News MDDUS MDDUS reports significant growth EDITOR Dr Barry Parker


COMPLAINTS are an inevitable part of providing a public service, and in medicine and dentistry there are guidelines and defined processes to follow when they arise. Health professionals are expected to provide a calm, rational and reflective response, using a complaint as an opportunity to learn and develop. An important part of our role as a defence organisation is to help practitioners navigate these complaint processes and support them with the emotional turmoil that can accompany a complaint, including anxiety, frustration and despondency. Sadly, in the case of more serious or


“Part of our role as a defence organisation is to help practitioners navigate these complaint processes”


protracted complaints, there can be a significant impact on the practitioner’s health. On page 10, Dr Clare Gerada, GP and Medical Director of the NHS Practitioner Health Programme, provides her perspective on this challenging and important issue. Tooth wear is


increasing in the UK – and there are myriad causes, from the effects of drinking too much fruit juice to bruxism to eating disorders such as bulimia. This can make identification and management particularly tricky,


with specialist care within and beyond dentistry sometimes necessary. On page 14, Professor Andrew Eder offers an expert view. “Duty of care” is fundamental in establishing clinical negligence, and its origin in UK law can be traced to an obscure case involving a bottle of ‘ginger beer’ and a dead snail. Dr Allan Gaw relates the tale on page 12. Our Briefing column on page 8 looks at a promised digital revolution in primary care and the Risk topic opposite (p. 9) concerns clinicians engaging with media producers – be it TV, radio or online. Our Dilemma on page 20 looks at a scenario involving a police request to access practice CCTV footage in order to investigate a crime. We are also pleased to welcome back


Professor Deborah Bowman with her regular Ethics column on page 21. Here she looks at the curious “doubling” – or “simultaneous yearning for the contradictory” – that can occur when dealing with illness.


Dr Barry Parker 4 / MDDUS INSIGHT / Q3 2018


MDDUS has reported another year of growth, with significant increases in GP, hospital doctor and dental membership. Figures from the MDDUS Annual Report and Accounts 2017 reveal a year-on-year


increase of 13.7 per cent in total membership. This upward trend has continued in 2018 with active membership at the end of June standing at over 47,000. Overall GP membership rose by 13.9 per cent in 2017, with those practising outside Scotland making up 73 per cent of the total, reflecting our expertise across the UK. As of June this year, MDDUS now has just shy of 20,000 GP members in total. There was an increase of 11.9 per cent among hospital doctors. Dental membership increased by 30 per cent in England, Wales and Northern


Ireland in 2017. MDDUS now has more than 7,000 dental members and a fifth of the UK market share (two-thirds in Scotland). MDDUS chief executive Chris Kenny said: “Increasing numbers of doctors and


dentists are putting their trust in our professionalism, responsiveness and value. Our membership growth has shown no signs of letting up and we now offer our indemnity and non-claims services to more people than ever before and across a wider range of professions. “With the twin uncertainties of the discount rate and state-backed indemnity


casting big shadows over MDDUS in 2017, we have responded robustly in the interests of our members. We have invested a lot of time and energy speaking to politicians and officials at every level in Westminster and across all the devolved administrations to ensure that our members’ interests are fully understood. “We have also moved to adapt and develop the services we offer in response to market demand, but we remain focused on our core business of supporting, advising and defending our members.”


MDDUS addresses “safe space” recommendations


MDDUS has welcomed an influential call for the Government to reconsider allowing NHS trusts and foundation trusts to conduct internal “safe space” investigations. A government committee has published its findings on plans to establish the Health Service Safety Investigations Body and stated that while safe spaces where medical professionals can reflect on incidents were an essential part of investigations, allowing trusts and foundations to run their own was not a good idea. The Joint Committee on the Draft Health Service Safety Investigations Bill today said that internal safe space investigations were “misconceived”. This was one of the main messages


that MDDUS had made in its written submission to the HSSI Bill. Joint Head of Medical Division


John Holden said: “We are pleased to see that the Joint Committee has agreed with our submission that whilst the public may have confidence in trusts carrying out their own ‘safe space’ investigations, such confidence is less likely to be shared by health professionals. “Health professionals are unlikely


to be reassured by the prospect of investigations being conducted by trusts in situations where resourcing or workload or other systemic issues within the control of the trust may be factors which have had a bearing on the patient safety issues under investigation. “It is essential that the new body is seen to be completely independent of existing healthcare structures and organisations and we are pleased to see that being recognised by the Joint Committee.”


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