Mr Osborne, GPs need crown indemnity
From Dr Kailash Chand, deputy chair of the BMA, and a retired GP
To George Osborne,
I write this letter to plead to you to save the jewel in the crown of the NHS, general practice, from brink of extinction.
Rising indemnity costs are having a serious impact on GPs as well as stifling innovation
Among all the other factors which are crippling general practice, rising indemnity is the one which could make general practice the least sought specialty to work in. The indemnity fees that GPs have to pay to practise have been rising for decades. When I started my career, the defence fee was £30. In recent years, however, the increasing costs of securing some types of cover have been threatening the viability of some of the services GPs provide.
Over one in ten full-time GPs pay sums greater than £10,000 a year for medical indemnity, while most are charged between £5,000 and £10,000. As GPs’ responsibilities grow, patient complaints are rising and society is becoming ‘increasingly litigious’. The reason fees are rising is because the ’cost of claims is spiralling out of control’ according to the MDU. Rising indemnity fees could force more GPs into early retirement. The rising costs could also dissuade younger doctors from entering general practice. Rising indemnity costs are having a serious impact on GPs as well as stifling innovation in primary care delivery. Doctors doing out of hours work are among those who are seeing the greatest rise in indemnity fees. We are going to have a real shortage of GPs willing to work out of hours.
One immediate step could be a repeal of the Law Reform (Personal Injuries) Act 1948, which calculates damages based on the cost of private rather than NHS care. I believe, legal reform is necessary to bring costs down and a fixed cost regime should be introduced for low value cases. Lawsuits paying out £15,000 to £20,000 end up with costs of £50,000 to £60,000. The ultimate answer is crown indemnity, like hospital doctors, which would be cheapest for the NHS and would make it easier for GPs to cover themselves.
Neither recruitment of young doctors into general practice nor retention of senior colleagues will improve until all GPs working for the NHS are indemnified by the Crown. Please Mr Osborne, even at this last hour concede this very reasonable demand from 40,000 hard working GPs of the UK.
Dr Kailash Chand OBE