GP leaders have called on the Government to directly reimburse the costs of medical indemnity, and to acknowledge the current system is making it uneconomical for GPs to work out of hours.
The annual LMCs Conference in London today heard that some estimates from medical indemnity providers put the cost of out-of-hours indemnity at £35 per hour.
The proposal to the conference, from Nottinghamshire LMC, called for GPC to investigate the pros and cons of GPs’ inclusion in the crown indemnity scheme which covers staff directly employed by the NHS.
The motion was passed in full, but GP leaders did urge caution about the limitations of crown indemnity, which would not cover GPs for criminal claims, and would limit GPs’ defence to what was best or cheapest for the NHS, and not neccesarily the best interests of GPs and their reputations
The proposal also expressed concern over reports that indemnity providers were unfairly refusing cover to GPs deemed a ‘high insurance risk’, thereby ‘denying them the means to practice and earn a livelihood’.
Dr Adam Harrison from Nottinghamshire LMC told delegates: ‘The insurance risks of undertaking out of hours work, or any services not performed by the generality of GPs, are viewed by the defence bodies as justifying premiums which render it uneconomic to continue to provide such services.
‘One estimate puts the indemnity cost of undertaking out-of-hours work, at £35 per hour.’
Dr Andrew Purbrick from Dorset LMC told delegates: ‘We’re the ones that have to take on the additional risk, and responsibility, that goes with [managing patients in the community].’
Dr Saqib Anwar from Leicestershire LMC said: ‘Doctors have seen an unfair and exponential rise in their defence union subsidies, the situation can now truly be declared a shambles.’
‘The supposed individual risk assessment, which cannot be shared, which cannot be validated as a result of commercial sensitivity, has seen premiums rise for GPs in my area alone, by a magnitude of 150%.’
An addition to the original proposal, by Cleveland LMC, calling on Government to directly reimburse the costs of indemnity cover for GPs was passed unanimously.
Dr John Canning from the LMC asked delegates if they would trust the NHS to defend them, though the NHS crown indemnity scheme, or whether they had attended the AGMs of their indemnity providers to hold them to account. The answer he took to be ‘no’.
He added the current model of reimbursing GPs indemnity expenses as an average across the practitioner population no longer worked and a direct reimbursement was needed, saying: ‘we should get that money back because we are needing to spend [it] to be able to practice in the NHS.’
Motion in full
NOTTINGHAMSHIRE: That conference:
(i) is alarmed at the increasingly prohibitive costs of medical defence cover for GPs – Unanimously carried
(ii) is concerned that medical defence societies are unfairly refusing cover to GPs deemed to be ‘a high insurance risk’ thereby denying them the means to practice and earn a livelihood – Carried
(iii) invites the government to acknowledge that the cost of medical defence cover is making it uneconomic for GPs to participate in OOH or other non-GMS work and to investigate ways of subsidising these costs; – Unanimously carried
(iv) requests the GPC to undertake a study of medical defence cover for GPs, to address current concerns and determine the pros and cons of crown indemnity being extended to GPs. – Carried
(v) Calls on Government to directly reimburse the costs of indemnity cover for GPs.