Doctors oppose health reforms

THERE is a real danger that the States will spend millions of pounds creating a new Health system modelled on the NHS which is neither suitable for Jersey,  safe for patients,  nor sustainable, doctors have warned in a hard-hitting letter to Health chiefs.

Health chief executive Julie Garbutt (right) with Health Minister Anne Pryke
Health chief executive Julie Garbutt (right) with Health Minister Anne Pryke

THERE is a real danger that the States will spend millions of pounds creating a new Health system modelled on the NHS which is neither suitable for Jersey,  safe for patients, nor sustainable, doctors have warned in a hard-hitting letter to Health chiefs.

Their concerns are raised in the letter written by the Primary Care Body, which represents the Island’s GPs, to Health chief executive Julie Garbutt and leaked to the media.

It was written to express the concerns of GPs about sweeping changes at Health which were set out in the States Health White Paper and approved by the Assembly last year.

Comments for: "Doctors oppose health reforms"

Sam

Very interesting.

Some parallels to be drawn here -

The UK government is currently initiating an overhaul of the NHS which was never mentioned in any manifesto nor put the public in any vote and therefore has no mandate (just like in Jersey).

Virtually everyone working in the NHS opposes the changes (just like in Jersey).

But we need to know a bit more about the changes and on what basis they are being opposed. The reaction in the UK has been serious opposition from the public who are incredibly angry about the nature of the countries most prized institution and will probably contribute very significantly to the demise of the government at the next election.

Wonder what will happen in Jersey over it.

The Thinker

Sam you paint a picture but not an entirely accurate one. There is of course much to praise the UK's NHS and Social Security benefit system however we live in a changing world where costs of care are rising and people are living longer and everyone knows changes have to be made. Although much has been said of changing the system whilst imposing radical cuts not everyone is against what the UK Government are doing. Will it work - probably not first time around but I'm sure we are seeing the opening moves to many structural changes that will go on for years.

However your submission was mainly about making a comparison between the UK and what is happening here in this small island and for me one of the most striking comparisons is the issue of immigration. The UK has seen a massive rise in population from the last census and perhaps of even greater concern is the significant rise in births to new immigrant families. So whether we are talking UK or on a much smaller scale Jersey there has to be population caps otherwise services simply cannot cope with demand.

In the UK (like here) whenever immigration issues are raised debate is stifled by an immediate use of the word 'racist'. Even the Labour (or New Labour Party) has now admitted that it got things wrong on immigration.

Be fair to everyone in your country not matter what race or religion BUT please put a front door in place.

Kermit

I think we all saw the NHS in the news for the wrong reason. Shame they have to turn to the UK for every decisions while France is around the corner and are known to have a very good system when it comes to health.

I would be curious to know the GP's arguments, but having to pay a £40 consultation for a 4 minutes visit is not right !

mallouin

On this I aggree,France is the mainland with an enviable health system,surely we should be looking at the best we can get and adapt it too our needs not just cut and pasting the basically English NHS which is in a constant state of upheavel.I seem to remember the Deputy stating that she would look to the best,as usual just words,take the easy option it appears to be all they do now.

Mario

They have a decent health service because they are a socialist country, where it isn't just about the bottom line.

Kermit A&E is free!

Kermit

You go in for free. They make sure you are not going to die while you are there. They send you back to your GP, for your GP to send you back to the hospital.

"Private" Dentist is not covered.

A dentist send me to the hospital dentist (after a Xray + consultation= £60 and no treatment) ), took me a month to see him. He told me 3 months wait and total (or almost ) anesthesia. I went a abroad and £10 and 30 minutes later I was sorted.

Up to a year waiting for some appointment is acceptable to you ?

-C. Le Verdic, using the french system does not mean having to speak French or going to France.

For your record French wants to speak English as much as English wants to speak French, think!!! There is actually a French saying on the subject concerning your comment on how French are lazy at speaking another language: "It is like the Infirmary is taking the piss of the Hospital"!!! Couldn't be more suited...

-Mario, Socialist country you are right, but in both countries you pay social security, and the difference must be on how well they use that money.

S2

Anyone going to A&E for an ailment not conforming to the title of the dept should be ashamed. The acronym is a giveaway.

No comprendy?

The people who abuse our accident and emergency department will, in all liklihood, claim that they don't understand what the department sign means, although they will have been characteristically quick to grasp the fact that it doesn't cost them anything.

Mario

They should be but it doesn't stop some from doing so.

