What changes will a state-backed indemnity scheme for General Practice bring?
Written by Bethany Hodgkins, Medical Negligence Solicitor at Fletchers Solicitors
In October 2017, the Secretary of State for Health and Social Care announced the intention of the Department to develop a state-backed indemnity scheme for General Practice in England. Although the finer details are yet to be confirmed, the plan is for the scheme to be rolled out in April 2019. So what are the changes and what difference will they make?
Up until now, GPs have needed to take out indemnity insurance with a private insurer such as the Medical Defence Union and the Medical Protection Society. As part of the General Medical Counsel membership, this insurance is compulsory and covers medical negligence claims along with other professional inquiries.
However, with medical negligence claims being at an all time high and recent changes to the discount rate inflating the value of those claims, insurance premiums have been rising. Latest statistics show that a GP can be expected to pay around £8,000 per year for such insurance. According to the BMA this is a staggering 50% increase from 2010 to 2016. This has been suggested to be a large contributing factor as to the nationwide shortage of GPs. The new scheme is hoped to therefore incentivise entrance to the profession.
As such, the proposed state-backed indemnity scheme is said to mirror the hospital scheme run by NHS Resolution and will be at no cost to the individual GP which presumably is music to their ears. However, this begs the question, how is it being funded? Thus far, no clear answer has been provided. The Government has said that they are expecting the scheme to be financed from existing resources allocated for general practice. This rather vague suggestion is somewhat concerning when it is considered that the NHS spent £2.23bn in 2017/18 to compensate patients for medical negligence claims that happen in hospitals.
With statistics showing that on average, a GP will have two medical negligence claims throughout their career, it is evident that the source of this funding needs to be seriously contemplated. GPs are already struggling with tight budget restrictions, will this then reduce resources even further? Ironically, if money is limited even more, surely medical negligence claims will only increase with GPs not having sufficient resources to do their jobs properly?
Furthermore, the proposed scheme will cover medical negligence claims only. Therefore, GPs will still need to take out private cover for complaints, GMC inquiries, inquests and disciplinary proceedings. The indemnity providers have advised that these premiums will be substantially lower, expected to be in the region of £1,000 per year.
It has also been mentioned that the scheme will not include any run-off cover. Therefore, certainly in the short term, it seems private indemnity will still be required to allow for any claims arising from acts pre April 2019. With claimants having three years in which to bring a claim for medical negligence, this will presumably be required up until 2022 to ensure protection.
A state-backed indemnity scheme for GPs to mirror that for clinicians working in hospitals is a step in the right direction, it however appears to have been founded on ideals rather than well thought out logistics. Perhaps the Government should be focusing on why clinical negligence claims have risen so much and attempt to concentrate their efforts on prevention rather than reaction.
The vast majority of claims are due to under-staffing and lack of available resources rather than sheer incompetence. It is the long hours and high pressured environment that many sight as their reasoning for leaving the profession. If even half of the money reserved to satisfy these claims was put into the NHS to begin with to be spent on additional resources, logic would dictate claims would fall and the profession would become more appealing.
Without this, it is suspected that this scheme is unlikely to do much in the way of incentivising a profession fraught with difficulties.