Historic defence cover faces axe

By Robin Stride

Private doctors face a huge defence cover shake-up under Govern­ment proposals advocating the merits of insurance rather than the discretionary cover provided by traditional medical defence organisations (MDOs).

Responses to the 51-page discussion document, reflecting widely different views, are being prepared by doctors’ representatives, private hospitals and interested parties.

The Department of Health and Social Care’s report, called ‘Approp­riate clinical negligence cover – a consultation on appropriate clinical negligence cover for regulated healthcare professionals and strengthening patient recourse’, spells out two key observations:

‘At the heart of a contract of insurance is a legally enforceable obligation to provide some form of benefit – usually in the form of a monetary payment – upon the occurrence of a certain event, which may be subject to specified caps and exclusions.

‘In contrast, MDOs offering discretionary indemnity do so on the basis that their discretion is absolute, that any assistance offered is at their sole discretion and they therefore are not obliged to pay out in any circumstances.

‘Consequently, regulated health-­care professionals have less visibility, certainty and assurance as to what incidents may or may not be covered under discretionary indemnity.’

The newly named Independent Healthcare Providers Network welcomed the consultation, saying private hospitals had long wanted fully comprehensive insurance indemnity cover to replace ‘simply not tenable’ discretionary cover.

It said it looked forward to working with the department, MDOs and the insurance industry to ensure private patients got the same legal and financial protection as NHS patients.

A spokesperson added: ‘There is a lot of detail to work out, including how any risk-pool might work and what the cost will be. But looking at other industries that have moved from discretion to comprehensive cover, costs have not increased as some feared they might, with it also allowing for a greater level of risk adjustment.’

The Independent Doctors Federation has long voiced concern about discrepancies in indemnity cover for private doctors. It said all stakeholders had to have confidence in public and private arrangements, which were for the safety of doctor and patient.

Doctors and others have until 28 February to respond.