C Le Verdic

France may superficially appear tempting for many aspects of life. However, most people in Jersey, including those of us privileged to have French names, don't speak fluent French and most French, unlike the Dutch for example, have no intention of speaking any English. Is that really a good start for critical health matters?

Let's explore the idea further. The vast majority in Jersey have stronger ties with the UK than with France. France doesn't have a half decent city within striking distance of Jersey or an airport with flight frequency approaching that of UK destinations.

France is OK for heritage freaks, francophiles and dreamers. Otherwise, Jersey is almost entirely tied to the UK in matters of reality, including medicine.

I'll save the time of those waiting to tell me about electricity and Calvados. I am aware.

Mario

We can sort the transport issue out with a bridge, which will have the added advantage of sorting out a lot of other issues at the same time.

The French have the right attitude of standing up for themselves, unlike the British who let everyone else walk all over the them.

As for the language barrier I am sure many French doctors can speak English. Doing business with them will encourage them to speak English. Money is money after all.

mallouin

Mario,If you believe France is a socialist country I suggest you look to the political makeup over the last 50yrs and like most EU countries including the UK it moves between parties.The bridge is a beautiful dream but dead in the water due to cost and demogaphics.

CleV,you appear to be morphing into an Anglo mon vie,language in most large hospitals is not a problem and why anyway should everyone have to speak English?The two largest towns within striking distance with excellent large facillities are Cherbourg and Rennes(both approx 20/30m by air),If the demand was there the decent air links would come.

My point was that we continually look to the UK with hardly a thought for other opportunities some nearer to home.We should be looking to make our Health service the best from wherever we gain our ideas,it's just b****y lazy to keep taking the easy option which does us a great disservice.

Mainland Frankie

What a load of old nonsense you've just spouted! Why o why do all you muppets get glassy eyed at everything from England and want to import it here? England is bust, its health service is second rate and we seem to get all their cast offs over here, trying to impose their failed ideas again! Time to try something else, like France! And perhaps you could get try and learn something new like a new language? Don't supposed you can be bothered!

C Le Verdic

I like France and learned French to a good standard, so I'm not speaking for myself. I am merely stating the obvious about the reality of changing our allegiance. We are a British island with a British population, not a French one.

If England is bust, MF, then so will Jersey be soon after. Just watch my old nonsense!

Jersey doesn't have to pay much for wars. France may be looking at bigger bills, though, sorting out its African interests.

There are just so many people of UK origin in Jersey and more arrive with every new white collar job creation that the connection with the mainland is massive. The only connection most have with France is weekend booze trips. Very few of the locals with French roots had much to do with France in recent history.

Mario, you unwittingly highlight the reality of the French attitude towards the British. They do want our money. They get plenty of that Via EDF and their car industry. They mainly do that sitting at home and speaking French.

Dream on with that bridge. In the meantime you would do better hoping for better conventional vessel freight shipping links with France.

Until I see much happening to change the relationship I will continue to regard those who want to defect to France as dreamers.

Kermit

C. Le Verdic, The link between Jersey and the UK is getting close to nothing.

They stop the tax loop hole (DVD and the rest).

You can't get free treatment in the UK and Vice Versa anymore.

They sunk our online gambling before it took off.

Passports can no longer be done there.

And there is probably more to the list.

For David Cameron to do a referendum on the in or out of the EU should show you how lost he is and how gloomy the future is looking.

Half of London is own by Qatar: Aouch. Punk is not dead but English manufacturing is, never mind the economy.

We pay less for EDF electricity than the French are, I would say they have pity for us more than anything else. And when it comes to quality of life, there is nothing to envy with the British system. French would have 60 bus drivers doing 35/hours/week while we have 30 of them over here doing 60hours making it unsafe and creating unemployment.

I saw how people were treated in the retirement homes in the UK and I would rather jump of a bridge rather than going there. Pretty gross. I ve been to one over here and the smell kind of shocked me.

Certain area in the UK cover some treatments and some other don't. As you are now allowed to go to another hospital in a different district you

are discriminated based on your UK location. Not fair. You can even choose where you want to be treated.

Money aside, a Bridge will definitely be a plus for everything, energy,food,trips,tourism... What do you do when the weather is so bad that you can't use the helicopter to go to Southampton hospital : you rest in peace !

The idea of a bridge is so stupid that then even built a tunnel between France and England...

Dr

Part of the reason for the opposition may be due to the exhorbitant fees which are charged.

Tim South

To visit a doctor in the UK the NHS charge nothing, paid for by the tax take. Helpful for pensioners, parents with sick children, in fact everyone.

