For over 100 years, the needs of the medical profession for professional indemnity have been met by the Medical Defence Organisations. The members of the profession have, until 1990, remained independent of their employers by paying their own subscriptions, but an examination of the Annual Reports of The Medical Defence Union [5] between 1979 and 1988 shows an increase in indemnity payments from £2 million to a figure in excess of £25 million. It was apparent by 1986 that the rate of increase was unlikely to be contained on a cost basis by the profession and on this evidence subscriptions were first subsidised by the Department of Health and then followed by the introduction of Crown Indemnity in January 1990. This trend has not been confined to the UK. It had been a feature of medical practice in North America for at least a decade before it seriously affected the profession in the UK and it has now permeated into the European and Australian systems.