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GPs go forth

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.

Yours sincerely,

Dr Kailash Chand OBE

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Readers' comments (16)

  • Where do we sign to back this? Spot on.

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  • The other thing would be to relax dispensing laws and allow us to see them privately if they so wish. Taken together these three reforms could transform things.

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  • But all Uncle George will say is...OK we will pay crown indemnity but we will dock all GPs income by £10,000 a partner.

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  • Do we need to plead for this?????? Isn't it obvious? that this is one thing government can do if they want to save GP and NHS. Big question is do they want to save it?.
    From the behavior of Hunt the dictator it does not appear that he wants to save NHS. He is taking all the precautions to dismantle it ASAP. Hence attack on doctors on all fronts (Junior doctor/Consultants /GP). I hope Mr Chand soon realizes that begging will not achieve anything. If we take militant options then only Mr Hunt or whoever is in power will listen.

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  • I agree this is a demand, not polite request

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  • Subscriptions are truly killing !

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  • Come on, people - stop your whining and actually sign the petition. As GPs, we are very good at moaning, but not so good at putting our money where our mouth is, and actually doing something.
    sign the petition

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  • Mr Mephisto

    The view sold by politicians and the press is that the patient is always right and the doctor is always wrong. Since the politicians seem to have whipped up the public into this doctor suing frenzy then they should at least pick up the bill.

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  • Pradeep Bahalkar & Roger Boyle there is a game to play here. A demand made cold tends to be unsuccessful. First you warm the public up to the concept, and whip outrage up in the profession, and then demand with the backing of the masses.

    We must learn from the Juniors and manage the message better. Nothing in our demands for the rescue package should be new news - first get everyone on the same page, and then you can hammer it home.

    And to all the purists, forget it. You need celebrity and social media to make it work. So get it on the Last Leg, and push it through every twitter account you can muster. Democracy is not won at the ballot box - we only elect our temporary autocrats. If you want them to listen to the will of the people, first you must shape that will, and then focus it at your target, and express it as loudly as possible.

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