GPs feel forgotten and neglected over rising indemnity costs - MDDUS
Chris Kenny
| Medical and Dental Defence Union of Scotland
Chris Kenny, Chief Executive Officer of the Medical and Dental Defence Union of Scotland (MDDUS), calls for greater focus on root causes of rising indemnity costs.
Like car and property insurance, paying for GP and GDP indemnity cover is a necessity, not a pleasure – but just as vital. Patients and professionals alike need the reassurance that they will be protected when things go wrong - fair and prompt compensation to patients when clinical accidents occur and lifetime protection as well as the best personal, professional and legal support for professionals facing scrutiny in court, at inquests or before the GMC. Everybody agrees that we need to maximise the proportion of damages going to genuinely injured claimants, rather than to lawyers.
Indemnity is a key part of the vital hidden wiring of the NHS – and one paid for by the medical and dental professionals themselves through MDDUS and the other medical defence organisations, all non-profit making mutuals, proudly owned by and serving the needs of their members, working in an sector judged competitive by Government just last summer.
But, when hidden wiring is forgotten and neglected, then it starts over-heating. That’s how English and Welsh GPs have felt in recent years, facing above inflation subscription increases caused by sharp rises in the number of claims and the costs of settlements.
The Department of Health and NHS England are working closely and creatively with the industry to tackle the consequences. The clear ring-fencing of monies in the last two years in part to offset these increases is welcomed, but there’s a danger of too much focus on sticking plasters, not enough on root causes.
Some examples. The Department of Health has some welcome, but over cautious, proposals out for consultation at the moment – but only two years after announcing its intention to consult.
Longstanding industry proposals to reform the Law Reform (Personal Injuries) Act 1948 await a Government response. In the meantime, awards continue to be calculated on the basis of the costs of private sector care, when all the evidence shows that those who receive damages, quite rightly, use excellent and readily accessible NHS services where they can do so. Legislation is needed on both issues urgently.
In a classic failure of joined up Government that looks set to make the problem worse, rather than better, doctors and dentists may now face a share of the £6bn bill for the NHS between now and 2022 caused by the Lord Chancellor’s recent astonishing decision to reduce the discount rate used in personal injury claims from 2.5% to –0.75%. That will drive up the size and number of claims (and associated legal bills) – and mean more of them will be painfully fought over in court rather than resolved amicably.
The promise of “appropriate funding” to reduce the impact, although welcome, is as yet undefined. And how can it be remotely sensible to proceed with such a change, when a review, with a promise of early legislation to alter the basis on which the rate has been set, is about to be launched? MDDUS is challenging the Lord Chancellor to stay implementation, while she shows her reasoning in greater detail, as advice from Leading Counsel suggests she has erred legally in both the process and substance of her decision-making. We do not discount further action once we have studied her response.
There is no need for the wiring to overheat. The solutions are clear – tort reform, cost capping and clearer, more transparent and broadly based tests for setting the discount rate. But will the governmental electricians rise to the challenge?
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