Personal professional indemnity and contractual issues for trainees in obstetrics and gynaecology.

Over the last few decades, more healthcare professionals have faced investigation into complaints about medical care and healthcare outcomes (Department of Health 2003). With increasing medical negligence cases being brought against doctors, it is time to carefully consider the implications of such actions to ensure appropriate safeguards (Ferner and McDowell 2006). At a time when the culture of 'no win, no fee' is rampant, the jobbing frontline doctor is on the back-foot trying to untangle the legalities of a malpractice claim (Ferner and McDowell 2006). Reassuringly, the numbers of doctors referred to the GMC or having to face legal procedures or claims for compensation are still very small (National Audit Office 2001). An essential issue for all doctors is having appropriate indemnity cover in the event that their practice is challenged. The opt-out for the European Working Time Regulations (EWTR) has caused further confusion as to what is covered for junior doctors by individual indemnity policies and the employer's liability scheme. Recently, the RCOG Trainees committee and the BMA Junior Doctors Association issued a joint advice regarding this issue (RCOG 2010). In this paper, we consider the differences in cover provided by the employer's liability scheme, individual professional indemnity schemes and the role of professional bodies. We also seek to clarify the understanding of these surrounding EWTR and the voluntary opt-out clause and provide up-to-date information on medico-legal issues and protection schemes regarding legal liabilities.

Clinical governance, litigation and human rights.

Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the introduction of the Human Rights Act 1998. Examines these issues from a legal perspective. Concludes that successful risk management, careful monitoring and the implementation of authoritative guidelines hold the key to legal change.

Guidelines in medical practice: the legal issues.

The use of guidelines represents a new culture in medicine-a shift of emphasis away from reliance on individual discretion towards greater professionalism and accountability. Although they are important vehicles for those who wish to evaluate and monitor healthcare practice against recognized standards, this paper explores the legal problems surrounding the implementation of guidelines in the National Health Service in the UK. The topic is considered from the clinician's perspective, but there are also lessons to be learned by managers. There is discussion of the difficulty in defining and prioritizing the numerous guidelines, and advice is given as to which guidance is the most authoritative. The legal consequences of ignoring guidelines are explored, and the paper concludes with the view that the time is ripe for clinicians to take the initiative in preparing, drafting, and disseminating guidelines before they are pre-empted by managers and employers and the future of clinical freedom is called into question.