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Government-funded GP indemnity 'on the table', say GP leaders

Exclusive NHS leaders in England are scrambling to cope with a massive projected rise in indemnity fees this year, with GP leaders saying that now 'everything is on the table', including a national scheme to cover costs.

Pulse understands that stemming the rising cost of GP indemnity has moved to the 'top of the agenda' in meetings between the BMA's GP committee and NHS England.

The urgency comes after the Government decision to reduce the 'discount rate' from March this year, which medical defence organisations say will mean lifetime payouts have risen by millions overnight with an immediate impact on their costs.

Speaking at the Pulse Live conference in Newcastle, newly-appointed BMA chair Dr Chaand Nagpaul said they were in discussions with NHS England and that 'everything was on the table' in an attempt to help GPs with what could be a very steep rise in indemnity costs.

Speaking in the first interview since his appointment to chair the BMA Council, former GPC chair Dr Nagpaul said: 'The arguments in favour of having state funded indemnity or covered by the provider is very much something we are having dialogue about.

'I would say that It is a little more complicated than meets the eye. There are issues around GPs, partly because we are not employees, [but] it is certainly something we are looking at actively as part of a wider discussion on indemnity.'

Also speaking to Pulse, acting GPC chair Dr Richard Vautrey said that rising GP indemnity is currently 'very much at the top of the agenda', with the GPC in 'live discussions with all parties' about urgently increasing the size of the funding pot put aside by NHS England to cover GP indemnity inflation.

The £60m pot, which sees GP practices receiving 52p per patient, has been pledged for this year and next as an interim solution to rising costs. However, this is based on an old projection of indemnity costs rising 8% per year.

Dr Vautrey said: 'There has been very detailed discussions about that. It is very much a live issue at the moment. Both [the Department of Health] and NHS England are very aware, and we have made them absolutely aware, of the imperative of sorting this out as soon as possible. These discussions are very much ongoing.

'The £30m that was put in for the rise for this year's indemnity and last year's indemnity is relatively tiny compared with the significant increase in indemnity costs that would be incurred if the discount rate impact went ahead in the way that has been projected by the MDOs.'

He added: 'We need clear answers to this situation now given, as you've seen, the MDO campaigns, they're very aware that there would be a significant rise in indemnity costs and therefore the fees of MDOs if the system didn't change.'

However Dr Vautrey poured cold water on the option of the Government becoming responsible for GP indemnity, saying that 'has always been one of the options looked at', but that GPs would still require 'some form of personal indemnity' to be 'absolutely certain that their own professionalism would be defended'.

He said: 'You need your own personal indemnity to be able to guarantee that you are going to have somebody standing up for you, not just the organisation.'

According to a spokesperson, the DH position remains that it will 'work with' GPs and the MDOs 'to ensure that appropriate funding is available to meet additional costs to GPs, recognising the crucial role they play in the delivery of NHS care'.

Pulse approached NHS England for comment, but they did not respond in time for publication.

What is being done about GP indemnity?

Both NHS England and the Department of Health have made the cost of indemnity for GPs a priority area.

They have funded a winter indemnity scheme to cover additional costs of working out of hours, and the DH said earlier this year that it intends to bear the cost of rising indemnity 'into the future'.

Despite this, it has made no moves to increase the short term fund of £30m set aside for this year and next to cover indemnity inflation in light of new developments that MDOs say will lead to indemnity cost hikes.

The Medical Protection Society (MPS) launched a campaign last month to bring down the cost of indemnity for GP members by reducing the overall NHS litigation bill.

MPS said this comes as almost nine-in-ten health professionals are concerned that if the cost of clinical negligence claims continues to increase at the same rate as currently, this will 'threaten the sustainability of the NHS'.

Although MPS' suggestions for legal reforms go significantly further, the DH has yet to respond to a consultation on plans to cap the fees lawyers can claim in negligence cases.

Readers' comments (14)

  • PLEASE LET'S BE EMPLOYED GPs. NO MORE 60 HOUR WEEKS AS THIS WOULD BE A BREECH ON CONTRACT, 6 MONTHS SICK PAY AND PENSIONS PAID.
    NHS ENGLAND KNOW THAT DESPITE THEIR "POLITICAL VIOLENCE AND VICIOUS BULLYING OF GPs" THAT WE ARE AMAZING VALUE FOR MONEY

    LET'S DITCH THIS DREADFUL DEAL AND ALL GO SALARIED

    "THEN WE CAN SAY...AIN'T MY PROBLEM".

    NHS ENGLAND WOULD NEVER BE ABLE TO RUN GP SURGERIES, COSTS WOULD SKY ROCKET BUT THEN THIS IS WHAT THE "DAILY NUTTER" ("A MORAL CRIMINAL") WANTS.

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  • I fear the 52p fig leaf is as good as it will get from this government.. The massive hikes coming down the pipe may well be the proverbial final nail in the GP coffin. OOH will finally collapse, retirees will see no sense in returning, and everyone else will look to reduce their sessions to cut their MDO bills.
    Et voila, Primary Care run by cheaper nurses working to protocol, with those pesky expensive GPs put out to grass. Mission accomplished.

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  • if there was a will it would be easy for govern ment to include GPs indemnity within the NHS fold.

    Its just not an issue in Europe, we've gone down the US road with regard to medico legal practice and everyone is getting defensive.

    The amount of time Pharma spends ticking boxes over medico legal protection is enormous - some very necessary much is cautionary.

    Again it only the fact that GP's who have never had an issue are now no longer able to afford to work that may bring on change despite this being an issue for sev years!!

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  • This needs to be dealt with urgently

    It almost needs to be the only conversation Over he next few months

    A government funded indemnity is much needed

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  • The indemnity for nurses and alternate practitioners will also be too high

    Its why many of those projects to bypass GP's have largely faltered

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  • NHSE is not interested in saving surgeries. they favour Surgeries with LMC and CCG members or APMS and Private Providers - that was the Tories agenda and NHSE is just a dagger in the hands of the government to dig into the heart of NHS and offers it's entrails to private sector on a platter.
    MPS sheds crocodile tears while preparing dry enema for GPs and having a 2 billion pot as reserves - (from their annual report). Govt won't take on indemnity - GMC and BMA have no teeth and are impotent. What's on the table, stays on the table - forever.

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  • Time for the Government to nationalize the MDOs .Make all their employees publicly funded and have a stake in the risks we take on thier behalf.Then maybe they will think before changing the compo laws.

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  • This is ultimately an issue of power. At present the balance is so far in the legal systems favour that we are effectively working for them in both fees and defensive practice. Since market forces always win we now have the present mess of GPs simply leaving because they can't afford to work. Everyone except politicians and lawyers looses in this scenario. Give is some powers back to defend cases more easily, cap claims, limit liabilities, counter-claim and seek alternative income with more choice of indemnity provision and the present situation would resolve. This won't happen because the Tories know they can use this to destroy the NHS once and for all.

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  • Cobblers

    Let's not focus too closely here on GP Principals. Working for the NHS all should be covered, automatically, by a National Indeminty Scheme. That would cover Hossie docs, GPs AND locums.

    That being said I might buy 'top up' cover as the Government Indemnity Scheme still might feed you to the wolves.

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  • Why can't there just a simple system of reimbursing us for our cover. I can't see that there could be a one size fits all solution, as there are now so many locums, OOH gps etc.Also, I don't think we would want to lose the often personal relationship we have with our Defence unions, as any of us can testify when we have had to call for help.

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