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DH-led review looks at increasing GP indemnity reimbursements

Exclusive The Department of Health is reviewing a rise in GP indemnity reimbursement amid warnings that fees for GPs are becoming 'unaffordable'.

A DH minister has said this comes as the discount rate reduction introduced in March has ‘significantly increased the cost of claims’.

Medical defence organisations estimate the Government’s decision to reduce the discount rate applied to personal injury claims from 2.5% to -0.75% will result in a steep rise in payouts and this will filter down to indemnity costs.

As it stands, the DH has set aside £60m to compensate GPs for indemnity cost hikes this year and next, but the department has acknowledged this will not be sufficient following the discount rate reduction.

Health minister Philip Dunne said in response to a written question that 'the cost of indemnity to GPs is already recognised as a business expense, and reflected in the sums received by GP practices via the GP contract'.

But he went onto admit that 'the change in the personal injury discount rate announced... in February 2017' had 'significantly increased the cost of claims'.

He said: 'The Department is working closely with GPs and medical defence organisations to ensure that appropriate funding is available to meet additional costs to GPs, recognising the crucial role they play in the delivery of NHS care.'

The DH declined to comment further but acting BMA GP Committee chair Dr Richard Vautrey said a review, 'led by DH', was working to determine the impact.

He added: 'This is consistent with what we’ve previously stated in that we are in active discussions with all parties about what the impact of the discount rate will be for GPs so we can ensure a sustainable system in the coming months and years ahead.

'The £30m was to cover the expected indemnity inflation, not the much bigger changes that will come as a result of the discount rate change.'

The news comes as Pulse revealed that 'all options’, including state-funded indemnity, are now 'on the table’, amid growing concerns from the Department of Health and NHS England about the impact rising subscriptions are having on the recruitment and retention of GPs.

But the MDU warned that unless an urgent solution is reached, GP members will be hit by higher indemnity costs, rendering the profession 'unaffordable'.

The MDU told Pulse it has been 'discussing this problem' with the DH since early December 2016 and 'yet we are nearly in August 2017 and there is no solution'.

Dr Christine Tomkins, MDU chief executive, said that the discount rate changes would 'double and could even treble settlement costs in high value claims'.

She added: 'Although the MDU has not passed on these costs to GPs yet, pending the promised funding to GPs to meet the costs of this catastrophic and unprecedented cut in the discount rate, this cannot continue...

'What doesn’t seem to be publicly appreciated is that without immediate government action this change will impede every citizen’s access to healthcare by making general practice an unaffordable career choice for doctors.

'The MDU is asking the Government to make good on its promise to GPs and to do it now.'

GPs reach end of their tether on indemnity cost hikes

A survey by the MDU has shown a third of GPs are thinking of leaving the profession or retiring because they cannot afford the increased cost of indemnity. Nine out of ten GPs questioned in the survey said they would like to be covered under an NHS indemnity scheme.

Meanwhile, a survey by MPS showed that if the cost of clinical negligence claims continues to increase at the same rate as currently, nine in ten health professionals think this will 'threaten the sustainability of the NHS'.

Defence organisations have called for legal reforms to bring down the cost of indemnity, including capping payouts and lawyer fees. To date the DH has only formally consulted on fixing legal fees in low-value negligence cases, although it has yet to respond to that review.

Meanwhile, grassroots GPs voted in May to make GPC policy to push for full reimbursement of GP indemnity costs, rather than just covering inflation.

 

Readers' comments (9)

  • The government don't care. They don't want general practice in its present form. The cut in the Ogden rate was a political decision with political consequences. Predictably, indemnity was deliberately weopnised and used against us to further their aim of destroying GPs.

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  • "by making general practice an unaffordable"
    simple, clear, straightforward, unarguable
    An unimpeachable reference, by someone who unarguably knows.
    Now, let's see the college produce their nine doctors to argue against that advice.

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  • Extra reimbursement to practices is all very well for partners and salaried doctors, but what about us locums? Practices are already strapped and any attempt to negotiate increased locum fees to gain access to our share of the reimbursement is going to be awkward and best and impossible at worst. The only fair way is for the Government to subsidise at source by either underwriting a proportion of the defence bodies costs or, preferably, going the whole hog and offer crown indemnity (note to some previously confused politicians, NOT immunity) as as per hospital doctors. We locums are as important for the continuing functioning of the NHS as all the other hard working doctors out there and we need to be included in the solution in a fair and easily accessible way

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  • That would be MDU chief executive Dr Christine Tompkins whose emoluments in 2015 were £779000 (plus pension accrual of £147000).

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  • Time is running out. If HMG refuse to help then the eye watering rises in fees will cause a stampede to the exit, everyone will drastically reduce their hours, OOH will finally collapse, locums will disappear, the over 50s will retire, the under 50s will look abroad. These consequences have already started, but this final straw (or final insult) will turn the trickle to a torrent before the decade is out.

    If HMG really care about the future of GPs they will.........hang on, who am I trying to fool? Push out the expensive GPs and run Primary Care with PAs, pharmacists, nurses etc, this is clearly the way forward.

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  • @David Wright

    As and when the money becomes available to practices, it will also be available to use for locum fees.

    By providing the money attached to patients, it means that it will be going to GPs serving primary care patients in a General Practice setting.

    Providing it to source (i.e. to MDOs) means that it will also provide for prisons/ OOH/ A+E etc who should instead be getting payments to cover indemnity from their procurement process (i.e. reflected in the cost of their tender bid)

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  • The basis of Litigation itself has to change, otherwise being a doctor will become unaffordable in anxiety and worry for doctors.

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  • Have GPs in Kent been given even a penny of this money? or has that again 'been included in the global sum' as rurality, deprivation and everything else under the sun which makes it unrecognizable and unidentifiable making a mockery of transparent working in NHS

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  • Why did the government reduce the discount rate. Was it by design or incompetence. It will put insurance premiums up across the board so cannot be politically popular.

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