By Nick Triggle
Health reporter, BBC News
GPs are not covered by the same insurance as hospital doctors
Some GPs may refuse to work if the swine flu pandemic spreads throughout the UK, union leaders have warned.
The British Medical Association said family doctors were worried about being sued over the care they provided and a lack of death-in-service cover.
The BMA said doctors would be "putting their lives on the line" and needed assurances they were properly covered.
NHS Employers, which negotiates GPs' contracts, said it was trying to resolve the death-in-service issue.
Talks are ongoing between the BMA and NHS employers, but the union warned that if a deal was not brokered over the summer it could create problems if flu really took hold across the UK later in the year.
The warning comes as details emerge about a swine flu patient who has died in Scotland, becoming the first fatality in the UK linked to the virus.
The death, announced late on Sunday, is also the first death from swine flu outside of the Americas since the outbreak began.
Dr Dean Marshall, one of the BMA's lead negotiators on flu planning, said of the pandemic: "Doctors will be putting their lives on the line and it is only right they can feel assured they are properly covered if anything goes wrong.
A locum could die at the weekend and their family might not get a pay-out. That is not fair and could make some think twice about helping out
Dr Dean Marshall, of the British Medical Association
"We don't want to be going into it with GPs feeling unsure where they stand. Doctors are only human and some will not want to go on the front line."
Hospital doctors are covered by NHS indemnity, which means they are protected if they are sued over the care they provide.
GPs, because they are effectively self-employed, have their own insurance but this may not cover them during a serious flu outbreak.
Dr Marshall said: "The problem is that the current cover expects GPs to act in a certain way.
"For example, if someone has a heart attack we should send them to hospital, but during the pandemic hospitals could be full and this may not be possible.
"Our fear is that later on people may sue us."
The BMA has asked the NHS to provide temporary cover for the 30,000-strong GP workforce.
For locum doctors, of which there are several thousand, the situation is further complicated by arrangements for death-in-service payments.
Under current arrangements, pay-outs to family would be made only if the doctor died during days when they were working.
Dr Marshall said: "A locum could die at the weekend and their family might not get a pay-out. That is not fair and could make some think twice about helping out."
GPs are an essential part of the NHS response to flu. Under the contingency plans, they can be shifted around the health service to help treat patients in the community.
In the worst-case scenario, the health service expects hospitals to become clogged up with patients and it would be left to GPs to work with Health Protection Agency officials to treat patients in the community with anti-viral drugs.
Andrew Clapperton, from NHS Employers, said it was up to GPs to arrange their own indemnity insurance cover.
But he added the body was looking to find a solution to the death-in-service issue.
"We are currently in discussion with both the BMA and the Department of Health to establish how we might best achieve this solution."
Are you a doctor? Are you considering not treating swine flu patients? Send us your comments by using the form below.
A selection of your comments may be published, displaying your name and location unless you state otherwise in the box below.
The BBC may edit your comments and not all emails will be published. Your comments may be published on any BBC media worldwide.