Professional indemnity insurance—the making or breaking of midwifery

The issue of professional indemnity insurance (PII) as a condition for practice has been hotly debated over the years. Although some professions required its registrants to have indemnity insurance, nursing and midwifery did not. PII did, however, feature on the Nursing and Midwifery Council (NMC) agenda in 2002, but the lack of affordable insurance for independent midwives resulted in notable divisions in the debate. Nevertheless, discussions continued and in 2008, the Code was revised.

The Code recommended that all nurses and midwives should have PII when advising, treating or caring for patients or clients. It acknowledged employer's vicarious liability but made clear that this did not normally extend to activities undertaken outside the registrant's employment. Nor did it cover independent practice of any sort and it was the individual registrant's responsibility to establish their insurance status and take appropriate action (NMC, 2008).

The thorny issue of the lack of affordable insurance for independent midwives was addressed by a caveat that where vicarious liability was not available, the registrant should obtain adequate PII—but if this was not possible, as in the case of independent midwives, women in their care must be fully informed of this fact and its implications in the event of a claim for professional negligence (NMC, 2008).