GPs need detail on state-backed indemnity as renewal deadline looms

Medical defence organisations are pressing the government to provide more detail on how state-backed GP indemnity will work, as the deadline nears for most GPs to renew their cover.

GP consultation (Photo: iStock)
GP consultation (Photo: iStock)

The UK's three main providers of GP indemnity - the Medical Defence Union (MDU), the Medical Protection Society (MPS) and the Medical and Dental Defence Union of Scotland (MDDUS) - all say that GPs need more information soon to make informed choices.

A state-backed GP indemnity package is set to take effect from April 2019 - 18 months after health and social care secretary Jeremy Hunt unveiled plans to intervene and put a stop to soaring costs that have exacerbated the workforce crisis by forcing GPs to reduce sessions and turn down extra shifts.

But as most GPs prepare to renew their medical indemnity cover in July and August - less than a year before the new system begins - virtually no new information has been made public about how the state-backed scheme will work since it was first announced.

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Details of what the scheme will cover could help GPs choose between the indemnity packages on offer from defence organisations. In the wake of Mr Hunt's announcement last October, the MDU set out plans to cut costs for GPs with a 'transitional scheme' designed to take advantage of the switch to a state deal, while the other defence organisations have maintained their existing indemnity schemes.

More detail on the state-backed deal would confirm whether a key assumption behind the MDU decision to switch to a so-called 'claims-paid' indemnity model, with lower fees, was correct. The organisation believes the government will assume responsibility for historic claims under the state-backed deal, as was the case when the NHS indemnity scheme for hospital doctors was introduced in 1990 - although the government has suggested it may not take on these liabilities.

If it doesn't, GPs on the transitional scheme could have to pay for extra 'run-off' cover - although the MDU says this will only apply for a maximum of seven years, and cost no more in total than standard indemnity cover.

Dr Matthew Lee, MDU professional services director, said: 'Our members have told us they are encouraged by the government’s commitment to bring in the new state scheme, but would welcome more information on the precise terms and conditions as soon as this can be provided.

Indemnity costs

'GP are understandably asking questions about how the scheme will operate, including what work, and which staff will be included and what the financial impact might be in order to plan for the future.'

MPS chief executive Simon Kayll said: 'We are continuing to push the government to move swiftly with the development of the state-backed scheme. With less than a year to go until the new scheme is set to start, it is important that the details around cost, scope, and how it will operate are finalised and communicated swiftly – to give GPs in England and Wales certainty that the scheme meets their needs.

'When the state-backed scheme was announced for GPs in England, the government said it does not plan to include run-off cover in a state-backed scheme. GPs with claims-paid or claims-made indemnity policies would therefore be required to purchase such cover separately themselves at the point they move to a state-backed scheme.

'There has never been a more important time for GPs to have access to all the facts so they can balance risks against benefits and make an informed choice that is right for them.'

Financial detail

MDDUS chief executive Chris Kenny told GPonline: 'MDDUS has been pushing the government hard to put some meat on the bones since Jeremy Hunt’s announcement in October. However, as it stands, much of what is proposed remains unknown and information has been slow in coming out about what exactly is proposed, how it will be run and who will run it.

'MDDUS has been speaking to all levels of government to try to ensure that the form of state-backed indemnity chosen is best for GPs, best for patients and best for the taxpayer.

'Fundamentally, we feel that the governments in Westminster and Cardiff have failed to address the cost drivers of the increase in indemnity and have chosen instead to shift the cost onto the public purse. Supposed savings to individual GPs may also not be as significant as is being made out in some quarters and it may simply shift rather than reduce the cost to the NHS, potentially leaving doctors worse protected.'

A May deadline for an update on state-backed indemnity promised by the government was missed, and an 'update' published in June said little more than that the government remained committed to launching the scheme from April 2019.

The DHSC has promised to publish findings from a survey of more than 1,200 GPs that aimed to ensure the state-backed indemnity scheme was based on full up-to-date information on the indemnity market 'in due course'.

Polling carried out by the BMA for the government - published in July 2016 - showed that indemnity costs for GPs rose by 50% in just six years from 2010 to 2016, and GP leaders say costs have continued to rise since then.

GPC chair Dr Richard Vautrey said at the BMA's annual conference on Tuesday that the BMA was 'working with government and NHS England to remove what is effectively an indemnity tax that GPs have to pay just to be GPs, and which acts as a significant disincentive to work in general practice'.

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