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The waiting game

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)

  • One factor that agravates the situation, and hence fees, are certain law firms, advertising for no win no fee cases. Also spurious specialist GPs employed by GMC to fish out possible Bad GPs. Blame Sipman for that. GMC are acting so they look good in survelling Doctors behaviour for the good of the patient. How about protection from spurious complaints.. my MDU fee for 1985 which I paid in July was £294 for working over 80 hrs per week in Orthopaedics, and my fees in 2014 for GP, 4 days per week i.e .40 hrs per week were over £10,000.
    I do not think , such increase in fees, is a reason for early retirement. I retired early , because of the stupidity of revalidation, and the pointless tasks we were being asked to do such as keeping elderly patients out of Hospital, with a care plan. And the Liverpool care plan ? this is a typical example of ill thought out, bureaucracy, thought out by idiots, not on the coal face. I think GP should be totally revamped, and it is up to the LMC's and BMA to start kicking instead of stamping up and down. If things were more favourable , even I might come back part time.! I'm only 60 yrs old, and my valuable experience is just being wasted.

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  • Erm correct me if I'm wrong but Crown Indemnity in NHS hospitals went down the Swanee about twenty years ago. I suspect that what you are requesting is something akin to "vicarious liability" that NHS Trusts carry for acts and omissions by their employees. This does not totally indemnify healthcare staff and they are still required to have individual indemnity insurance

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  • 8.00pm
    you are wrong. CORRECTED!!

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  • GPs are step children of Her Majesty's NHS. We pay Employer's contributions for ourselves and our patients. We pay overheads which increase annually despite our diminishing budgets. We bear the costs of OOH visits in emergencies to our patients from dwindling funds. We bear the responsibility for giving staff wage increases to ensure we still have a team to work with next year. We pay exorbitant premiums for indemnity which have risen over 300 -500% in the last 10 years which no other NHS doctor in a Hospital has to pay.
    Please can we have a break and get this indemnity sorted out because this is the most glaring discriminatory factor for primary care doctors.

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  • Read: for NHS contributions...for ourselves and 'our staff' (thankfully, not yet for our patients:)

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  • Hey 'anonymous' I've checked my facts are I'm afraid you're incorrect - Crown Immunity is dead and buried. Good idea to remain anonymous though.

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