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GP 'quoted £30,000' for annual indemnity insurance

Exclusive An out-of-hours GP has been quoted £30,000 for annual indemnity insurance, in a trend that providers say could lead to urgent care services becoming unmanned.

The GP, who works full time out of hours and has not been subject to any formal complaints proceedings, was insured by MDU and has seen the cost of indemnity almost quadruple in two years, from £8,000.

The GP, who wanted to remain anonymous, has been able to reduce her premium by switching to another organisation but her employer Derbyshire Health United, which provides out-of-hours cover and NHS 111 across four counties, voiced concern that this could be a sign of things to come.

The MDU has said it is inevitable that subscriptions have to rise, and it is campaigning the Government to reform how compensation awards are calculated and to initiate caps on the level of damages awarded.

Derbyshire Health United clinical director Dr Aqib Bhatti, who was speaking on behalf of the GP, said the GP had ‘worked predominantly in the out-of-hours setting for the last 20 years’.

He added: ‘She has been asked by the MDU for almost £30,000 for this year’s indemnity costs. We have seen an increase to the cost of indemnity for all doctors but this really is taking the biscuit.’

This could be a sign of things to come, he said: ‘This GP’s subscription expires from May but for most renewal is traditionally in August, so my concern is if this is the first of a new batch of price increases.’

He added that the NHS will have to intervene to provide indemnity cover: ‘There is no way around it because otherwise we are going to be left with a service that physically is not manned.’

The quote, which was the largest Dr Bhatti himself has ever seen, comes as Pulse reported that close to half of GPs have already turned down out-of-hours shifts because of the rising cost of cover, while increasing litigation against GPs have pushed up costs for defence organisations.

The MDU said it was unable to comment on the specific example because all premiums are individual.

But it added that it agreed that large hikes in fees were ‘not fair’ to GPs and said it is campaigning for reforms.

A spokesperson said: ‘As a member owned, not-for-profit organisation our subscriptions have to be set at a level that ensures sufficient funds are collected now to support members in the future. In the face of the level of claims inflation outlined above it is inevitable that subscriptions have to rise. This is not fair and we are taking action on behalf of members because the problem can only be addressed through legal reform.

‘We have launched our fair compensation campaign in order to persuade the Government and other influencers to change the law. Legal reform has been effective in controlling claims costs in other countries and it is urgently needed in the UK.’

The Medical Protection Society said that as a not-for-profit organisation, ‘we must ensure that we collect sufficient subscriptions to be in a position to meet the future costs of defending claims against members’.

However, it also said that the ‘Government should undertake a review to consider the extent to which provision of OOH services is held back due to a shortage of GPs, what barriers stand in the way of GP uptake of OOH work and what policy proposals would tackle these issues.’

Meanwhile the MDDUS confirmed that its out-of-hours indemnity rates would indeed increase from 1 June, although it had yet to determine by how much.

NHS England said it was ‘keeping in touch with the main medical organisations about the issue of indemnity for GPs’.

It also said it was too soon to evaluate a brief trial of covering GP indemnity costs to aid its bid to place GPs on the floor in NHS 111 call centres that was run at the tail end of this winter season.

GPC urgent care lead Dr Charlotte Jones said the GPC was aware that in some cases ‘the cost of indemnity does prohibit doctors from taking on out-of-hours work’.

She added: ‘That is very, very difficult with the costs [of cover] going up. We are looking at a variety of options with NHS England and the defence organisations because we accept and recognise that the indemnity premium is becoming a more significant issue.’

A Welsh risk-sharing system run by health boards has been effective in increasing the number of out-of-hours shifts GPs are willing to take on.

However, Dr Jones said that it was not straight forward to emulate this in England where there is a wider spectrum of out-of-hours providers and local solutions.


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Readers' comments (28)

  • did someone try to find out what is the bonus/ salary of MDU directors? This is called work smart not hard.

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  • The MPS just moved into new premises in Canary Wharf. Can't be cheap.

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  • I had my premium increased from 8700 to 15700 just because there were two complaints one of which was withdrawn. The other is on-going and yet to reach a conclusion.
    I reduced my sessions from 9 to 8 and the premium is down to 14000/year.
    One has to realize that Indemnity providers put it on your record as high risk if you ask them for advice and if you send them a response letter to check and approve !
    Question arises_ what are they paid the 8700 for and is a complaint that has not been resolved reason enough to jack up your premium to almost double?
    My request for a letter of standing included a case from 2006 which said - member not involved. However, 2 years ago I was sent on a course to reduce risk and one of the cases shown as 'Open' was this case in 2006. Some of these providers act as wheelers dealers and there is no system in place to keep checks.
    The government needs to step in and take over indemnities for GPs. We are NHS employees like hospital staff and with dwindling budgets and incomes it may not be worth practising if you are to earn 60-70k and pay 15 to 30k to insurance companies.

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  • Every time I call out the medico-legal industry for being dishonest and self serving, Pulse moderate me down. We cannot run scared from words like 'cartel' and 'fraud' anymore.

    GPs can only work for one employer in an NHS that is running red hot and yet we are obliged to 'insure' ourselves against the inadequacies of this system.
    Furthermore, with everything now going out to tender and vast pots of money up for grabs, it's fairly obvious that there are huge conflicts of interests at play here between MDOs, the regulators and lawyers, private providers and the government. Urgent reform is needed now. Individual GPs cannot afford to underpin big business.

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  • A GPC member was mentioning in a talk that in the U.S, Primary Care physicians would not be insured if they saw more than 10 patients per session as that is considered the upper limit for safe medical practice.
    We have some practices who see 24 patients per session (4 hrs) and then a few extras at the end.

    We also have less beds per population compared to the insured population in U.S and most of Europe so we cant admit easily "in case of doubt". Also the average no of patients per Gp has risen and that means even when we are not seeing patients we are handling requests from hospital etc which needs to be processed.
    This rising expectation and drop in no of beds per population to admit means we are fire fighting and the proverbial is going to hit the fan sooner rather than later.
    I believe that GP`s should be covered by NHS Crown indemnity.

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  • I switched from MPS to MDU last year to try to join a group scheme and like yesterday's commenter 7.54am 29/4/15 was suprised to see I had an "open case" with MPS relating to some advice I requested regarding a dilemma but not a complaint. Although they like to encourage you to use their services for support/advice/education it's like asking for counselling for work related stress from a malevolent employer! Just don't bother!

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  • 10:58: like a mafia huh ! will give u a bad reference if you try to go to somebody else.

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  • I did my own on call for 7 years and never had to pay such a premium. It's the profession's fault for giving up being responsible for out of hours that caused this split and extra costs.

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