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CAMHS won't see you now

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A Medical Defence Union spokesperson said: 'GPs continue to practise safely but indemnity costs rises are due to an outdated legal system.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)

  • Why are people still discussing this as if it's just come about as a result of unfortunate decisions? Unaffordable indemnity is exactly what is intended by a party who want to destroy GPs and destroy the NHS. It was a political decision to drop the Ogden discount, it is a political decision to prevent tort reform and it's a political decision to kick this into the long grass. Putting a bit of cash into the GP contract is not going to cover the shortfall but is baiting the sharks into a feeding frenzy. Wake up.

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  • I have to say that the claims of unfairness by locums and ooh doctors should fall on deaf ears. Both groups should just up their hourly fee - that is the whole point of being a locum. That is why locums in our area charge 100/ hour.

    OOH providers should include the costs of increased indemnity in their bids for the services, and then pass that on through their pay for staff. I understand that OOH indemnity is ridiculously expensive and think it should be reflected in their pay more - that is what they should ask for (unless the employing organisation is paying for their indemnity).

    Any correction should be via the organisation that is contracted to provide the service - i.e. GMS/ PMS/ APMS and contractor.

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  • We should be covered by the NHS litigation authority just like consultants. It has always been an unfair tax on GP's.

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  • Why are patients not surcharged to cover the risk of them taking private legal action to obtain a private payment from the courts (paid for by the private indemnity insurance that GPs have to fund from their own pockets) that, as Peter Swinyard says, is calculated to fund future private treatment? Less than £10 per patient per annum would currently cover this cost.

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  • In a private sector provider this cost would be passed onto the customer,in a Stalinist system you crucify the provider until the entire system is dead. The NHS disappears in a puff of Tory illogical ideology.

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  • so if my indemnity went up by 10k per year and im working 8 sessions then id have to put my fees up by 50 squid per day. Probably not the end of the world but I think the gov should be reforming the legal system if the pay outs are to cover private care TBH.
    Is if fair to pay out for errors and honest oversights etc when no actual negligence or incompetence. im not sure?

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  • David Banner

    1- fees will rise sharply
    2- crown indemnity will NOT be offered by HMG
    3- another token amount of reimbursement will be put into the next contract
    4- more practices will go bust
    5- nobody sane will do OOH any more
    6- retired GPs will stay retired
    7- locums will become unaffordable
    8- we'll be here next year hearing the same vague promises of help from the usual suspects

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  • "3- another token amount of reimbursement will be put into the next contract"

    For what it is worth, I think the payment this year was fairly reasonable. I am not sure if it is supposed to represent changes from 2015 to 2016 - when my indemnity went up 700GBP Or 2016 to 2017 when my indemnity went up 1000 GBP, but my payment was just over 1000GBP, so about right, in fact slightly more than my increase in indemnity.

    Certainly not a token amount.

    For reference I am a full time partner. We split our payments in share of sessions including partners and salaried doctors. We don't really use locums.

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