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GPC in urgent talks as indemnity makes general practice ‘untenable’ by autumn



The BMA is in urgent talks with the Government to introduce a ‘radically different system’ for indemnity ahead of expected increases this autumn that could make GP work ‘untenable’.

In one of his first interviews on being elected to chair the BMA GP Committee, Dr Richard Vautrey told Pulse that the increases in litigation costs for defence organisations this year were ‘significantly increased’ – which GPs will now begin to see. 

This is as a result of Government changes to the ‘discount rate’, the formula for calculating compensation pay outs for victims in personal injury suits, which had been frozen since 2001.

Medical defence organisations have raised concerns about the change in indemnity, and last week Pulse revealed that the DH was urgently reviewing the threat to GPs.

But Dr Vautrey said the GPC’s ‘fear is that [MDOs] can only hold off for so long’ before increasing costs and this likely to materialise in a matter of months when GPs start to get their annual letters to renew.

He told Pulse: ‘We need to ensure that every doctor – whether they are a contractor, salaried or a locum – any GP on the performers list needs confidence that they’ve got the indemnity to be able to work.

‘Whether in an out-of-hours setting, extended hours, in a practices doing locum sessions without the worry of indemnity costs.

‘We’ve made it very clear to the Department of Health, even in the last few days, that this has to happen quickly. Because there is a real risk that medical defence organisations will be forced to put up their rates to a level that will make it untenable for many GPs to work, or to do the number of sessions that they were able to do.’

He said it was welcome that the GPC had secured reimbursement for the inflationary rises in indemnity this year and last, but this will not cover for the latest increase.

Dr Vautrey added: ‘That cost pressure has yet to materialise and our fear is that they can only hold off for so long.

‘As indemnity renewals start to appear in GPs’ letter boxes in the coming months… there is a real risk that that’s the point where MDOs have to make the change and it will be significantly greater than the annual expected rise that we’ve seen in recent years.’

He explained that the GMS contract is supposed to cover GPs business expenses, of which indemnity is one, but even with the inflationary cover in recent years the contract has fallen behind the pace of rises.

Also in the interview Dr Vautrey set out:

  • That the GPC is prepared to take a formal ballot on industrial action as long as practices understand the consequences and show they are ‘prepared to do so in sufficient numbers’ – though he would not say what this threshold was.
  • That it will this year produce guidance on how practices can identify when they are working beyond safe limits and where to redirect patients when they go beyond this. But it says defining a national threshold of patient contacts which practices shouldn’t routinely go above could would be ‘simplistic’ and could be ‘counterproductive’.
  • That NHS England’s pace in delivering recurrent, and increased investment needs to increase significantly, and that he recognises the GPC hasn’t yet ‘managed to address the fundamental issues of the sustainability of workload management in practices that were promised in the Urgent Prescription.’