Part of the debate – in the Senedd at 4:59 pm on 15 October 2019.
Thank you. I'll deal with the three specific questions and then a point about the rise in costs.
On your last point, I'm not sure that's particularly relevant to the Bill in the sense of people working in the prison sector. We have two different schemes; the future liabilities scheme is already in place. This is about existing liabilities and, actually, as I've said in response to Dai Lloyd, as long as someone has a pre-existing membership of a medical defence organisation, then they'll be covered. The purpose of the amendment is the existing liabilities that may have been reported, but not incurred, as I set out in my statement.
In terms of the point about cross-border activity, again, part of the point and purpose of having this Bill and the shorter scrutiny period that the Business Committee have agreed is to ensure that we have these regulations and the scheme in place. One of the express things it will do is to make sure not just about the comparison between doctors working in general practice in England and in Wales, but also that cross-border flow in activity that goes in both directions—so, make sure that there are comparable schemes. I'm not, though, going to use this Bill to remove the locum register. If Members want to bring forward amendments, they're welcome to do so, but I want to state that is not the policy purpose and intention of the Bill, and I'm just going to be honest that I'm not seeking to do that in this piece of very tightly focused legislation dealing with a specific issue.
I do want to come back to the point about the issue about the rising costs, because the rise in GP indemnity costs came from a number of different factors, but I don't think it's right to say that it's about an explosion in claims. Actually, one of the biggest issues that led to action being taken across the UK was the decision by the Lord Chancellor to change the personal injury discount rate. Now, this really matters because it significantly increased the costs and the challenge about cover, and, actually, the move from 2.5 per cent to a -0.75 per cent discount rate on future losses meant that GP subscription costs could have increased by up to 25 per cent, and that really was a significant driver that meant that the current scheme, which was already under pressure—. When I became the deputy health Minister over five years ago now, for my sins, it was an issue then, at that point in time, about the costs of indemnity cover. The steps we took in putting money into the GP contract enabled some of that to be covered and dealt with, but it was still a pressure. But the change in the discount rate was really the issue that forced us to look at something that is radically different, and that's why we're here now.