A review of statistics concerning fatal medical negligence in the NHS shows that, despite fears of a ‘compensation culture’ and the right to life protected by Human Rights legislation, only about one in every 1,000 such cases is investigated by the courts. This appears to be largely due to very poor reporting of adverse incidents by health authorities. However, as a result of recent healthcare scandals, the reporting of incidents is expected to significantly increase in the near future. The case of R v Southampton University Hospitals NHS Trust 2006 illustrates the striking effect that enhanced levels of scrutiny can have in these cases. While there was nothing extraordinary in the facts of this case, and the hospital’s safety record did not appear to be any worse than average, the doctors involved were convicted of gross negligence manslaughter and the hospital was heavily fined under Health and Safety legislation for systemic failures. R v Southampton demonstrates that poor hospital systems are not immune from legal action in cases of fatal medical negligence, and recent developments suggest considerable potential liability for the NHS in this respect.