There are a number of reasons why there is a severe shortage of GPs in the NHS, including overwhelming workloads, a shortage of skilled junior doctors wanting to become GPs, underfunded Primary Care services and the indemnity cost to a GP for just being able to practice.
It has been reported that some GPs have been quoted as much as £30,000pa to include out of hours cover and many are incurring an average yearly increase of 25% in their policies. Last year the magazine Pulse said that GPs who live in the northern UK border regions are choosing to practice in Scotland instead of England just because indemnity costs are one third of what it would cost them in England.
One doctor was quoted at the LMC Conference saying that on moving from Scotland to England his indemnity fee rose by 500% for the same level of cover. While the MDDUS claim that they aim to keep their fees competitive, they justify the cost by stating that GPs in England apparently are three times more likely to have claims against them and the value of the claims is higher in England than Scotland. Operating as not for profit organisations, MDOs insist that their increasing subscription fees are justified by having to pay out larger compensation claims and they see the problem as a legal reform issue.
With fewer GPs available for out of hours cover inevitably hospital A&E departments are crammed with non urgent cases, creating long waiting times and urgent cases not getting the immediate attention that they need. Only last week one hospital had a queue of 13 ambulances waiting to unload their patients.
Although there has been some media coverage about the cost of indemnity insurance, apart from magazines such as Pulse most media outlets take the easy route and blame GP shortages on the lack of funding for the NHS or whichever government is in charge for mismanagement.
While the NHS is trying various schemes to solve the indemnity cover crisis, interestingly most patients would be completely unaware that one of the main reasons they can’t speak to or see a GP during the out of hours period is primarily an insurance issue and not because GPs aren’t willing to work during that time.
One GP, who only works out of hours and who has not had any formal proceedings against her has seen the cost of her indemnity insurance rise from £8,000 to four times as much in just two years. The MDOs might say that the cost of insurance inevitably has to rise because of the increase in claims and how much compensation is awarded, yet all GPs are affected by these prohibitive insurance policy costs, not just the much smaller percentage of GPs in the NHS who have to make a claim.
There have also been assertions by unnamed GPs that just calling an MDO helpline for advice without even making a claim has affected the cost of their next policy and seen it soar. While legal reforms on compensation might help, in reality it will take far longer to change the law than review the real cost of indemnity insurance and bring it down. One leading medical recruitment consultancy has already found a way to actually solve this crisis issue.
Primary Care Professionals has researched and studied the market for two years and has now resourced a unique indemnity insurance policy, covering in hours and out of hours care, which is available totally free of charge to all of its GP candidates. The policy has exactly the same level of cover that GPs have in their current indemnity insurance.