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Wednesday 11 May 2016

What happens when doctors harm patients?

We should all be getting used to the idea that pharmaceutical drugs and vaccines cause harm to patients. This manifests itself when patients, who take drugs for one illness, develop new diseases (often called side effects), and even death.

So how do doctors protect themselves from the consequences of prescribing drugs and vaccines, that by their own admission, are inherently harmful?

The answer is that they insure themselves against the risk. If my doctor harms me, or if your doctor harms you, or your children, the consequences are borne by an insurance company - much in the same way that our cars, and our houses are covered in the event of being damaged.

There have been a series of articles on the issue of 'indemnity insurance' in the GP e-magazine, Pulse, which outlines the problem doctors are facing with this. The underlying problem is that as conventional medicine is harming an increasing number of patients so the cost of this indemnity insurance is rapidly increasing.

On 22nd March 2016 Pulse reported that there had been a large increase in 'multimillion pound compensation claims against GP's. The article refers to figures reported by the Medical Defence Union (MDU).

          "Multimillion-pound compensation claims against GPs and private consultants have risen three-fold over the past decade.... The Medical Defence Union said that it has settled 12 compensation claims in excess of £1m in 2015.

It was stated that in 2005, just 4 settled claims exceeded £1m, whilst there was only one claim of that amount in 1995.

And it is not just conventional doctors that are facing this problem. On 16th February 2016 Pulse reported a 'Sharp rise in negligence claims against practice nurses'. The MDU stated that the number of clinical negligence claims against practice nurses have risen sharply over the past decade.

          "Only two nurse practitioner members reported clinical negligence claims to the MDU in 2005 but climbed to 25 in 2015."

So is this a problem for the conventional medical establishment? In an earlier article, on 4th February 2016, 'Out-of-hours group increased recruitment threefold', Pulse reported that a GP out-of-hours service provider had offered doctors free indemnity cover and that this had boosted recruitment threefold over the last six months. The company, Vocare, said it recruited 175 GPs to work out of hours during the past six month period, compared to just 60 in the six-month period prior to this when it struggled to fill shifts.

          "A survey by Urgent Health UK recently found that four out of five out-of-hours GPs said spiralling indemnity fees are limiting the number of out-of-hours shifts they’re willing to do."

The article mentions that doctor recruitment was at 'an all-time low', the implication being that doctors are increasingly reluctant to practise their medical skills, dominated as they are by the prescription of pharmaceutical drugs, in case they damage their patients, and are brought to task for doing so.

Similar news came through five days later, on 9th February 2016, when Pulse reported that 'Paying out-of-hours indemnity added 15,000 shifts this winter'. It stated that over 500 GPs had booked extra out-of-hours shifts under NHS England’s £2m winter scheme "to cover their medical indemnity costs". This totalled 14,264 extra shifts made available to patients needing out-of-hours GP care. The article stated that NHS England will run the 'experimental scheme' until the end of March "while continuing discussions with the GPC on longer-term solutions to the problem of rising indemnity fees for out-of-hours work."

At the bottom of this article was another feature, entitled "We need to protect GPs from litigation. Here's how." It stated that the scheme was introduced "after increasing evidence that the cost of indemnity fees was putting GPs off taking on out-of-hours shifts, with a Pulse survey revealing that half of GPs turn down out-of-hours shifts because the cover is too expensive."

NHS England said that they introduced the scheme as indemnity fees were acting as "a barrier to delivering care."

So the message is clear. Doctors, who provide us with conventional medical care, are increasingly reluctant to do so because of the cost of indemnity insurance, that is, that cost to them if they harm patients by their treatment. Doctors, it would appear, are more prepared to do so if they do not have to bear the cost of insuring themselves against such an eventuality.

GP practices have also expressed their concern about the cost of indemnity insurance, and whether it covers their staff in all eventualities. On 14th March 2016 Pulse sought to answer the question 'How do I make sure all my staff have appropriate indemnity'. This article started with the observation that GP indemnity costs were "spiralling out of control", quoting the Pulse report that they rose by an average of 25.5% in 12 months leading up to November 2015. Yet the article goes on to explain that some indemnity cover can leave staff "without the necessary cover, which can be dangerous for the practice, as well as the affected staff".

So the conventional medical establishment has a problem. Its drugs and vaccines can cause harm to patients. When patients are harmed it can lead to expensive litigation. To protect themselves from this litigation doctors, nurses, pharmacists and others need to be insured.

Yet conventional medicine is now causing so much harm the spiralling cost of indemnity insurance had become an important issue, affecting whether doctors are prepared to offer their medicine to patients.

So the government recognises indemnity insurance is a problem for the conventional medical establishment, and decides to intervene - in order to encourage doctors to practise their trade! On 21st April 2016 Pulse reported that 'NHS promises to address rising indemnity fees but falls short of full funding'. What they are proposing, apparently, is a problem for the conventional medical profession.

          "NHS England is not going to cover GP indemnity costs as part of its general practice rescue deal, despite calls from the profession to do so, instead focusing on a ‘discussion’ to address rising fees."

Instead of fully funding the cost of indemnity insurance, NHS England is proposing to look at how costs can be contained, or reduced, or perhaps to enable new 'multi-speciality community practices' to take on corporate indemnity cover for all their GPs under one policy.

The article also discusses a proposal that there should be a cap on costs that claimaint lawyers can recover from clinical negligence claims. In response, NHS England said it did not believe that 'Crown Indemnity' was actually ‘the intent of the profession’, as this would ‘mean it is not possible to sue for damages and that the small minority of patients who had suffered harm as a result of clinical negligence would not have recourse to any financial compensation’.

So is this is what our doctors want ? Full indemnity against harming patients, without any cost to them? This series of Pulse articles have described what doctors (and other medical practitioners) want but it might be useful to consider what this means for patients. So let's use an analogy.

Suppose I drive a dangerous car (all cars are dangerous) on the roads, and I know that driving too fast can cause serious injury to other road users. In order to do so I pay for motor insurance every year, but as I and my colleagues have caused a series of serious accidents over a period of many years, I find that my insurance premiums are now sky-high! They have become a serious expense. They have actually raised questions about whether I should continue to risk driving my car.

So I persuade someone else to pay my insurance premiums for me! And actually, it is YOU (as a tax payer) who have taken on this responsibility. I am extremely happy about this! It means that I can continue to drive my dangerous car, I can drive it as fast and recklessly as I want, and I do not have to be too concerned about the serious damage I might do to other peoples lives.

Pharmaceutical drugs companies have achieved a similar result, with governments throughout the world providing them with indemnity against the consequences of any harm caused by their drugs and vaccines. It is not the companies who profit from their drugs and vaccines that pay for the harm they cause to patients - it is patients. And if their drugs and vaccines lead to expensive litigation, the government, courtesy of the taxpayer, will pay all the costs.

Now, conventional doctors want to have equal treatment! In the world of conventional medicine, it would seem, the responsibility for causing harm to patients has been taken away from those who cause it.

For an update of this information, go to this blog, "What happens when doctors harm patients? (2)"

A further update is available here. "Indemnity. What happens when doctors harm patients? (3)"