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DH pledges to protect GPs from looming indemnity fee hikes

Exclusive GP practices can expect to be reimbursed if, as expected, the indemnity providers radically increase their prices in the next few months, the Department of Health has said.

Medical defence organisations are expected to increase fees 'within months' because of increasing costs to lifetime payouts in clinical negligence cases, directly linked to the reduction to the discount rate that came in from March this year.

The BMA's GP Committee has said it is in 'urgent talks' with the Government about increasing reimbursement, which is £30m for this year, or 52p per patient for each practice. However the DH has told Pulse it will not announce any increase to this until the medical defence organisations actually increase their fees.

But when they do rise, a DH spokesperson said funding would be made available.

The spokesperson said: 'The Department of Health will work closely with GPs and medical defence organisations 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.'

Asked whether they are due to increase fees, the defence organisations said they were awaiting the outcome of ongoing talks with the Government.

A Medical Defence Union spokesperson said: 'GPs continue to practise safely but indemnity costs rises are due to an outdated legal system. The Government’s decision to drastically reduce the discount rate used for calculating compensation payments has made matters much worse.

'The sad fact is that our current subscriptions, while unaffordable for some GPs, do not yet reflect the true cost.

'The MDU has held back from charging the full subscription to take account of the discount rate because the government has since February promised additional funding. We are continuing to discuss this issue with the Department of Health to find a solution.'

A Medical Protection Society spokesperson said: 'MPS has not yet made any changes to membership subscriptions for GPs to reflect the reduction in the [discount rate], as any changes will be dependent upon the outcome of our discussions with the Government.'

The MDOs have raised serious concerns about the discount rate changes, which they have said would double the cost of some payouts, and last month Pulse revealed that the DH was urgently reviewing the threat to GPs.

But the plans for further reimbursement comes as LMC leaders have condemned the current scheme, which sees practices receiving the top-up funding based on patient list size, for being 'inequitable'.

Dr Fay Wilson, a GP in Birmingham and medical director for out-of-hours provider Badger, said the reimbursement scheme has 'not done a thing for out of hours and urgent care'.

She said: 'If the discount rate changes come in, which they are going to, and if indemnity rates double, I can’t see how people are going to carry on.'

Solving the indemnity cost problem

New GPC chair Dr Richard Vautrey has warned that working as a GP would become 'untenable' for many as MDOs were expected to raise fees this autumn and many GPs have already reduced their sessions due to soaring legal costs.

Ministers in England made a two-year commitment to bear the cost of any indemnity cover increases for GPs and have indicated this will continue past 2019.

LMC representatives voted in May for GPC to negotiate full reimbursement of indemnity costs for GPs and for any future reimbursement scheme to target individual GPs directly.

Although the push for a long-term solution is taking its time to materialise, the GPC has said that ‘everything is on the table’ in their discussions with the Government, including a state-funded scheme.

Readers' comments (18)

  • Meanwhile..........
    Back at the college,the grown ups, in gangs of 9, are advising the children, to put their financial necks in the indemnity noose;
    Since the GMC appear oblivious to this unfairness,perhaps the NSPCC should act

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  • Peter Swinyard

    The root cause of this has to be addressed - the legal framework in which awards of damages are decided. There was legislation passed in 1948, bizarrely the same year as the NHS was founded - which required judges to award damages to reflect the probable cost of full private care for the remainder of the victim's lifeltime. As most victims of medical accidents or negligence continue to use the NHS, there is double funding there, which needs to stop. There are also all sorts of legal twists and turns in the law of tort (I am not a lawyer) which have cumulatively increased the burden of the guilty or presumed guilty. The discount rate is the icing on an already fruity cake.
    This requires political will to change - and soon - if doctoring is not to be priced out of business. Some years ago, my sister in law having a baby in New Orleans saw on the wall of her doctor's office a notice which said "I have no insurance. I have no assets. Feel free to sue me as you please". Only the GMC ruling that we must carry insurance avoids a similar pattern here.
    While there is a chance for salaried and partner doctors in practice to get reimbursement, this does not cover locums or those with portfolio careers.
    I continue to represent these views to NHSE (which actually does get it, although they have not yet sorted it) and government whenever the opportunity presents.

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  • Full crown indemnity for all GPs.
    That will help.

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  • What is the argument against crown indemnity? It must be powerful as the argument for it is strong. I assume that the unofficial policy is to do little and hope that local solutions emerge eg. group policies etc.

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  • Instead of faffing around - if we were fully covered by the state for indemnity (we will need some extra for our practices etc which is acceptable) means there is no ambiguity and I for one would do extra sessions and work

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  • No mention about how to help locums. I'm please to see Peter Swinyard (above) has picked this up. Locums are expected to claim this back through whatv they charge practices, but there is alreadsy an official cap of £80 per hour (which I have already reached). I have not increased my rates this year and, if indemnity premiums continue to rise, my only option will be to leave completely. I'm certainly not going back to salaried work at 57.

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  • Very important to ensure indemnity for locums and especially for those with portfolio careers.

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  • Cobblers

    12:34 John. Official cap my backside. You are independent. Charge what you like. Going rate round here (deprived south east) is £100 per hour plus extras.

    The practices are told to report any payments above £80 per hour. And then what? Will the NHSE & DoH send the boys round? Doubt it when washed up politicians are getting £2000 for less than an hour's presentation.

    Free market innit.

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  • That's fine to get reimbursed for ever increasing indemnity fees but where is the money to come from? Presumably there will be cutbacks in other areas to pay for this. For GPs to get crown indemnity will likely need all GPs to become salaried to the state so that the beaurocrats can have complete control over us and that is what the fat controllers all medical practitioners are fully state employees.

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  • I don't really get this. "The MDU says that they've held back charging the full rate to take account of the discount rate". I renewed last month at my standard six sessions Locum and the rate went from £8000 to £9600 without me accessing the MDU once that year, and they sent me a letter advising that the rate change was specifically because of the change in the discount rate. If this isn't taking it fully into account then just how high can it go? Much further and we're beyond tolerance.

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