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Independents' Day

GPs paying £35 per hour for indemnity fees as LMC leaders vote for full costs to be covered

GP leaders have called on the Government to directly reimburse the costs of medical indemnity, and to acknowledge the current system is making it uneconomical for GPs to work out of hours.

The annual LMCs Conference in London today heard that some estimates from medical indemnity providers put the cost of out-of-hours indemnity at £35 per hour.

The proposal to the conference, from Nottinghamshire LMC, called for GPC to investigate the pros and cons of GPs’ inclusion in the crown indemnity scheme which covers staff directly employed by the NHS.

The motion was passed in full, but GP leaders did urge caution about the limitations of crown indemnity, which would not cover GPs for criminal claims, and would limit GPs’ defence to what was best or cheapest for the NHS, and not neccesarily the best interests of GPs and their reputations

The proposal also expressed concern over reports that indemnity providers were unfairly refusing cover to GPs deemed a ‘high insurance risk’, thereby ‘denying them the means to practice and earn a livelihood’.

Dr Adam Harrison from Nottinghamshire LMC told delegates: ‘The insurance risks of undertaking out of hours work, or any services not performed by the generality of GPs, are viewed by the defence bodies as justifying premiums which render it uneconomic to continue to provide such services.

‘One estimate puts the indemnity cost of undertaking out-of-hours work, at £35 per hour.’

Dr Andrew Purbrick from Dorset LMC told delegates: ‘We’re the ones that have to take on the additional risk, and responsibility, that goes with [managing patients in the community].’

Dr Saqib Anwar from Leicestershire LMC said: ‘Doctors have seen an unfair and exponential rise in their defence union subsidies, the situation can now truly be declared a shambles.’

‘The supposed individual risk assessment, which cannot be shared, which cannot be validated as a result of commercial sensitivity, has seen premiums rise for GPs in my area alone, by a magnitude of 150%.’

An addition to the original proposal, by Cleveland LMC, calling on Government to directly reimburse the costs of indemnity cover for GPs was passed unanimously.

Dr John Canning from the LMC asked delegates if they would trust the NHS to defend them, though the NHS crown indemnity scheme, or whether they had attended the AGMs of their indemnity providers to hold them to account. The answer he took to be ‘no’.

He added the current model of reimbursing GPs indemnity expenses as an average across the practitioner population no longer worked and a direct reimbursement was needed, saying: ‘we should get that money back because we are needing to spend [it] to be able to practice in the NHS.’

Motion in full

NOTTINGHAMSHIRE:  That conference:
               (i)    is alarmed at the increasingly prohibitive costs of medical defence cover for GPs - Unanimously carried
               (ii)   is concerned that medical defence societies are unfairly refusing cover to GPs deemed to be ‘a high insurance risk’ thereby denying them the means to practice and earn a livelihood - Carried
               (iii)  invites the government to acknowledge that the cost of medical defence cover is making it uneconomic for GPs to participate in OOH or other non-GMS work and to investigate ways of subsidising these costs; - Unanimously carried
               (iv)   requests the GPC to undertake a study of medical defence cover for GPs, to address current concerns and determine the pros and cons of crown indemnity being extended to GPs. - Carried
  (v)  Calls on Government to directly reimburse the costs of indemnity cover for GPs.

<<< Back to LMCs Conference 2015 coverage

Readers' comments (17)

  • £30,000/yr for OOH GP insurance....what's the point in working when all the money is eaten up by can cost more to work than not!!!

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  • Which other profession is paying 15- 20% (some have to pay more than 30%) of their earnings as insurance fees?

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  • Government indemnity is needed urgently to protect the viability of UK primary care but this is just a sticking plaster. The real need is to regulate and push back the claims culture that is profiting off the back of the NHS. The public need to accept that medicine is complex, we cannot explain every symptom nor can we prevent every cancer and save every death - it's not for want of trying. Sometimes things happen because of bad luck. No examination is 100% certain no test is without it's drawbacks. We will always miss some pathology and some treatments go wrong or have adverse consequences.The law-courts need a large dose of scientific reality.

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  • 1. I think people should not get compensation unless there is gross negligence from someone who has done it reapeatedly not just because someone missed something once or made a mistake. Medical treatment should not come with a guarantee and perhaps we should make our patients sign a disclaimer such as when I went downhill mountain biking in whistler:
    'the doctor does not take responsibility for any illness or injury as a result of treatment given or not given. see this doctor at your own risk.'
    ha ha. im actually not joking. then we wouldn't need insurance then.
    2. Otherwise we just charge more to cover it. Ive negotiated fees with out of hours and said look ill do that shift or £100 (rather than 80 offered) per hour if you don't cover it etc. If what they offer isn't worthwihile due to insurance costs we make our own offer and they take it or leave it like any business would.

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  • Brilliant point. We pay buckets into a made up litigation industry for the privilege to get bashed and not much of the public know that. There is a dirty conspiracy of fear here, almost dictator like.

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  • Maybe this is what Mr Hunt is going to announce as part of our "New Deal" next month ;-). As a GP and also MD of our OOH Service this would be so very welcome!!

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  • I am still surprised GPs are working for OOH companies.

    Investment in OOH has increased but pay remains the same. The costs as we all know have gone up dramatically.

    The best way to deal with this is to ask for a fair wage or stop doing it - that will get the government listening.

    However I am worried about this new contract - no one seems to know anything about it!

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  • Lot of hot air. Until you are prepared to strike, the Govt will ignore you.

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  • Lawmakers are lawyers - they will not go against MPS or MDU because they may have children working there as solicitors and advisors. Hard to expect, therefore, that anything will change and in all probability the collaboration between government and the indemnity providers will continue till all the rats have deserted ship

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  • Anonymous | Salaried GP | 22 May 2015 12:41pm

    Until recently Independent Midwife insurance was around 20k. For the part-time IM this would quite often cost more than they were earning, effectively putting them out of business.

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