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Why I’m not confident about the state indemnity scheme

Editor’s blog

When it was announced that the Government was looking at a real solution to disastrous rising indemnity costs, there was a real feeling of positivity.

jaimie kaffash 2 duo 3x2

jaimie kaffash 2 duo 3x2

But, I’ll be honest, the more I think about the unanswered questions with just over two months to go before its implementation, the less positive I feel.

We still need to know:

1. How will it be funded? The big question. We know that the BMA GP Committee and NHS England are in a stalemate about this. NHS England wants the funding to come out of the global sum, while the GPC wants it to be on top of existing funding. If NHS England win this battle, it renders it pretty much pointless. My interview with Matt Hancock provides little reassurance here.

2. Will it include run-off cover? You would hope that this is a given, considering run-off cover is what enables the medical defence organisations to charge the fees they do. But this has not yet been guaranteed.

3. Will it include run-off cover for MDU members now? You may remember, the MDU reduced its fees for its members when the state-indemnity scheme was announced, with the belief that the Government would fund run-off cover for incidents that took place in the transition period immediately before the state scheme is rolled out. The Government immediately said it wouldn’t.

Either way, there will be losers. The Government may relent – meaning members of the other indemnity schemes have every right to feel short changed – or it sticks to its guns, meaning MDU members will have to continue taking out an extra policy for future years. It has the potential to be a flashpoint.

4. What exactly will the state scheme cover? We don’t believe it will cover other practice staff, and there have been suggestions that it won’t cover things like fitness-to-practise hearings. So GPs are still unsure about what private cover they will need to take out.

The indications so far are that the Government wants to get away with the minimum on all these points. Mr Hancock’s comments – and the contention in the long-term plan that the scheme will be ‘cost neutral’ – suggest as much.

In which case, it bodes poorly not just for the scheme itself, but for the whole approach to general practice. Because if health bosses are not willing to invest part of that £4.5bn a year into this - a sensible idea that would immediately get GPs on side - then I fear what they will expect GPs to do to receive any funding. 

Jaimie Kaffash is Editor of Pulse. You can follow him on Twitter @jkaffash


Readers' comments (15)


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  • I find it amazing that such a scheme can be announced prior to be it being fully thought through/ costed. It is little wonder we are in such a mess with Brexit.

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  • Jaimie, you need to get an urgent interview with Nigel Watson.

    he has only just published his review and already it is gathering dust !
    This year is going to be grim for General Practice

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  • Ultimately, the market place will determine what primary care practitioners are worth AND there is remarkable shortage of the latter? Some people/agencies are in for a horrible shock!

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  • Everyone who claims to represent us eg BMA, RCGP etc have had us holding on again and again to give time for promised things to arrive
    This is something that would make a huge difference to us and doesn’t require magically finding unavailable staff and it doesn’t look like it will appear as we expected
    The fall out from this will be huge: sometimes it is the unexpected things that trigger the biggest change

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  • They will reap what they have sown one way or another, it also seems sooner rather than later.

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  • I have been saying for months that I am less than positive about this; it seems obvious that funding it properly would cost too much for our paymasters. I am pretty stunned at all the GPs who have ridden off on the unicorn offered by the MDU.

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  • @ Deborah White | Locum GP23 Jan 2019 9:13pm

    But it's not the 'Unicorns' or 'Magic Pixies' promised by 'Machiavellian PPEs' that has occasioned the demise of the medical profession. It's been the total inability of said profession to function as a united and coherent political/corporate body? Pragmatic politicians have RIGHTLY judged us as a leaderless cadre of faint-hearted, chaotic intellectuals (i.e. a community of 'savants') who are incapable of marshalling or accepting any form of leadership.
    So we continue to 'Ride off alone into the Sunset'.

    Can somebody step-up Please? Please?

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  • The only thing the BMA step up to is the trough,oink,oink.

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  • David Banner

    There is the strong whiff of expectation lowering going on here. NHSE sowing doubts that this will be a whitewash, that we will all be no better off than before, then cheer us up with an indemnity deal that is marginally better than now expected, but nothing like as all singing/all dancing as promised by Hunt in 2017.

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