State-backed GP indemnity scheme could start from 2019, says Jeremy Hunt

Health secretary Jeremy Hunt has revealed that a 'state-backed scheme for clinical negligence indemnity for general practice' could go ahead from April 2019 in a landmark speech at the RCGP annual conference.

Health secretary Jeremy Hunt (Photo: Pete Hill)
Health secretary Jeremy Hunt (Photo: Pete Hill)

The proposals will aim to deliver a 'long-term solution' to soaring indemnity costs that have become a key factor in the escalating GP crisis, pushing thousands of GPs to reduce the sessions they work or quit the profession altogether.

The health secretary unveiled the groundbreaking plan for state intervention in the provision of GP indemnity alongside measures to boost GP recruitment, with significant new investment in golden hellos for GP trainees, flexible working proposals and a new international recruitment office.

Mr Hunt confirmed that GPs would need to maintain indemnity provided by MDOs in parallel with the state-backed cover. Government guidance published as the speech was delivered confirms: 'We envisage the scheme would only cover clinical negligence risks arising from the delivery of GMS/PMS/APMS contracts and any other integrated urgent care delivered through NHS standard contracts.

'We do not envisage that a state-backed scheme would indemnify individuals against claims arising from other private, non-NHS activity. Individuals are also likely to want to continue private indemnity arrangements to provide help should they need it for private work, in coroners’ cases, GMC hearings and other matters relating to professional regulation.'

GP indemnity deal

The health minister also confirmed that the deal would extend to GPs in all roles, rather than being limited to partners.

However, GP leaders are demanding more detail on how the scheme will be funded. Medical defence organisations have warned that the announcement 'raises more questions than it answers' and warned the plans did not address the core issue of rising negligence costs across the NHS.

The BMA warned that indemnity costs for GPs rose 50% between 2010 and 2016. GPs now pay on average around £8,000 per year for indemnity - suggesting the total bill for over 40,000 GPs comes to more than £300m annually. This suggests the government could have to find in excess of £100m a year to reverse the impact of soaring costs on the profession this decade.

In his speech on Thursday, Mr Hunt set out plans to develop the state-backed GP indemnity scheme in negotiation with the GPC, RCGP and medical defence organisations.

The health secretary acknowledged that doctors are being forced out of the profession by increasing fees that have now reached around £8,000 per year for an average GP. Recent polling by GPonline found that more than a third of GPs working full time who do not carry out any out-of-hours work or non-standard work such as minor surgery now pay in excess of £10,000 per year.

Mr Hunt told the conference: 'Last month, the CQC gave a glowing verdict on the state of general practice in England, but this should not distract us from the fact that the profession is under considerable pressure at the moment.

'By introducing targeted support for vulnerable areas and tackling head on critical issues such as higher indemnity fees and the recruitment and retention of more doctors, we can strengthen and secure general practice for the future.

GP workforce

'Our talented GP workforce is one of the reasons why we have the best healthcare system in the world, and our commitment of an additional £2.4bn a year for primary care by 2021, will ensure this continues.'

GPC chair Dr Richard Vautrey said: 'It is encouraging that the health secretary has recognised this unacceptable financial burden being placed on GPs. Average indemnity costs have risen by more than 50% between 2010 and 2016. There is clear evidence from a recent NHS England survey that this is reducing GPs willingness to work, for example, in out-of-hours settings where the average annual indemnity rise is around 20%.

'It is vital that every GP has this form of insurance, but they should not be expected to be in a system where they are facing inflated yearly increases, especially at a time when many GPs are working increasing numbers of hours to provide care to patients.

'The commitment to provide state-backed indemnity cover is a particularly welcome step after the talks the government has being having directly with the BMA over the summer. We do, however, need more detail on the financing of this scheme. It is also important we make progress quickly and deliver real change.'

MDDUS chief executive Chris Kenny said: 'Today’s brief announcement raises more questions than it answers. GPs need detailed and specific answers on a wide range of issues including the cost of the scheme, how it will be managed and ensuring GPs have a choice with fair competition.'

GPonline revealed earlier this year that unaffordable indemnity costs have stripped the equivalent of thousands of full-time GPs from the NHS, with many forced to turn down additional shifts or reduce the number of sessions they work to keep a lid on indemnity fees.

More than 90% of GPs saw their fees rise over the past year, with increases in excess of 20% for one in four respondents to a poll by this website.

Full coverage of the RCGP annual conference 2017

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