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Observations Body Politic

Dangers of rising indemnity insurance costs

BMJ 2015; 350 doi: (Published 12 May 2015) Cite this as: BMJ 2015;350:h2542
  1. Nigel Hawkes, freelance journalist, London
  1. nigel.hawkes1{at}

Soaring subscription fees could discourage new entrants to general practice

UK general practitioners reeling back in frank disbelief at their annual subscription renewal for indemnity insurance must be tempted to echo Oscar Wilde: when the gods wish to punish us, they answer our prayers. Many blamed the legal aid system for fomenting medical negligence claims: the BMA itself asserted in 1997 that, by funding worthless cases, legal aid was draining millions from patient care. The money, said Mac Armstrong, BMA secretary, “was going into lawyers’ pockets.”

Its wishes were in due course granted, with changes enacted that scrapped legal aid for almost all clinical negligence cases in England and Wales. In future, said the then justice secretary, Kenneth Clarke, all claimants would have to use the “no win, no fee” provisions that were already used by those too well off to qualify for legal aid. Lawyers warned that the removal of legal aid would make it harder for people to find advocates willing to launch complex negligence cases.

There’s little evidence of that. The medical protection organisations and the NHS Litigation Authority warn of a tsunami of claims funded by no win, no fee agreements …

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