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State-backed or practice-backed indemnity?

Hard-wired GP

Luke Koupparis

Wednesday, 05 December 2018

AdobeStock_125811106_indemnity.jpgThe cost of medical indemnity has been skyrocketing in recent years for many doctors. The cost has risen by more than 50% from an average £5,200 per year in 2010 to £7,900 by 2016 and has been a cause of serious concern with surveys showing GPs were considering leaving general practice because of the price hikes. The medical defence unions have said that they are facing higher claims, not helped by the change in discount rate introduced by the Lord Chancellor. This change has resulted in even higher compensation payments and thus had ramifications on the insurance industry to further increase premiums.

In October 2017, there was a huge cry of relief when the secretary of state announced that there would be a state backed indemnity scheme for GPs and this would commence in April 2019. Early enthusiasm was abound in the profession with it being heralded as being “free at the point of delivery” and of no cost to members of the scheme. As a result, some of the defence unions substantially cut premiums for GPs in the anticipation of this new scheme, that in all likelihood cover historic litigation claims.

Fast forward to winter of 2018, with only four months to go before the introduction of the scheme and what has become apparent is that there was a nasty sting in the tail of this glorious indemnity rescue package. The Government has published a set of frequently asked questions on the new scheme. Buried in the middle of the publication, under the heading of who will pay for the scheme, they had outlined the following:

Our intention is that individuals covered by the scheme will not be required to make any payments into the scheme. We would expect funding for the scheme to come from existing resources allocated for General Practice, and discussions are ongoing with the GPC.

The clear issue is written for all to see in plain text with very little ambiguity; funding for the scheme will be taken from resources that would have been allocated to general practice. In other words, a reduction in contractual payments or a practice funded indemnity scheme being labelled as state backed.

Surely, our negotiating leaders would not let this happen having heralded this scheme as the being part of their negotiations to stabilise and bring new funding into general practice.

Richard Vautrey, GPC chair, was reported to have recently said at a conference that they were currently in negotiations which included a decision how costs will be shared and nothing was agreed as yet. It is likely that we will need to wait until the new year to hear the outcome of these talks.

Even the RCGP were riled when they found that this had been published, as they had warned of the profession’s negative reaction having seen a draft copy. RCGP chair Professor Helen Stokes-Lampard wrote a letter to health and social care secretary Matt Hancock on the issue. In it, she urged him to deliver sufficient funding for the scheme to ensure it has the intended impact of improving affordability, and for assurances to be made to the profession to this effect.

So, on paper, this looked like a rescue package directly aimed at soaring indemnity costs that were forcing many GPs out of the profession. However, in the clear light of day, we now see that funding for this may simply to be taken off money already allocated to practices.

I appreciate that nothing has yet been set in stone, but the reaction from the GP community has been clear and robust. On that note, let’s hope that the GPC hear this cry and negotiate a package that does not merely move the indemnity burden onto practice balance sheets. This was labelled as a “state backed” indemnity scheme and thus should not be a covert way of removing much needed funding from practices.

Author's Image

Luke Koupparis

Luke is a general practitioner in the Bristol area with interests in men's health, child health, minor surgery, online education and medical information technology. He is the IT lead for Bristol clinical commissioning group, LMC representative and chair of the locality provider group. He also works as the medical editor to OnMedica helping to deliver high quality, peer reviewed information to the wider medical community. In his spare time he is a keen road cyclist and likes to ski with his children.
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