Medical fees are set to increase as some doctors pass on part of their soaring professional indemnity insurance costs to patients. The Medical Protection Society, which offers professional indemnity insurance to most doctors, recently told the Medical Association that insurance subscription rates next year would increase from 3 to 30 per cent. In the private sector, obstetricians and doctors in high-risk specialties, such as neurosurgery and spinal surgery, will face the biggest rise, at 30 per cent. Private obstetricians, who pay the largest annual subscription rate, at HK$250,380, will have to pay more than HK$325,000 next year. Their rate had already jumped from HK$209,500 last year. The society said the increase for next year was due to an increase in claims by an average 20 per cent. In 2004, there were six cases per 1,000 members but last year there were 14. It said there were also a number of large claims awaiting settlement, including one estimated at HK$45 million. The largest claim paid last year was HK$27 million. 'It is inevitable that private doctors will have to pass on some of the higher costs to patients,' said Choi Kin, the association's president. 'Doctors also face higher costs due to increasing rents for their clinics and inflation.' He doubted obstetricians would have to drastically raise their fees because the private market for deliveries had been quite good recently. 'If doctors have a large enough customer volume, they don't need to charge each much more to cover the higher costs.' Private doctors in low-risk specialties, such as community medicine and dermatology, will be least affected, with a 3 per cent increase from HK$20,865 a year. The rate for interns and public doctors will rise by 3 to 5 per cent from the present range of HK$2,200 to HK$12,800. Tse Hung-hing, a Medical Association council member, said it was natural for the number of disputes and claims to increase because of a global trend of higher awareness of patients' rights. He said some specialists in obstetrics and gynaecology might consider only practising gynaecological treatments and stopping their delivery services. He added that the higher insurance fees would affect younger private doctors the most because they might not yet have a stable volume of patients. Private obstetrician Law Chi-lim said injuries to newborns could be lifelong, thus the high claims. He also said that it was easy for parents to apply for legal aid to sue obstetricians if they made the application in their baby's name as the Legal Aid Department accepted applications based on assets.