NHS indemnity insufficient

Most doctors will join at least one medical defence organisation (MDO) in medical school – sometimes more than one if only just for the incentives handed out. Many will then let that membership lapse upon entering postgraduate training, relying upon NHS indemnity to see them through their programme. It’s a risky move. Even the GMC states on its website: "The protection that comes from employment in the NHS is by no means sufficient to cover all situations in which you may find yourself".

Each year the MDDUS receives calls from NHS doctors wanting to join the Union but who are currently facing GMC or other disciplinary procedures. Such requests must be either declined or conditionally accepted with exclusion from assistance and indemnity for any pending cases.

Legal advice and representation in such cases can be expensive and sadly these individuals are left exposed to the full costs.

Foundation tutors and educational supervisors should encourage trainees to seriously consider the risks of not having the additional protection provided by MDDUS membership.

To be clear, NHS cover does NOT provide:

• Representation and legal support at GMC proceedings
• Assistance with disciplinary matters
• Individual legal representation at fatal accident inquiries and coroner's inquests where the interests of a particular doctor and their employer may diverge
• Indemnity for Good Samaritan acts.

Over the past decade, ‘non-claims’ GMC, disciplinary and other such cases undertaken by MDDUS have risen steadily. MDDUS estimates that in 2008 only 20% of medical adviser time was taken up by professional negligence claims. A significant portion of MDDUS cases now involve GMC or GDC matters.

It’s a hard reality but doctors remain on the Medical Register 365 days a year, 24 hours a day. In many ways the work–play split does not apply in medicine as it does in other professions. Questions of conduct or behaviour, such as breaches of criminal law or offences involving drug abuse and alcohol, can restrict and sometimes end a medical career. Even inadvertent errors can lead doctors into difficulty. With so much at stake, not making provision for costly expert legal advice and representation would seem foolhardy at best.

ACTION: All doctors employed by the NHS should seriously consider joining MDDUS if not in membership already. Foundation tutors and educational supervisors should encourage trainees to consider now the risks of not having the additional protection provided by membership.