Endpiece: Thoughts on Dental Indemnity 2018
Tony Jacobs
None of us own a working crystal ball, if only we could predict the future? Like the country chap asked for directions by a passing tourist, "well if I was going there, I wouldn't start from here!". So much of the change in the last decade or so has been far outside the control of the profession, and even now, the profession is simply unable to create the leverage to make common sense changes to aspects which have gone badly wrong. Years go, our profession only used lawyers occasionally, buy or sell a property or practice, partnership agreements and little more. Yet today's dental panorama has lawyers reaching to the profession over so many matters, CQC, NHS contracts, partnerships and one hears practice sales are both lengthy and a minefield these days. It is no comfort to feel our profession is helping the lawyers with their balance sheets and pensions. UK dentists feel like they are truly over a barrel with the current dento-legal crises. The no win no fee lawyers are trawling through any notes they can find for any historic issues from which they can create a case. The GDC complaints train still rolls along, seemingly frictionless, although GDC says the Case Examiner system is throwing out most cases over the last year, suggesting the number of Practise Committee cases will fall.

In both those aspects, litigation and regulatory matters mean costs for the indemnity providers must have risen markedly, they have larger teams, large offices, and their costs rise. The largest of the mutually owned indemnifiers have large free reserves available, in the billions of pounds, trying to cover the "unknown-unknowns", they raise their fees due to the present climate, and to increase that reserve for future unknown claims.
Mick Armstrong, Chair of the BDA has said "we have a broken indemnity market" when he called for the Government to include dentists in a new indemnity scheme for general medical practitioners. Why does it seem that dentists are always left out of these new concepts?

The free market does behave in predictable ways, and the rise in those fees has led to several entries in to the dental indemnity market, fuelled by one sided stories from colleagues who feel they have been treated unfairly by the traditional mutual indemnifiers. Some colleagues have had defence dropped for what seems minor reason, fees appear to have risen unfairly, but those organisations retain their confidentiality, so the dental public only hears one side of the story. What are we to make of the new entrants? Should colleagues jump to an insurer, or an advisor who also sells them an insurance policy? Some colleagues feel untenable or unfair rises in premium/membership fees push them in that direction, older colleagues feel they must stay with the occurrence based solution, so they remain covered in their twilight years. So where will we be in a few years? I can write what I hope will come about, but it might be that these fees continue their rise, and dental fees to patients will have a definite element to allow for this cover. If we look our patients in the eye, and explain our indemnity has risen from £100 a month [or less] to £1000 a month [or more] in the last 8 years, they can surely understand why fees have risen. I have learnt this sort of article cannot change policy, but perhaps might influence some colleagues. My advice, if you are thinking about changing provider of indemnity cover:
  • think very carefully
  • take advice from all sides of the indemnity market,
  • talk it over with you life partner and trusted dental colleagues,
  • read forum discussions on this matter,
  • plan ahead cautiously for your renewal, you must not have even one day without this cover.
Iage credit - Kevin Dooley - under CC licence
20th Anniversary Magazine