performance was "unacceptable".

He added: "These delays in patients presenting with symptoms and cancer being diagnosed at a late stage inevitably cost lives. The situation is unacceptable."

Professor Richards went on to state that many people were "pretty poor" at recognising symptoms, but also criticised GPs who needed to "play safe" and refer more patients to hospital.

As a medical negligence lawyer in the city I have vast experience of cases involving delay in diagnosing cancer and in particular breast cancer.

I do believe the people of Liverpool are better than ever at recognising symptoms relating to cancer but once the symptoms are recognised, our lives are then in the hands of the professionals which includes the doctors, pathologists, oncologists and the radiologists.

From my experience this is when the delay in diagnosing cancer starts. I have dealt with several claims against Liverpool Trusts involving:

1. Misinterpreting biopsy slides
2. Misinterpreting CT/MRI imaging
3. Reassuring clients that symptoms do not relate to cancer and therefore not doing any diagnostic testing
4. Filing results away without informing the patient he/she has cancer
5. Failing to do any chemotherapy/radiotherapy to prevent spread
6. Failing to detect family history of cancer

In my experience this is where I believe the delay in diagnosing cancer in the city is caused and in the main it is due to patients slipping through the screening net at the hospital stage.

I always hope that on conclusion of a case LESSONS WILL BE LEARNT but reading this article and speaking to new clients on a daily basis maybe not.

THE INCIDENCE of asbestos related illness has been a talking point in legal and insurance circles for some time, and has long be talked of as a ticking bomb; but what is this all about?

Asbestos is a naturally occurring substance and comes in a variety of forms, but each share a common characteristic that their fibres are both small and sharp.

As a consequence, the human bodies ability to catch and expel these fibres, as it might to do with some dust, is extremely limited and many of the fibres find their way through, especially into the lungs and chest.

Once present the resilient nature of this material that made it so attractive to industry means that these fibres can and do remain in the lungs.

However, once inhaled it does not automatically mean that an associated condition will arise, although it can only take one fibre, but it is not possible to predict precisely if or when this might be.

The most common condition arising from the inhalation of asbestos is pleural plaques, and not all those with this condition will be aware. However, it should be noted that other conditions, for example tuberculosis, can be responsible for this condition arising.

In this instance pleura, namely the membrane surrounding the lungs, is subject to localised scarring and thickening. Medical opinion remains that this does not cause any material significance symptoms and there is no evidence that suffering this condition automatically leads to the more serious asbestos related illness described below.

It has been over this condition that there has been much controversy, the Law Lords, in October 2007, found that neither the symptoms, nor the anxiety that something worse is round the corner, were sufficient to give rise to a claim; and whilst the Scottish Parliament passed legislation in March 2009 to reverse this decision, in England and Wales the debate continues.

Beyond this condition the impact on life does become more marked. Pleural thickening affects a larger area of the pleura than in the case of Pleural Plaques; the membrane around the lung calcifies and loses it elastic quality, obstructing the lungs ability to expand and results in breathing difficulties of varying degrees. There is no cure and this condition reduces the quality of life and can be life threatening in the most serious cases.

Asbestosis affects the small air sacs of which the lungs are composed, causing scarring and putting pressure on neighbouring air sacs, causing these to collapse. Again the result is a reduced lung capacity and all the symptoms associated with this.

The condition at its most severe is Mesothelioma, a cancer caused by exposure to asbestos. This mostly affects the lining of the lungs, although not exclusively, and sufferers can deteriorate rapidly. It is not uncommon for death to occur within six to 18 months of diagnosis.

From a lawyer's perspective any client who presents with a condition potentially related to asbestos would need to consider the nature of the condition, at present the House of Lords decision means that at best we can advise the victim of Pleural Plaques to keep an eye out for any changes in the law, particularly if the English Parliament takes the same route as Scotland.

Beyond this, a case would be progressed in a similar fashion, but in the case of Mesothelioma, speed is of the essence, the hard facts of life are that the victim may not be well enough to provide the necessary evidence in the months to come.

Cases can and do require vast amounts of information. In every instance, it is not enough just to consider where exposure occurred, it is necessary to give consideration to the entire employment history in an effort to establish every potential source.

It may be necessary to demonstrate that there was exposure and that this was significant enough, for which witnesses may be necessary, or documents held by the company against whom the claim is pursued.

This presents a multitude of challenges and difficulties, the working history may be over 40 or 50 years and inevitably presents the victim with the need to try and recall events over a long spell, witness may be difficult to locate, the companies themselves may have closed down long ago and locating insurers then becomes problematic, which has not been helped by the Government abolishing the need to keep a history of insurers for the previous 40 years.

Of course, it is not always from working with asbestos that health problems ensue. The wives of asbestos workers inhaled the dust particles brought home on the husband's clothes, whilst in some cities, asbestos was discarded on to the streets and children played in it.

If you think that you may have been exposed, even if you are not immediately suffering from a health problem, the first advice would be not to let this destroy your quality of life by needless worry. On this score a brief chat with your GP may hopefully be enough to put your mind at rest.

However, our advice would be to use the opportunity to make a few notes, recording your employment history when not under pressure to do so can make the task a little less fraught.

You need to consider where you worked and when, from leaving school to the present day. If you have any documents, payslips, records, etc. from previous employers do not throw these away, they may be vital in locating a company. Try and recall the names of work colleagues, even if you have lost touch.

The more information that can be provided early on in a claim the greater this will assist your lawyer.

If you think you have an asbestos related condition, seek medical and legal advice without delay.

* Simon Smith is a public and employers' liability solicitor at Goodmans Solicitors