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We need to give the government an ultimatum on out of hours indemnity



Over the past couple of years indemnity has made headline news. We have talked about how the rise in indemnity has deepened the workforce crisis, stopped one in four GPs from doing out of hours and more generally led to colleagues dropping sessions and not working to capacity as they can’t afford to pay indemnity.

This is in parallel to the news that GP numbers have gone down in the first year of the NHS rescue package, showing the government’s pledge to deliver 5,000 more GPs by 2020 is simply a myth.

Last year NHS England offered GP practices reimbursement of 10% hike in indemnity fees, which is a welcome move. But it is a drop in the ocean, as our fees are so high to begin with and it is unclear how it will reach the sessional workforce. From where I stand, I believe NHS England has not fully grasped the ramifications of the indemnity crisis and is still out of touch with reality – the inaction following the drop in the discount rate, which stands to increase our subscription costs multifold, proves my point.

So what we need is action – and to say once and for all, ‘enough is enough’. I have thought long and hard about what we are going to do, and suggested to the LMCs conference that if, by August, we don’t have a tangible action plan for indemnity, we should advise GPs not to indemnify themselves for out of hours, and let the whole system collapse.

Out of hours is voluntary and we need to let the Department of Health know that we are done with propping up a broken system at a personal cost. We GPs are as much a part of NHS as our colleagues in hospital, so why are we personally responsible to pay for indemnifying ourselves? Why the step-brotherly treatment? So the ball stays firmly in Department of Health’s court as to whether we will have an out-of-hours service in August or not?

Dr Preeti Shukla is England representative for GP Survival. These are strictly the author’s personal views and not those of any organisation she works for or is associated with.