In this paper it is argued that courts must, where appropriate, take into account the fact that National Health Service hospitals are under‐funded when they determine the standard of care owed by such hospitals and their professional staff to patients. Although this suggestion is inconsistent with the traditional view of the courts, its adoption would bring negligence cases into harmony with judicial review decisions. It would also cohere with a new understanding of accident causation within complex organisations, which suggests that (...) many of the injuries suffered by patients in under‐funded hospitals are the result of systemic failures that cannot necessarily be attributed to those who are the last actors in the causal chain leading to damage. (shrink)