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Medicolegal chief slams UK’s “oudated” indemnity system

2 October 2008

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The UK is persisting with an “outdated” system of indemnifying doctors that risks leaving patients uncompensated, say medicolegal experts.

The chief executive of the Medical Defence Union (MDU) has warned that the UK allows “unregulated indemnity” in contrast to other EU member states, such as France and Germany, which require practising doctors to have professional indemnity insurance in order to protect patients where they are negligently harmed.

In the UK, while there is insurance, there is also discretionary indemnity that provides only the right for a practitioner to request assistance and have the request considered.

The MDU believes that this is as detrimental to the interests of UK patients and doctors as it would be to patients from other member states who were negligently harmed by treatment provided in the UK.

Dr Michael Saunders, MDU Chief Executive, said: “In this current medicolegal and economic climate, we cannot understand why the UK still allows unregulated indemnity.

“The UK has fallen far behind other EU states on this. A German patient who was treated in the UK and negligently harmed by a doctor who was reliant on discretionary indemnity might not be compensated if the indemnifier decided not to assist with the claim. Of course, a German patient who was treated and harmed at home by an insured doctor would receive insured compensation.

However, Dr Saunders points to “an opportunity to resolve this anomaly”: the European Commission is currently developing a directive to safeguard patients’ rights in cross-border healthcare, including the need for appropriate “systems of professional liability insurance or a guarantee or similar arrangement … appropriate to the nature and the extent of the risk”.

The MDU has made a submission to the House of Lords Select Committee looking at the draft directive, calling for the EU to ensure that insured professional indemnity is the way forward for doctors and patients in all EU member states.

Dr Saunders added: “We hope that the European directive will be amended to ensure that indemnity must be provided only by the state or a regulated insurer. This would make discretionary indemnity unacceptable in the EU.”

“In the current volatile economic climate it is particularly important that professional indemnity is regulated, as this provides a high degree of protection.

“Insurance offers a range of protection for policyholders and patients, including the Financial Ombudsman Service to provide a means of redress when assistance is refused; the Financial Services Compensation Scheme, which pays claims in the event that an insurer fails; as well as rights for patients in the event a doctor is declared bankrupt or dies with an insolvent estate.

“Discretionary indemnity has none of these safeguards.

“When damages are awarded in negligence cases it is imperative that patients know they will receive the compensation due to them. The UK has some of the most forward-thinking and technically advanced doctors in the EU but discretionary indemnity is distinctly last century.”