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GPs indemnity to be provided through state backed scheme, says Hunt

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4755 (Published 12 October 2017) Cite this as: BMJ 2017;359:j4755
  1. Abi Rimmer
  1. The BMJ

GPs will have access to a state backed indemnity scheme from 2019, the health secretary Jeremy Hunt has announced.

Speaking at the Royal College of General Practitioners’ (RCGP) annual conference in Liverpool on Thursday, Hunt said that the Department of Health would create a state backed scheme for clinical negligence indemnity for general practice in England.

The announcement comes after repeated warnings from the RCGP, the BMA, and defence unions that indemnity costs were spiralling and risked creating a crisis in general practice.1

Hunt said, “I know a big issue has been the fluctuations, variability, and the cost of indemnity, and we’ve seen that rise to around £8000 per GP. We need to introduce a state backed indemnity scheme for general practice.”

“It will take us 18 months to negotiate with the medical defence organisations, and we also need to negotiate with the BMA, but we will introduce those discussions in this years’ GP contract talks,” he said.

“The intention is to have a scheme that is more affordable, and more dependable and reliable for you. The great advantage is that we have control of a number of the variables that, in the current system, have caused the cost of indemnity to fluctuate and increase significantly.”

Asked by RCGP chair Helen Stokes-Lampard whether the new scheme would mean that GPs would no longer need their own indemnity cover, Hunt said that it would be similar to the existing scheme for hospital doctors.

Hunt said, “It doesn’t mean that there won’t be any requirement for indemnity cover but we want to match what we do in the hospital sector where we have better control of the costs and we can bring those costs down.”

He added, “We are confident that we will be able to deliver a system that is more predictable and more affordable. Essentially we have concluded this will be a much lower cost way both for GPs and the NHS.”

When asked by Richard Vautrey, chair of the BMA’s General Practitioners Committee, whether the scheme would be open to all GPs including sessional, locum, and out of hours GPs, Hunt said the commitment was “for all doctors working in general practice, not just for partners.”

The Department of Health said that it would work with the General Practitioners Committee, the RCGP, and the four medical defence organisations on the best way forward for the scheme.

The issue of indemnity costs came to a head this year after the lord chancellor, Elizabeth Truss, announced a legal change in February 2017, that critics said could add £1bn a year to the NHS bill for compensation.2 The reduction in the “discount rate”—the rate that people receiving lump sums for personal injuries are expected to get if they invest the money—means that awards will have to be significantly higher to compensate. The change came into effect on 20 March.

Commenting on Hunt’s announcement, Chris Kenny, chief executive of the Medical and Dental Defence Union of Scotland, said, “GPs need detailed and specific answers on a range of issues including the cost of the scheme, how it will be managed, and how a choice with fair competition will be ensured.”

Simon Kayll, chief executive of the Medical Protection Society, said the scheme would not solve the underlying issue of rising clinical negligence costs. “The cost of claims will always need to be paid for, and will continue to increase unless the root of the issue is tackled, through legal reform,” he said.

“It is important that the government develops this detail as soon as possible—GPs will need certainty that the ‘small print’ is fair and meets their needs, and we will continue to push the government to ensure this happens swiftly.”

Christine Tomkins, Medical Defence Union chief executive, said, “To be workable, the scheme will not only need to pick up new GP claims, but also claims costs which have not already been paid for GPs working under an NHS England contract.”

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