Increased competition 'will accelerate fall in GP medico-legal costs' from April

Competition from new providers entering the medico-legal market as state-backed indemnity takes effect from April could drive down costs for GPs, the BMA believes.

GPC chair Dr Richard Vautrey
GPC chair Dr Richard Vautrey

GPonline revealed today that annual costs for GPs will drop by around 80-90% as landmark reforms to indemnity cover for general practice see the government assume responsibility for clinical negligence costs.

The state-backed GP indemnity scheme that takes effect from 1 April will cover the cost of clinical negligence for GPs and other practice staff carrying out NHS work - but GPs will need to maintain cover for non-NHS work, GMC representation and other matters.

BMA GP committee chair Dr Richard Vautrey told GPonline that the market for providing this ongoing cover was likely to become 'quite competitive' as new providers - including insurance providers and potentially law firms - joined existing medical defence organisations (MDOs) in offering subscription packages for GPs.

Market forces

Dr Vautrey said: 'We anticipate an expansion of the different providers offering services, so it is likely to become a quite competitive market. Once we have taken away the risk to MDOs around clinical negligence payouts, going forward this becomes more of an advisory and support service and other organisations may choose to offer that type of package.'

The GPC chair predicted that many packages would be offered 'at a practice level primarily rather than individual'. MDOs currently offer reduced rates on practice-wide cover - and one insurance broker offering GP cover said it would also provide significantly lower rates per GP for group deals.

Specialist insurance broker MIAB is among providers that will compete with MDOs to provide cover for GPs. A spokesperson told GPonline: 'The change in indemnity arrangements beyond 1 April means the market has opened up for GPs and become more commercial. They shouldn’t settle for the potentially high prices of MDOs and should consider alternatives.'

The company is offering basic legal cover for 'less than £450' that may be suitable for some doctors providing NHS work only. But it recommends a package costing around £960 a year that would incorporate the basic element - such as fitness to practice cases, medico-legal advice, coroner's inquests - and a further 'malpractice' element covering GPs for work such as report writing, private medicals and vaccinations.

Expertise

The existing MDOs, however, highlight their experience and established expertise in supporting doctors through medico-legal problems.

A spokesperson for the MDU said: 'Last year over 6,000 GPs needed our help and we advised over twice that number of GPs who called our 24-hour advice line.

'Our medico-legal team of over 40 specially trained registered doctors are available to guide, support and defend our GP members around the clock. We are the only MDO to have specialist disciplinary and criminal teams dedicated to achieving the best outcomes when our members’ professional careers are threatened.'

MDDUS chief executive Chris Kenny said: 'Our new integrated product will provide the most comprehensive and best value coverage for the many risks not covered by the clinical negligence scheme for GPs and our members will continue to receive the gold standard service they currently enjoy.'

Medico-legal support

MPS chief executive Simon Kayll said: 'While Medical Protection members in general practice in England and Wales will pay substantially less for their membership, they can expect to continue to receive the same high quality advice and support.'

A recent government consultation on medical indemnity also highlights potential for disruption in the medico-legal market, and backs plans to require indemnity for clinical negligence risk on work that falls outside the state-backed scheme to be backed by an insurance model rather than the discretionary system that MDOs have operated for years.

The consultation document highlighted concerns that MDOs could be destabilised before new entrants came into the market. It said: 'There is also the possibility that existing providers of discretionary indemnity choose not to or face difficulties in continuing to provide indemnity.

'Depending on the market response and the pace of the transition, there is a potential that there could be some gaps in coverage. It may also take time for new or existing market participants to enter the market or expand their operations. The introduction of changes to regulation could therefore be accompanied by a lead-in time and/or transitional arrangements to mitigate these risks.'

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