Recently read an article in Pulse titled ‘ GPs paying £35 per hour for indemnity fees as LMC leaders vote for full costs to be covered’. Interesting read, however, it included some muddled examples perhaps perpetuating a common misconception regarding the medical defence unions. To clear it up, the three main medical defence unions, MPS, MDU and MDDUS are NOT insurance companies, nor are they providing insurance cover in respect of the individual indemnity they offer to members. They are mutual organisations who offer membership and as a part of that membership they could make available their support if needed.
In my time as an insurance broker I have provided many an medical indemnity insurance policy for healthcare entities and individuals and in the vast majority of cases they thought that the defence union’s cover was insurance. Of course I put them right and in some cases they were quite shocked at the lack of transparency and recourse available to them in relation to a defence union.
The rising cost of medical indemnity for GP’s has been on the cards for some time now, but with their numbers accounting for a good proportion of the defence unions membership costs are being spread. What I mean is that the risk spreading nature of the defence unions works to large respect, however, it is distorting the actual medical indemnity costs of many GP’s out there. Out of hours work is in it its nature a higher risk element of GP’s work, however, extended working hours is not out of hours, as those patients seen are registered at that practice.
My experience of the defence unions of the last 10 years or so is that they are becoming more heavy handed with their members. Perhaps a clearing out exercise to try and off load those individuals that no longer fit their membership criteria.
So should indemnity go over to the crown? You may think I am bias in my opinion, but I don’t believe this to be the best option for GP’s, as the cover is very limited and not always in the best interests of the GP involved. What is required is competition in the market. It is currently dominated by the three defence unions, offering cover on a discretionary basis, unregulated and not accountable to anybody outside of the unions. Many other countries actually put in a minimum requirement for indemnity cover and that it is insurance based, therefore, regulated and accountable in a court of law. I know competition can sometimes be a dangerous word in areas of healthcare, but if you think about it, many already view the indemnity as insurance cover. The only difference is that it is not working in a competitive market, such as the insurance market that is global and highly competitive in it nature. Perhaps it is time that the indemnity question is revisited, as the last outcome only rubber stamped the current method, but many things have changed since then.