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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)

  • The Canadian system (why did I leave?), provides doctors with virtually 100% subsidy since 1986. One pays the indemnity organisation directly and is then reimbursed by the state. Thus the state has no control over the terms of coverage. The organisation is a mutual.

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  • yes reimbursement of fees is the only way to go.

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  • Indemnity paid, yes please

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  • If they pay my indemnity, they'll reduce my list size by another 200 patients -that's our vengeful and spiteful NHSE. I applied to close my list and support a colleague with re-training, who was blacklisted by the NHSE, they warned me not to support the colleague but I insisted - the list size dropped by 200 patients:) I am glad, however, the colleague has his registration back and is working in another part of the world.

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