Exclusive An out-of-hours GP has been quoted £30,000 for annual indemnity insurance, in a trend that providers say could lead to urgent care services becoming unmanned.
The GP, who works full time out of hours and has not been subject to any formal complaints proceedings, was insured by MDU and has seen the cost of indemnity almost quadruple in two years, from £8,000.
The GP, who wanted to remain anonymous, has been able to reduce her premium by switching to another organisation but her employer Derbyshire Health United, which provides out-of-hours cover and NHS 111 across four counties, voiced concern that this could be a sign of things to come.
The MDU has said it is inevitable that subscriptions have to rise, and it is campaigning the Government to reform how compensation awards are calculated and to initiate caps on the level of damages awarded.
Derbyshire Health United clinical director Dr Aqib Bhatti, who was speaking on behalf of the GP, said the GP had ‘worked predominantly in the out-of-hours setting for the last 20 years’.
He added: ‘She has been asked by the MDU for almost £30,000 for this year’s indemnity costs. We have seen an increase to the cost of indemnity for all doctors but this really is taking the biscuit.’
This could be a sign of things to come, he said: ‘This GP’s subscription expires from May but for most renewal is traditionally in August, so my concern is if this is the first of a new batch of price increases.’
He added that the NHS will have to intervene to provide indemnity cover: ‘There is no way around it because otherwise we are going to be left with a service that physically is not manned.’
The quote, which was the largest Dr Bhatti himself has ever seen, comes as Pulse reported that close to half of GPs have already turned down out-of-hours shifts because of the rising cost of cover, while increasing litigation against GPs have pushed up costs for defence organisations.
The MDU said it was unable to comment on the specific example because all premiums are individual.
But it added that it agreed that large hikes in fees were ‘not fair’ to GPs and said it is campaigning for reforms.
A spokesperson said: ‘As a member owned, not-for-profit organisation our subscriptions have to be set at a level that ensures sufficient funds are collected now to support members in the future. In the face of the level of claims inflation outlined above it is inevitable that subscriptions have to rise. This is not fair and we are taking action on behalf of members because the problem can only be addressed through legal reform.
‘We have launched our fair compensation campaign in order to persuade the Government and other influencers to change the law. Legal reform has been effective in controlling claims costs in other countries and it is urgently needed in the UK.’
The Medical Protection Society said that as a not-for-profit organisation, ‘we must ensure that we collect sufficient subscriptions to be in a position to meet the future costs of defending claims against members’.
However, it also said that the ‘Government should undertake a review to consider the extent to which provision of OOH services is held back due to a shortage of GPs, what barriers stand in the way of GP uptake of OOH work and what policy proposals would tackle these issues.’
Meanwhile the MDDUS confirmed that its out-of-hours indemnity rates would indeed increase from 1 June, although it had yet to determine by how much.
NHS England said it was ‘keeping in touch with the main medical organisations about the issue of indemnity for GPs’.
It also said it was too soon to evaluate a brief trial of covering GP indemnity costs to aid its bid to place GPs on the floor in NHS 111 call centres that was run at the tail end of this winter season.
GPC urgent care lead Dr Charlotte Jones said the GPC was aware that in some cases ‘the cost of indemnity does prohibit doctors from taking on out-of-hours work’.
She added: ‘That is very, very difficult with the costs [of cover] going up. We are looking at a variety of options with NHS England and the defence organisations because we accept and recognise that the indemnity premium is becoming a more significant issue.’
A Welsh risk-sharing system run by health boards has been effective in increasing the number of out-of-hours shifts GPs are willing to take on.
However, Dr Jones said that it was not straight forward to emulate this in England where there is a wider spectrum of out-of-hours providers and local solutions.