Professional Medical Indemnity Insurance — House of Commons, 2022-06-16
Topic: Health
Alexander Paul Beresford (Conservative, Centre-right): I am delighted to see my hon. Friend the Minister on the Front Bench. She and I have vied in the Chamber a few times, but we are on the side. I hope that we will be on the same side on this issue I apologise for the topic being niche, and I obviously have a declared interest. As a very part-time practising healthcare professional and a very full-time MP, I have been under considerable pressure on two issues relating to professional medical indemnity. The whole of the medical and dental professions seem to be on my back at various times. All registered healthcare professionals in this country are required to have indemnity insurance to be allowed to practise. As my hon. Friend the Minister will be aware, her Department has a couple of consultation documents relating to indemnity and it is, I understand, currently considering responses. Bearing in mind the time available—that has lengthened, but I assure her I am not going to fill the time, much to the relief, I suspect, of Madam Deputy Speaker as well—I will raise two key issues. They are from my own personal experience, and particularly from the experience of other medical and dental professionals who have been pressing for action I have a closer link than most with the first subject, having been a board member of Dental Protection, which is a subsidiary of the Medical Protection Society. I obtained my own personal indemnity cover through Dental Protection for many years, from when I first started practising in the United Kingdom. Later, I moved from discretionary to contractual insurance indemnity through MIA insurance and, more recently, through Densura, which is part of Lockton As I am sure the Minister will be aware, there is a distinct difference between the two types of organisations offering indemnity. Dental Protection is one of the three discretionary mutual membership organisations. They are not insurance companies. There are now several contractual insurance companies, such as the British Dental Association and Densura. They are insurance-based companies and they source their indemnity through huge multinational insurance companies, such as the Royal and Sun Alliance I understand that Dental Protection and the Medical Protection Society still maintain their cover as discretionary. That allows them to apply discretion to accept or reject any particular case that is brought to them. I realise that that is not commonly used, but it is a major and important contractual difference, in that that does not apply to the insurance companies, which are bound by contract. I believe that that discretionary section should not be allowed. In effect, discretion means that, if a self-indemnified professional is challenged and sued, and seeks assistance from their indemnity provider, it is possible for Dental Protection, MPS or either of the other mutual societies to use their discretion for whatever reason and decline the indemnity for the professional I reiterate that that is uncommon, but I can recall a number of cases in discussion with the professional media over past years. I also reiterate that, although it is uncommon, it is damaging. One particular case sticks in my mind. A dentist was abandoned—that is exactly what he was, abandoned—by his indemnifier. Despite considerable financial difficulties, he funded his challenge to the claim through the courts. He won the case. Despite that victory and despite being awarded costs, I very much doubt that he recovered 100% of his costs. It should also be remembered that, if a claimant has a genuine claim and indemnity is withdrawn, there is a reasonable possibility that the claimant, particularly if the claim is large, will not receive the appropriate reimbursement if the clinician has insufficient funds to meet it. That has happened I understand that the Secretary of State for Health and Social Care has announced, following the Paterson breast surgery inquiry, that professional medical indemnity will be reformed and that discretionary indemnity will, as I hope, come to an end. I reiterate yet again that, although it is uncommon, the cases I know of or have been told about would have been covered by the insurance indemnity providers by contract. Those have been rejected by mutual indemnity societies exercising their discretion, resulting in both patients and professionals being distinctly disadvantaged. I therefore anticipate, as indicated by the Government in 2018, that discretionary indemnity will be ruled out of order and abolished. I certainly hope so The second area on which I wish to touch is the subject of a consultation document, published at the end of January, entitled "Fixed Recoverable Costs in Lower Value Clinical Negligence Claims"—a mouthful if ever there was one. I understand that the consultation concluded on 24 April. This is particularly relevant to dentists, who remain the principal group who purchase their own indemnity cover, through subscription or premium, as the case may be. Increasingly inflated claimant legal costs will, I believe, seriously increase the cost of that indemnity It has been brought to my attention that a number of claimant solicitors have been grossly inflating their costs because it is seen, to put it bluntly, as an easy cash cow. Some of those cases have been challenged by costs draftsmen, and when that happens it is not uncommon for the claimant solicitor to reduce their bills by 20% to 30%. To my mind, that suggests that the bills are being inflated, to put it simply and bluntly, as a try-on I have obtained a large number of examples, but will draw the Minister’s attention to only two, which I consider to be classic examples of opportunistic abuse of the system. One case, which concluded in 2019, resulted in a claimant award of £9,250 and a clinician solicitor cost of £10,042.80. The claim submitted by the claimant solicitor, however, was nowhere near that £10,000. Instead, it was for £87,297.89. The second claim, which also goes back to 2019, resulted in damages of £5,000 for the claimant, and the indemnity legal costs were similar to those for the first case, at £8,225.40. The claim for the claimant solicitor costs, however, was £72,886.23. That is quite outrageous Not all claimant solicitors are grossly inflating their costs—I must rush to point that out—but they are sufficient now to drastically affect indemnity subscriptions or premiums. Annual indemnity cover for the average full-time NHS dentist now costs in the region of £4,000. Many pay more. It is a substantial sum, especially to an NHS dentist at a time when the profession is under huge pressure, with a shortage of dentists and a considerable number of vacancies. The prospect of rapidly increasing costs to a beleaguered profession calls for prompt ministerial action. I await.