Part of the debate – in the Senedd at 4:50 pm on 15 October 2019.
Can I warmly welcome this statement, and also the National Health Service (Indemnities) (Wales) Bill? I'll declare my usual interest as a GP who has been known to pay his medical indemnity for many years, otherwise I wouldn't be allowed to practice being a GP at all.
Now, this Bill brings GPs into line with what has always happened with hospital doctors and hospital consultants, in that the state has always paid their huge medical indemnity fees, and now we're going to be doing the same for GPs—long overdue, many people would say, because medical indemnity insurance at the moment can run up to about £15,000 per year, on a sliding scale, depending on where you work—out-of-hours, A&E, riskier times in the middle of the night. But it's a huge personal cost that obviously has been highlighted in recent years as a reason for GPs deciding not to be GPs, particularly part-time or those towards the end of their careers—actually, it costs them more in medical indemnity than they would actually earn doing a lesser amount of work. So, the rising cost of medical indemnity is what has driven this welcome piece of legislation.
Just a couple of points: obviously, future liabilities, that part has already kicked in since April this year. What we are passing now is a technical improvement, if you like, of that. And obviously we're scrutinising that in the health committee and in CLAC. It's about existing liabilities—in other words, things that have happened prior to April 2019. And, just as a point of fact, obviously, medical negligence, so called, or claims, can start a very long time ago and only come to surface, or to note—or somebody decides to put in a claim—many years after they've happened. I know of examples of a 20-year gap and more between the actual incident and that incident being complained about. Now, if we're going to say now this existing liability scheme covers everything prior to April 2019, can you just state how you feel that would operate, in fact? Are you going to go back 20 years or so, because I would have that worry then about Welsh Government and how Welsh Government is protecting itself, as it were, from the potentially huge liabilities incurred.
Because there's no getting away—and this is my final point, now—from the fact that there are huge costs involved, not in the actual running of the Bill, obviously, but in the huge legal costs. That's why we have to have medical indemnity insurance in the first place, because there's a very adversarial system at the moment: patients and their families have to prove that a doctor or nurse has been negligent—that's a very complicated situation—as opposed to, in some countries, we just accept the possibility of mistakes and medical mishaps and people have a sliding scale of compensation, called 'no fault' compensation, where you don't have to prove fault, you just get the money a lot sooner than you do in the current adversarial legal system that we go through in this country. So, while welcoming this Bill and obviously taking GPs and putting them on the same level as hospital doctors and consultants who already have Crown immunity, in terms of expanding the thought processes for the future, what consideration also has the Minister given to a system of 'no fault' compensation, as exists in other countries, like New Zealand? Thank you.