From 1 January 1990 medical and dental practitioners employed by health authorities were no longer required under the terms of their contracts to subscribe to a medical defence organisation. The health department, however, advised practitioners (DHSS circular) to “maintain their defence body membership in order to ensure they are covered for any work which does not fall within the scope of the indemnity scheme”. The expediency with which the scheme was introduced enabled little discussion on the consequences of such change and surprised medical practitioners and defence organisations alike. This major change in medical indemnity since 1954 will have long-term implications for practitioners, medical defence organisations, local health authorities and most importantly, the quality and quantity of health care which can be delivered. A meeting held on 9 April 1990 at Charter Nightingale Hospital was convened to discuss the implications of the NHS indemnity scheme between senior registrars in psychiatry and representatives from the Medical Defence Union, Medical Protection Society, British Medical Association and the local health authority.