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Independents' Day

Defence body subs approach £7,000 a year - but are they worth it?

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Seven thousand quid, eh? That would buy you one pretty nice holiday, seven ninths of a year’s tuition fees at many universities or the exact amount of caffeine I require per annum to stay vaguely functional.

Except you can’t use it for any of the above, because you’ll need it for this year’s defence body subs.

I know I’m at risk of sounding like a flatulent old bore, but £7,000 seems like an awful lot of money to have someone watch my back for 12 months. In fact, I reckon it’s not far from my starting pay when I was a pre-registration housedog. And I can still remember the profession going mental when subs first broke through the £1,000 barrier. Seems like only yesterday, in fact - and quite possibly was, given that these fees are rising exponentially.

At this rate, in a year or two, standard GP defence subs will surely top five figures. True, a clampdown on ‘no win-no fee’ should ease the pain a bit.

But to counterbalance that, we only have to look at what’s currently being asked of us in the Brave New Commissioning World, and how that could explode with a big medicolegal bang.

Never has cost-cutting in primary care been more explicitly in our faces, or rather, dumped in our laps. This translates into enormous pressure on us to not do things which patients specifically want us to do, such as refer, prescribe, admit to hospital and investigate.

And what, like one of Pavlov’s dribbly dogs, does the average punter do when the word ‘No’ rings his bell? Correct: complain.

Patients have developed a zero tolerance policy to denied instant gratification at the very moment that GPs are being boxed into a high risk form of practice.

And because I’m too busy reading CCG briefing papers on cost-cutting which will require me to attend CCG meetings about cost-cutting which in all likelihood will have me spending a good deal of time banging my head repeatedly on the desk over CCG cost-cutting, I haven’t the time to spend on the one activity the CCG isn’t actually trying to cut and which patients value above all else: the house-call. Nothing gets a patient’s litigious goat so much as the doctor ‘refusing to visit’.

All of which means that £7,000 is starting to look like something of a bargain.

Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield.

Readers' comments (5)

  • Given tax, NI, pension contributions,practice expenses including professional fees there are powerful disincentives to full-time working in GP now.

    Surprised we have increasingly part-time workforce?

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  • Wasnt crown indemnity brought in when obs&gobs fees went over 5K, and the rest of us were paying around £500.
    Crown indemnity would be difficult to apply in primary care, although could a CCG purchase group cover for their area?
    Locums now have to work over 2 months to pay this off before receiving a living wage - the current arrangements aren't sustainable

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  • As a salaried GP, I asked for my contract to include costs for indemnity insurance - good decision!!!

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  • MDDUS is a cheaper alternative. An online quote for a GP partner working 7-10 sessions is £4,930. Do a price comparison?

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  • It's time for indemnity costs to be handed back to the ultimate beneficiary - the taxpayer. This would concentrate minds on getting medico legal costs down!

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder