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Boycotting out of hours will force Government to address the indemnity crisis



This year I resumed doing out of hours work, using the long awaited winter indemnity scheme. Part of me was exhilarated at the prospect, as I love acute care, but another part felt guilty as there are coal-facing GPs who do out of hours all year round without any relief on indemnity and keep the system afloat .

So even though I welcome the scheme, it seems to be more about relieving winter pressures than any acknowledgement of the out of hours indemnity crisis.

Earlier this month, after much hype, health secretary Jeremy Hunt announced at the RCGP conference that a new state indemnity scheme could start from 2019.

On the face of it, it looked like a recognition of the pressures faced by the profession and the key role the indemnity fee hike played in the crisis. But the glaring lack of detail cast a cloud over what could have been the most significant announcement in recent NHS history.

Furthermore, the Department of Health later announced that it cannot guarantee that state backed indemnity will slash costs.

This defeats the purpose, as it fails to acknowledge the fact that GPs are personally absorbing the exorbitant costs of indemnity and finding it unaffordable to work.

Considered on the background of an unprecedented workforce crisis, the folly of this statement is further compounded when you look at the numerous poorly thought-through schemes we have had to secure retention and recruitment of GPs, supported by very limited evidence and efficacy, and contrast them with the solid evidence we have that the winter indemnity scheme increases capacity.

Last year at the LMCs conference, due to sheer frustration at the lack of progress on this issue, I called for a total boycott of out of hours, which received a lot of support.

This year, the idea is being proposed as a motion, meaning we could see GPs vote with their feet over the lack of clarity in the state indemnity scheme.

If out of hours collapses as a result, the blame will solely lie with the health secretary, as GPs cannot prop up a broken system anymore.

So ponder this, stay true to your word and protect GPs from the monstrous cost of indemnity.

Otherwise this crisis will not only devour general practice but our beloved NHS too.

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.