MDDUS sounds note of caution over state backed indemnity scheme


The UK’s fastest growing GP defence organisation today sounded a note of caution over plans aimed at developing a state-backed scheme for GPs in England.

MDDUS said the Government must spell out the details of what is involved and commit to tackling the real issues behind rising indemnity costs before GPs can make a decision on the scheme.

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.”

Mr Kenny said that GPs have the right to expect such detailed assurances – and the option of opting out at no financial detriment if answers are inadequate. "It is no secret that the rising cost of indemnity has been a major concern to GPs, particularly in England,” said Mr Kenny.

“The Government’s failure to reform the law of tort and cap costs that lawyers are taking from the NHS and GPs has been the main driver in rising indemnity costs. That’s outside the control of medical defence organisations and today’s announcement doesn’t tackle that.

“GPs in particular have borne the brunt of a financial ‘perfect storm’ and it’s profoundly disappointing to see Government seeking to move rather than reduce claims costs as it fails to tackle the underlying issues.”

Last year the Government’s own conclusion was that: “Ultimately any move towards adopting a different model of indemnity in primary care would need to reconcile the fact that the cost would not disappear, and would still need to be funded within the overall health budget.”

Mr Kenny added: “In the absence of legal reform, that conclusion still holds good. We wait to see how Ministers propose to square this circle. We are nevertheless prepared to talk to Government about this proposal, whilst maintaining protection for doctors and patients.”

MDDUS is seeking detailed assurances on the following key principles:

1. Claims must be handled in a way which protects patients and the professional reputation of doctors as well as the financial interests of the state;

2. GPs must be able to choose who provides the claims indemnity for them and their practices and organisations. That means a financially neutral choice with the same public support available to all GPs inside and outside any state-backed scheme;

3. The scheme must cover today’s and tomorrow’s NHS. In promoting new ways of working, it must protect GPs from all of their potential liabilities – including liability arising from employing or supervising other healthcare professionals and administrative staff – across all of the organisations in which they work. All doctors must be protected individually irrespective of how many organisations they work for, how their career develops and it must cover them after their retirement;

4. A scheme must recognise that healthcare professionals remain personally liable for their actions, irrespective of whether they work as an employee or contractor for the NHS. The scheme must not impose arbitrary caps or limits on claims, and must ensure that patients and individual doctors remain protected even if an NHS body fails to pay the required premium, or decides to opt out of the scheme in future;

5. There should be absolute transparency about how setting up the scheme will impact on the GP Remuneration System. GPs should be given firm assurances about pricing of the scheme in the longer-term, given the absence of action on claims inflation;

6. The new scheme managers must recognise the enormous stress that claims can place on healthcare professionals, and must have the specialist skills to provide the personal support and expert medico-legal advice needed to help them throughout the litigation process. The recent outsourcing of PCS to Capita shows the harm caused to doctors and the NHS when untested outsourcers blunder into sensitive healthcare markets;

7. GPs must retain the wider existing medico-legal advice and support for times when they may come under professional scrutiny, through medical defence organisations (MDOs) and other bodies. Those advisory arrangements should remain funded under these new arrangements;

8. There should be no financial detriment to the other medical and dental members of MDOs, whether in England or other jurisdictions, as a result of any change made for GPs in England.

9. There must be certainty that a new scheme can be introduced with no operational and IT failures and no disruption to existing claims being processed at the time of its introduction.

Mr Kenny concluded: “We welcome the opportunity to continue to address the issue of how to ensure the best result for GPs and their patients. But an ill-defined scheme which only provides some short-term relief to a problem that is much bigger and has many more issues at its core will not help anybody.”


Note to editors

The announcement today only affects GPs in England. MDDUS works across the UK and is in discussion with the devolved administrations in Scotland, Northern Ireland and Wales about the direction they may wish to travel, based on today’s announcement. For further information or to speak to Chris Kenny, please contact Stuart Wilson, Head of Public Affairs and Strategic Communications at MDDUS on 07964 345 842 or email

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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