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Top medical defence salaries rise by up to 45% as fees spiral

Exclusive The UK’s three medical defence organisations have boosted income for their top executives by hundreds of thousands of pounds in the past three years amid spiralling GP indemnity fees.

Some top earning medical defence organisation (MDO) executives have seen their salaries reach close to £1 million on 2015  - nearly five times the amount of NHS chief executive Simon Stevens.

The hike in salaries for MDOs’ top executives comes as GPs struggle to pay for huge hikes in their indemnity bills, which saw fees increase by an average of 26% in 2015, with one in ten GPs seeing their indemnity bill double in the period.

NHS England said earlier this month that it would subsidise GP indemnity costs with a £60 million support scheme. The scheme, which is set to launch in April 2017, will reimburse GPs the average increase in indemnity costs for the previous year.

But an analysis of the MDOs’ accounts has revealed that pay packets of the top executives have been increasing while the fees have gone up. Pulse has found:

  • MDU chief executive Dr Christine Tomkins earned £926,000 in 2015, including benefits, a 31% pay rise from £702,000 in 2014, compared with Stevens’s 2015 pay package of around £190,000.
  • The Medical and Dental Defence Union of Scotland (MDDUS), paid its highest earning executive £786,000 in 2014, up 45% from £432,000 paid to the organisation’s CEO in 2013. Executive pay figures for 2015 are yet to be released.
  • Meanwhile, Simon Kayll, chief executive of the Medical Protection Society (MPS), was paid £436,000 in 2015, up from £385,000 in 2014. Total director pay costs at the MPS increased by 35% from £994,000 to £1.34 million since 2012.

The MDOs have said that many of these increases relate to one-off payments.

An MDU spokesperson said: ‘These figures exclude one off payments in 2012 and 2015 made in return for surrendering certain pension rights.

’The MDU has been supporting members for over 130 years and our sustainability is in part because 90% of our subscriptions are spent directly on providing medico-legal advice, indemnity and risk management support to our members.

A spokesperson for the MDDUS said that the hike in CEO pay was due to ‘a one off payment’ made to outgoing chief executive Professor Gordon Dickson, adding: ‘The (2015) figures will be comparable to 2013.’

While MPS chief exective Mr Kayll said: ‘As a large, complex international organisation, it is important that we benchmark the salaries of council, including the chief executive, against the market rate for their roles and we seek to pay at the median rate.

’The chief executive’s salary is around the lower quartile of the market group, which is based on a number of mutual, similar size organisations in the financial services sectors.’

 A spokesperson for the Department of Health said: ‘Medical defence organisations are private, member owned organisations and responsible for setting the terms and conditions for their staff. If GPs feel they are not getting a good deal, we would encourage them to shop around.

‘The GP Indemnity Review found that the increases in GP indemnity were related to recent increased volume of claims, and increases in the amount of damages being paid out. We committed to support GPs with this inflation in the short term, and also to explore ways of reducing the rising costs in the long term.’

Organisation/Pay in ’000s2012201320142015% increase 2014-2015

MDU – total director pay, inc incentives






MDU -Highest paid director (CM Tomkins) salary inc pension






MDDUS- total director pay






MDDUS- Highest paid director salary (ceo C Kenny)






Medical Protection Society- total director pay






Medical protection society - Highest paid director salary (ceo simon kayall)






Readers' comments (28)

  • That's the commercial world.

    I get paid several multiples more then I did in hospital or GP land.

    In work for it and it could easily disappear.

    the execs get paid much more - some deserving some not.

    The reality is that UK doctors are grossly underpaid in relation to the risk they take on and the skills they have.

    Dr's need to understand their self worth and realize our biggest enemies are often our own colleagues ( within RCGP and BMA)

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  • what is going to be done about this? I do not wish NHS funds to be spent on this excess. this should be front paper news!

    - anonymous salaried!

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  • Peter Swinyard

    Any vacancies for a non-executive director??? I think I could find a window in my diary for it!

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  • ’The chief executive’s salary is around the lower quartile of the market group, which is based on a number of mutual, similar size organisations in the financial services sectors.’

    That tells you everything you need to know about the medico-legal industry which is benchmarking its finances on bankers bonuses whilst pricing doctors out of providing basic OOH healthcare.

    They hide behind the 'mutual society' status so we cannot issue FOI requests and they cannot be regulated like insurers. As a consequence, these lawyers are free to do as much damage to patient care and the NHS as they like without any threat of repercussion. Doctors meanwhile are compelled by rule of law to subscribe to this monopoly and cannot shop around much as there are only 3 of them! It's corrupt, out of control and time for a public enquiry.

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  • Jo Smit is right - they are not particularly overpaid - we are massively underpaid. And our being underpaid doesn't mean they should be underpaid too. We are terrible at fighting our own corner thanks to a martyr complex that is foisted upon us and that many of us carry around like a moronic badge of honour which makes life hard for all of us.

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  • whether we are under paid or not, what about the salaries mentioned above!! what risks these CEOs they have in their job. They never get sued, do they? they never have risk of catching infections. This is gross, utterly unacceptable and needs action.

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  • Jo Smit - priceless comment!

    Agree we don't realise our self worth.

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  • agree with above - they are getting the market rate.

    if we left the NHS our pay would increase as well

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  • The defence unions are rubbish.
    Their advice is mostly dispiriting acquiescence with any complaint (no measure of the morale sapping this achieves ever occurs).

    Its all part of the 'anything but see patients' establishment that has taken over UK medicine. Increasingly a self selected elite protect their parasitic interests feeding off the rest of the medical workforce.

    GMC, CQC, BMA, RCGP, defence unionts, all in the same boat - crippling our ability to get on with the job.

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  • Who wouldnt like to get 1 million a year? Good on them if they can get it without stepping over dead bodies. Agree with above comments that we do not know our worth and are being taken for massive mugs. The government has had a cracking deal for way too long. Time to wake up people.

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