Restoring balance

John Makin examines the real issue threatening to undermine indemnity provision for dentists.

Dental professionals considering the recent consultation from the Department of Health and Social Care (DHSC) on appropriate indemnity may be forgiven for thinking there is something wrong with the dental indemnity market.

But, I’m happy to report that discretionary indemnity provided by the defence organisations, for more than 130 years, has served the profession and patients well and should be allowed to continue.

The proposal is that all healthcare practitioners have insurance, rather than discretionary indemnity, for clinical negligence claims.

This would affect thousands of dental professionals and large numbers of other healthcare professionals.

It would result in considerably higher indemnity costs, for no obvious gain.

In my view, to ensure patients are appropriately compensated, a regulatory body – probably funded by practitioners – would need to be established to decide which insurers should be allowed to provide indemnity and to prevent the restrictive exclusions and conditions that currently feature in many policies.

Unlimited cover

The Dental Defence Union (DDU) assisted with a number of claims last year where the initial incident dates were in the 1990s and early 2000s.

To meet such claims, insured indemnity would need to be unlimited in time and amount, which would probably make it unaffordable.

There is no evidence that discretionary indemnity, provided by defence organisations that are not for profit mutuals, is failing to protect patients.

Aside from NHS indemnity, discretionary indemnity is the only proven way of ensuring dental professionals are adequately indemnified and patients compensated.

Insurers, however, can leave the market.

As happened when regulated insurer, the St Paul, unexpectedly withdrew from the market in 2001, leaving many UK dentists without indemnity for claims notified after their policies ended.

If dental professionals wish to leave a claims made insurance provider, they will need to put indemnity in place for past practice, a GDC requirement.

If run-off cover is not offered or is unaffordable, the practitioner may be left financially vulnerable and patients left uncompensated.

If the government wants to address the real issue threatening to undermine indemnity provision for dentists, it should focus on restoring fairness and balance to the UK’s civil negligence system.

The problem is the rising cost of claims, not the providers of indemnity.

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