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Independents' Day

We need to protect GPs from litigation. Here's how.

From Dr Preeti Shukla, a GP in Blackburn and GP Survival member

The spiralling cost of clinical negligence claims against the NHS in England amounts to one-sixth of the annual health service budget, which is unsustainable.

For a GP it means premiums rise substantially, making it increasingly unaffordable to work. Many colleagues in the GP Survival forum have stated that they are reducing their work and dropping OOH or urgent care work as they cannot afford to pay indemnity.

This makes recruitment and retention of GPs a far-fetched possibility and the idea of a seven-day NHS a complete failure.

The NHS Litigation Authority (NHSLA) current and future liabilities are around £25.6 billion, costing £1,030 per English taxpayer. And according to the MDU clinical negligence inflation is running at 10% and is doubling every seven years. So a claim that costs £9m now will cost approximately £18m in 2021.

I have a few ideas that could help the problem:

1. I believe that patients should receive compensation for negligence, but the NHS and its employees could be protected from litigation with the introduction of a direct system as is done for vaccines in the Vaccine Damage Payment Scheme. Over the past decade, payouts made by the NHS have trebled to more than £1.3bn a year, of which more than £200m is in legal fees. However, since 2001 only 3.2% of claims had damages proved by court and the rest were settled out of court. The NHS should not be paying for the legal industry.

The Dutch have a similar system and it seems to improve patient safety and helped develop a culture of no blame.

2. Legal reform - currently the Personal Injuries Act 1948 states that when compensation is considered, it is based on private care rather than NHS care. English damage awards are among the highest in world, including many states in the US. This high award funds the private future care of an injured patient, when we already have the NHS, social care and benefits. So we need a repeal of S2(4) of the Law Reform (Personal Injuries) Act 1948, limits on future damages and loss of earning awards. 

3. I understand that these processes take time but general practice has reached a tipping point and we need immediate action. So in the meantime, GPs should be offered Crown Indemnity like our hospital colleagues or we could follow the Welsh model where GPs are covered by the Welsh risk pool.

These reforms will help the NHS by saving billions of pounds which could be invested in the resurrection of the NHS and averting the impending crisis in general practice.


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Readers' comments (42)

  • That is an excellent appraisal of the current situation. The legal fees are frankly
    immoral. Really pragmatic and sensible suggestions to benefit all (except the legal bonanza!).

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  • Another excellent reason to jump ship! Soon we'll pay more in indemnity than we earn...

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  • Thank you going beyond just highlighting an issue we're all only too familiar with, by suggesting sound sustainable alternatives which could just well prevent a melt down of the current system.

    GPs are getting squeezed from all directions, increasing workload compounded by increasing costs. Take home profits are diminishing further as our pension contributions keep rising. And now we're being told that the tax relief on our pension contributions could be limited to a lower tax relief rate.

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  • I agree, when will Gps gain anything by these forever increases!!!

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  • Brilliant article Preeti. Well said. Since I started working as a GP my clinical sessions have gone down from 8 to 7 to 6 and soon to be 5. To ignore the contribution that indemnity plays in these career decisions is negligent.

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  • Jai ho

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  • Comprehensive review of current state of affairs with indemnity cover and its very negative effect on potential work worce. This high cost of indemnity cover is exactly the reason why I do not consider any OOH work, economically not attractive at all! Preeti also highlighted the alternatives, well done. Really good article. Thank you.

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  • Couldn't agree less! Well written article.

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  • I have opted out of Law after 2nd year after the figures of unemployed lawyers started coming out 12 years ago.

    Too many of my friends are doing no-claim-no-fee work backing hundreds of frankly frivolous claims, including medico-legal ones, hoping for a 2-3% strike rate. They have nothing better to do with their time in an overcrowded market.

    Considering that medical schools are steadily emptying, medics need no worry. Soon you will be earning enough dosh in a month to cover the most serious negligence settlements short of murder. The beauty is that you will be able to pay the patient "hush money" and the GMC will never find out.

    R.I.P. NHS

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  • Well analysed Preeti. Hope some things turns up for the benefit of GP atleast in this area

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