Independent self employed General Practice is on it’s way out if the trend in cost of insurance continues. If nothing is done the geese who layed the golden eggs of the old former NHS will be extinct. They are already being deskilled in emergency and Out of Hours (OOH) care. Many trusts who use their GPs for OOH cover them on their own policies. Many GPs, demoralised and disengaged, will welcome a salaried service. But the public will only miss what they had – when its gone.
‘Out-of-control’ GP indemnity costs have increased by more than a quarter in a year, show the results of a Pulse survey.
Indemnity fees rose by an average of 25.5% in the last 12 months leading up to November last year, according to an analysis of responses from over 900 UK GPs.
But the increase could be even higher, as a large number of GPs said their fees had decreased because they had had to reduce the number of shifts they worked.
Over one in ten respondents said their fees had more than doubled, and more than a quarter saw hikes of more than 40% in the last year.
Medical defence organisations (MDOs) said that the figures were not representative, and they were seeinfg rises of around 10%.
However, these figures currently represent the best estimate so far of the rising burden of legal indemnity as medical defence bodies have refused to provide comparable figures to Pulse.
Dr Zishan Syed, a GP partner in West Kent said his indemnity costs have increased by 60% in the past 12 months and said the MDOs needed to do more to challenge individuals who engage in campaigns of vexatious complaints against clinicians.
He added: ’Furthermore, the fact that they pick and choose what case to defend can leave a GP who has paid year after year of fees in the lurch with no defence.’
Dr Graham Scott, a GP locum in Warrington, said his fees had more than doubled, adding: ’‘I think that it is out of control and unfair. It needs serious regulation.’
Dr Ishwar Bhatia, a GP locum in Ipswich and East Suffolk, said: ’Compared to sessions worked, the amount has increased to double. A regular four sessions in surgery cost £5,100, and out of hours is more.’
Several GPs commented it was ’not worth increasing hours of work’ as the cost of indemnity was so high and that they felt helpless to question fee rises.
A GP who did not want to be named said: ’There are no clear understandable rules for charges and because I don’t know how they work it out, I don’t have evidence for whether the charges are correct or not. I can’t complain as it is compulsory and we can’t work without indemnity.’
However another GP who also wanted to remain anonymous, who saw a 20% increase in fees in the last year, said: ’When you’ve been through a complaint you realise how worthwhile it is, the support you get.’
The Medical Defence Union (MDU) disputed the survey findings, claiming that average member subscriptions increases were lower at around 10% a year. A spokesperson said: ’Long term, GP claims inflation has been running at over 10% year on year. Inevitably, this affects the subscriptions we need to collect to ensure our members’ peace of mind. Average subscription increases for our members reflect these trends rather than the figures your survey found.’
MDDUS also said most of its increases were smaller than 25%. A spokesperson said: ’MDDUS were able to limit subscription increases for the vast majority of our GP members to well below 20% this year. The numbers seeing increases at the level you quote were small – far smaller than the number of our Scottish members whose subscriptions were held stable.’
NHS England recently said it would reimburse GPs who take on extra out-of-hours shifts over winter under a temporary £2m scheme. A Pulse survey last year revealed that already a year previously half of GPs were turning down out-of-hours shifts because the cover is too expensive.
The last LMCs Conference voted in favour of a motion for all GP indemnity costs to be covered all year round and the Government has looked into capping legal costs for small value claims.