GPs returning to UK practice struggling to cope financially, warns Cameron Fund

Growing numbers of GPs returning to work in the UK after career breaks, time abroad or suspension are unable to cope financially because of soaring indemnity costs and long delays in securing permission to practise medicine, a charity has warned.

The Cameron Fund describes itself as the 'only medical benevolent charity which solely supports general practitioners and their dependents'. The charity helps current and retired GPs and their families cope in times of financial distress caused by ill health, disability, death or loss of employment.

But the fund's administrators warn that it is becoming unable to cope with rising demand for financial support, particularly because soaring indemnity fees - well into five figures in some cases - have left doctors looking to get back to work struggling to afford it.

The Cameron Fund has called for a fast-track system to make it easier for UK-trained doctors who have had exemplary careers abroad to come back to work in the UK, and for the extension of crown indemnity to GPs who have been suspended and now face unaffordable indemnity costs if they wish to rejoin the GP workforce.

Read more: GPs need funding to return to UK

For doctors working overseas, the charity's chairman told GPonline, some checks should be done while they are still abroad so that they can return to practice soon after arriving back in the UK.

Cameron Fund chairman Dr Stephen Linton said that in the past year or two the charity had noticed a surge in GPs struggling financially as they looked to return to work after suspension, career breaks or time abroad.

He said that it was vital that delays in allowing people to return to practice when they were fit and ready to join the GP workforce were tackled, at a time when general practice faces a growing workforce crisis.

'Particularly for people who have been suspended by the GMC, when they try to come back they find they can’t get medical indemnity from the normal providers,' Dr Linton explained. 'They are not offered cover at all in some cases and have to go to commercial providers – that is currently costing something like £25,000 a year.'

He added that despite the high costs, the cover provided under these policies was often not equivalent to the lifetime cover offered by medico-legal organisations.

GP indemnity

'We have had half a dozen over the past year where this applies,' he said. 'We are there to help with smaller sums for cost of living - the idea of covering £25,000 is too much.'

Dr Linton said that GPs returning from a spell of work overseas were also facing delays that could leave them in financial difficulty. 'The cohort coming from abroad are facing long delays, but as long as they have a satisfactory past history, they can usually get insurance from the usual providers.

'However, there have been cases including a doctor returning from Germany who took 18 months to get back to working in this country despite an unblemished record – because of exams, then an attachment to a practice, then having to set up for 6 months. This was a perfectly standard doctor who had been working in Europe, and it took 18 months. It can be similar for those returning from Australia or New Zealand.'

Dr Linton added that in some cases doctors struggling to return to practice are doing so despite not having done anything wrong that was associated with their clinical work.

'Suspensions can be to do with behaviour that the GMC is unhappy with, such as something in their personal life. That is something the GMC takes into account – behaviour in your personal life that brings the profession into disrepute – drink driving, perhaps.

'Or sexual behaviour, or misprescribing for people they are not supposed to, like family members or more minor misdemeanours associated with drugs for instance. That can result in suspension for two or three years, potentially, and then they are allowed back onto the register. They have to go through the returner scheme to get back to practice, and need insurance. But the problem is related to behaviour - they are not bad doctors.

GP workforce

'The problem is, these guys are needed back in general practice. NHS England is trying to get them back through the returners scheme, but they can’t start the scheme because of the insurance cost. They are willing to work, have a place on the returner scheme, but can’t get insurance except at high rate.

'I don’t know what the answer is, but there needs to be a similar scheme such as hospital crown indemnity – these guys could go back to hospitals – but in general practice, we need something to cover their time as returners. At that time, in a sense, they are lower risk because they are fully supervised. I would have thought NHS England would be prepared to have a situation to cover them.'

RCGP chair Dr Maureen Baker said: 'The updates to the I&R scheme has resulted in more doctors now using this route to return to practice and that is very welcome given the current shortage in GP numbers across the UK.

'The revised scheme, now co-ordinated by the GP National Recruitment Office (NRO), makes it easier for GPs to return to practice in the UK - returning GPs can get bursaries for the period of time that they are in supervised practise and can claim back assessment fees if they go on to work in the NHS.

'The application process has also been streamlined and it can now be started overseas, while there is also recognition of a rapid return possible for qualified and experienced GPs working in primary care outside the UK.

'Despite these improvements to the scheme, the college believes it is still too slow and bureaucratic, and the information provided by the Cameron Fund on what many GPs are currently are experiencing when trying to return to practice in the UK suggests that the level of financial support through the scheme should be reviewed.

'We’re hopeful that the upcoming formal review of the scheme in 2017 will address some of the issues outlined by the Cameron Fund, so that the process is made even easier and helps us build our GP workforce across the UK.'

Photo: iStock

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