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Independents' Day

Nine out of ten GPs want the NHS to take on the cost of their indemnity cover

Exclusive A vast majority of GPs, questioned in a survey carried out by the Medical Defence Union (MDU), would like to be covered under an NHS indemnity scheme.

As part of its Save General Practice campaign, MDU asked nearly 900 GPs what they think the Government 'should do to shield GPs from rising indemnity costs'.

By far the most popular, nine out of ten (88%) of GPs supported the option of 'introducing NHS indemnity for primary care'.

The news comes as Pulse revealed that 'all options’, including state-funded indemnity, are now 'on the table’, amid growing concerns from the Department of Health and NHS England about the impact rising subscriptions are having on the recruitment and retention of GPs.

Providing Government reimbursement for GP indemnity costs was second most popular solution in the MDU's survey, with support from over two thirds (64%) of respondents.

To date, the Government covers the cost of indemnity inflation, at 52p per patient paid directly to practices via the GP contract.

Six out of ten (61%) of GPs surveyed by the MDU also supported moves to introduce caps on fees that lawyers can claim from the NHS - a proposal which the DH has consulted on but has yet to respond to.

Over half (55%) also thought that the Government should make legal changes to the way compensation is calculated to make payouts more affordable.

Dr Shaba Nabi, a GP in Bristol said: 'I know the reason for the increasing costs is because of rising clinical negligence claims, but I think it’s very unfair that GPs, who are working for the NHS, are treated differently from hospital doctors who have NHS indemnity.

'I can’t understand this. I would like to see NHS indemnity for GPs. Covering our inflationary rises in indemnity costs is not enough. We need to be covered in full to stop people leaving general practice.’

Dr Matthew Lee, MDU professional services director, said that the Government 'needs to act fast to protect GPs from further indemnity cost increases as it is facing a looming crisis'.

He said: 'GPs clearly want the same arrangements for NHS indemnity their hospital colleagues enjoy. We can see the benefits to our members of this option which would relieve them from the pressures of paying for spiralling indemnity costs driven by a toxic legal environment and the decision of the government to lower the discount rate earlier this year.

'NHS indemnity for primary care would also support NHS England’s plans to introduce new models of care under the Five Year Forward View by providing a comprehensive, consistent indemnity solution across all parts of the NHS.'

According to Dr Lee, the time to solve the problem is now, with the cost of claims rising at a rapid rate.

He said: 'Whatever happens, one thing is clear. The indemnity costs crisis needs a solution and quickly. We are already seeing large GP claims which would have settled for £8m heading towards settlement at £15-20m.'

As previously reported, MDU's survey also showed that a third of GPs are thinking of leaving the profession or retiring because they cannot afford the increased cost of indemnity.

Dr Lee said: 'If GPs aren’t supported, many won’t be able to pay the increased indemnity costs that will result. There would be a crisis in the GP workforce that which would leave patients at risk.'

GPC executive member Dr Mark Sanford-Wood said: 'This is a call that is in line with the strenuous arguments being made by the BMA and we call upon Government to address this threat as a matter of urgency.

'Continued inaction will be catastrophic and will cause the collapse of services to patients. A solution is within their grasp. History will judge them harshly if they allow it to slip through their fingers.'

NHS Resolution said yesterday that its bill for damages in 2016/17 reached £1.08bn, an increase of £132m from the year befiore. However this excluded general practice-related payouts, which are covered by the medical defence organisations.

Survey question in full

What do you think the Government should do to shield GPs from rising indemnity costs? (tick all that apply)

- 55%

- 64%

- 88%

- 61%

Source: MDU survey of 879 GPs


Readers' comments (12)

  • Vinci Ho

    (1) Nobody can say now he/she could not understand why there is a GP recruitment and retention crisis . At least ,ridiculously high indemnity fee is one of the few substantial explanations. Even if the government paid a large proportion of our indemnity fees , would be essential.
    (2) Difficult to understand that 12% did not support a crown NHS indemnity for primary care. Like to read their arguments.
    (3) Whether this crown indemnity will happen is a test and challenge of the government. If nothing would materialise , that simply showed there was in fact , no willingness, determination,sincerity or truthfulness in the GP five year forward view plan .
    Simon and Sarah , please respond.

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  • with a note of caution :I would like the level of cover to be as good and comprehensive as my current mdu cover,or if less comprehensive the option of being able to top up to achieve this-rather than a 'cheap budget minimum cover' I suppose I mean I would like option of better than 'third party ' only cover by analogy with motor insurance.

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  • My concern is who will be the client - the health service or the GP. I want someone fighting for me and my profession, not just accepting a plea and paying out damaging me because it would be cheaper than fighting the case. My other concern is that the money will be taken off the global sum in its generous entirety rather than the miserly addition we had to pay the increase last year leaving me worse off.

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  • 1) It needs to be funded out of a separate budget to GMS. i.e. new money. To an extent the patient/taxpayer needs to have liability as incentive to control costs.
    2) It needs to be at least as good as the cover in secondary care. Some top-up is inevitable to cover costs not related to claims eg GMC.
    3) It needs to happen with significant legal reforms to tort law to limit certain claims for example.
    4) We also need reform of regulation generally to put an end to the multiple jeopardy system and move towards a no-blame learning culture with scope for continuous safety improvement.
    5) There needs to be recognition that this is at least if not more important to the Forward View plan. Indemnity underpins the entire existence of the NHS.

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  • @George 1253 - I suspect you have an unrealistic opinion of what your MDO would do if there were a legal case. The MDO would absolutely consider accepting a plea for a winnable case if the cost/ risk of defending a case is too high. The individual GP has very little sway in changing their mind unless they are willing to take on the risk themselves ad defend themselves.

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  • If the government pay for this I will eat my Fez.

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  • It's the legal profession that needs reform. Why do the lawyers charge so much for fees?
    Much of the payouts not getting to the patient anyway

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  • We should almost make this a single policy issue for GPs against the government

    Have the BMa the RCGP and the GPs talk about this only and force the government to sort this out

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  • @George: Even my present MDO wanted to enter into a plea accepting my fault for one appointment which was actually somebody else's. Fortunately, I insisted and we have a closed case. I don't think the government taking on our indemnity is going to be worse than it is at present unless you have meddling from NHSE who might want to meddle with your complaint handlers and take a side route to derail you out of the profession. This doesn't happen at present as the legal issues are strictly between the MDO and you without local health authority involvement.

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  • National Hopeless Service

    Perhaps the 1:10 would like to pay mine which has gone up 12% this year. Never had a single claim. NHSEs offer of 'inflationary cover' is a piss in the wind.

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