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GPs buried under trusts' workload dump

Jeremy Hunt may announce major reform to GP indemnity this week

Exclusive The Government may be about to make a major announcement on GP indemnity at the RCGP annual conference on Thursday, Pulse understands.

Several well-placed sources have confirmed they expect health secretary Jeremy Hunt will use his speech at the conference in Liverpool to announce how he intends to support GPs amid rising costs. 

The Department of Health told Pulse its plans ‘are still to be confirmed’ but didn’t deny an announcement on indemnity was on the cards.

It comes after Pulse delivered a letter signed by more than 300 GPs to Mr Hunt last month calling for full reimbursement of indemnity fees.

GP leaders told Pulse they had made clear that full reimbursement for GPs’ NHS work ‘is the only acceptable solution’ but said health ministers were keeping the content of this week’s announcement under wraps.

The Department of Health has already pledged that it will protect GPs from rises and ‘ensure appropriate funding is available to meet additional costs to GPs'.

But this has caused a stalemate with the major indemnity organisations, saying they have held off on increasing their fees until the Government makes clear how it intends to address spiralling costs.

At the last meeting of NHS England’s board, chief executive Simon Stevens said a ‘very substantial, medium-term GP indemnity solution’ was expected in the ‘not too distant future’.

And sources close to NHS England and the negotiations said they expect something this week.

While no party would share details of the announcement, some GP leaders set out what steps the DH needed to take to avert a crisis.

Chair of the Family Doctor Association Dr Peter Swinyard said that he believed the DH had seemed open to the idea of complete reimbursement for indemnity fees, after the BMA this summer suggested that full reimbursement ‘was on the table’.

He told Pulse: ‘I haven’t had a sneak preview, but we at the FDA along with many others have made it clear to NHS England that the only acceptable solution for GPs is full reimbursement of indemnity costs for the NHS part of their work.’

‘That’s not 100% reimbursement, but certainly for partners it would relate to NHS works, in the same way that hospital consultants don’t pay indemnity for their NHS work.

‘It’s certainly what we’ve been pushing for, and I think we’ve been pushing against a bit of an open door.’

And he added that this should apply to all GPs, telling Pulse: ‘We want it to cover locums as well, because we fear they could be hung out to dry otherwise.’

Solving the indemnity problem

The Government announced last month that it was already looking at how it could reduce some of the costs GPs are facing.

It announced new legislation that would mean a rapid review of the discount rate, the formula for calculating compensation payouts, and potentially avert some rises.

The discount rate changes introduced under the last Conservative government have been at the root of the expected increases to indemnity this year.

And the prospect of a review meant indemnity provider MDDUS pledged not to increase its fees – on top of its already scheduled increases - until next summer.

And NHS England was again forced to offer reimbursement for any GPs picking up additional out-of-hours shifts this winter, despite pledging a long-term solution this year.

But Pulse has shown 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.

But 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 (22)

  • AlanAlmond

    Classic media manipulation.
    'Big announcement' that JH will soon be making a 'Big announcement'. The announcement is going to be 'very substantial' and JH is a really great guy.
    This wonderful (impossible to challenge and essentially meaningless ) statement of government spin will wash around the media for a while creating positive news for the government at zero cost. And if/when the announcement is actually made? ..expect empty crap, with a myriad of strings attached. But what does it matter, the important thing is that everybody was informed the government was making 'Big generous announcements' ..that's the news that will stick...doubly so, because noone was able to challenge this when the 'we're going to be making a Big announcement' announcement was made.
    ...and when we realise there was nothing much on offer and we point this out, the wider public will ask 'hang on you guys, I seem to remember the government made a very substantial and generous announcement, I remember that well ..why are you guys moanimg again?'

    The announcement of an announcement is more important than the announcement itself ..that is certain

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  • I would like to announce that I am going to make an announcement about Mr Jeremy Hunt shortly after he has made his announcement on Thursday.
    The announcement may or may not be unpredictable but given the subject matter, probably not.
    I am sorry to trouble you with this pre- announcement announcement, but I just felt this surge of self importance to get it out there as soon as possible.

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  • I will not be expecting much. It will be just a sticking plaster on a leaky pipe. Short term and does not go far enough. Crown indemnity like all other doctors if you have the guts to make real changes to help the NHS Jezza.

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  • I remember the last big announement this man made re GP rescue package a couple of years back.
    we were all waiting for some fantastic package/offer on the table..
    Came to the announcement ...all he wanted to talk about was the '7 day doctor working week'
    Won't be holding my breath this time.......

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  • I have a GP friend who managed to get very cheap indemnity from a medical insurance company in Italy. He spends some of his time living in Italy and working there as a private doctor performing Botox. It covers him working in Italy in addition to the UK. This may be just a one off and probably would not really be applicable for the majority of UK GPs, nevertheless

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  • No hint as to what strings will be attached, though.
    I suspect - as stated by a previous poster above - that full indemnity will be granted to those GPs willing to surrender their GMS contract and their professional autonomy and join a hospital-dominated MCP (with no right of return) as a salaried GP.

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  • What I find curious is that many salaried GP's have to pay their own indemnity at the same or a similar rate as partners. Surely if one is working for a business (which is what practices are), it is the business which is sued when something goes wrong. I am unaware of any other situation where employees are expected to cover the cost of such liabilities. When hospital doctors are accused of malpractice, it is usually the hospital trust which is sued. GP's also have to have indemnity to pass the appraisal process and stay on the performer's list - why? Appraisal is supposed to be about competence and suitability to perform. What if you don't happen to be in work at the time of appraisal and therefore do not need indemnity?
    Are there any other comparable situations or have salaried GP's just accepted an incomparable and unfair situation?

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  • Don’t expect some of our indemnity to be paid for free. Hunt will make us jump through numerous hoops and tick scores of boxes before we might get it repaid in the tax year after next. Pointless. We need to strike.

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  • Funny really, we all know the game but just cannot stop ourselves from playing it!
    Genuinely wonder wondering whether to phone Clare Gerada's helpline to try to learn how to disengage from the charade.

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  • I like Do Goods summary of things. Is there anyway we could send the message of this to the public. i.e can we go on the offensive bbc news/radio4/lbc to highlight this plight and put more pressure on government to sort this mess. surely there are bma members out there who can speak for us through the media?

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