In Jersey a visit to a Doctor costs the visitor £38.00 and then £20 from social security paid of course by the working people. A consultation therefore earns a doctor £58.00.

Doctors in Jersey not happy to follow the NHS the JEP article says, it would mean taking a drastic pay cut which is obvious.

The Health Minister has got something right, now carry through the reforms. If Jersey based Doctor's do not like the reforms, open the doors to qualified GP's from the UK and let them work in the new system. The time has arrived to break the millionaire GP doctors monopoly for the benefit of the Jersey population.

Tim.

CC

OK, for starters, doctors in the UK on the NHS payroll are getting paid considerably more than doctors in Jersey that are in private practice. If the reforms were to follow the UK model, surely this would mean a considerable pay rise for them, not a pay cut. This being the case it is admirable that they would put patient care before their own wallets.

Secondly, I always find it mind boggling that people view doctors fees as unreasonable. I work in the IT industry and for the sake of comparison our front line support is chargeable at the rate of £85 per hour, in chunks of one hour. So even if it takes 5 minutes you will still be charged the full hour. this support is mostly carried out by people with absolutely no formal training whatsoever. Our second line support is chargeable at £125 under the same terms. This is carried out by people with higher level qualifications. I would say the more junior members of the team have the equivalent of about 3 years of university training, with the top guys maybe having 5-6 years. If you consider it takes a decade for a doctor to qualify (and vastly more financial outlay) I would say the fees are in fact very reasonable, particularly if you factor in the huge insurance premiums doctors have to pay due to people viewing a lawsuit as an easy money maker.

Finally, what monopoly? Do you understand the term? There are many different practices on the island in direct competition with each other.

anon

If you do charge £124=5 for 5 mins Isuggest your clients should sue you.

Propaganda

£125 per hour for your second line support is still cheap compared to GPs seeing 6 patients per hour at £60 each. GPs can and do earn, gross admittedly, £360 per hour.

Have a look here at what each one earnt in just social security supplements over the last three years. Remember these figures are JUST what they get from Social Security, these figures do not include the £37 - £40 payable by the patient for each consultation.

Yes doctor 41 earnt just under £200k in one year from social security!!

http://www.statesassembly.gov.je/AssemblyQuestions/2013/Deputy%20Higgins%20to%20SS%20re%20HIF%20payments%20to%20doctors.pdf

Bill

And of course all of the "pro" arguments conveniently ignore the fact that these huge profits are made off the back of sickness and misery.

The doctor and the often obstructive telephonists behind whom he hides acts as though he is doing you a favour, when in fact you are paying through the nose for a so-called service.

Charging to see patients, particularly at these levels, is unethical to say the least. But will it change? I very much doubt it, because physicians are protected and largely unaccountable.

Bill Gates

CC

"I work in the IT industry and for the sake of comparison our front line support is chargeable at the rate of £85 per hour, in chunks of one hour. So even if it takes 5 minutes you will still be charged the full hour. this support is mostly carried out by people with absolutely no formal training whatsoever. Our second line support is chargeable at £125 under the same terms. "

and there's the problem with business in Jersey. There still living in cloud cuckoo land and think they can go on getting away with these charges for ever.

I know plumbers who have had to reduce their hourly rate to £27 per hour from £45 just to stay afloat.

Builders that are charging 10% over cost just to stay in business

We need more competition in the IT field to bring the small number of IT service companies back to reality

Kermit

Fair enough you have to pay expensive prices for IT when you own a business.

Doctors fees should be affordable and realistic for all classes of the society.

May be less people would go to A&E.

I would rather have the doctor free and the medication to our expense until you get to retirement where everything is becoming free (or almost).

CC

OK, But 6 patients an hour is an absolute best case scenario and quite far from the norm. In any case, this figure is still vastly lower than that of a top lawyer, who once again does not require quite as rigorous training as a doctor and doesn't need anywhere nears as much continual re certification and re training as someone in a fast a moving field as medicine, as well as again been less susceptible to lawsuits from those looking for a quick buck.

Granted this money is 'made of the back of suffering', but what do you expect? That's simply the nature of the business.

If you truly believe it's all a complete rip off and in no way worth the expenditure, you are of course, totally free to just not go to the doctor!

Peter

You clearly don't know any lawyers otherwise you would know that your comments about training, dedication, potential lawsuits and continual professional development are somewhat incorrect.

What a ridiculous closing comment as well. Sick people have no choice but to go to a doctor. That is where the exploitation angle from this laregely unaccountable profession is at its most prominent.

Overpopulated

This is paid for by 20% VAT, 45% top rate of tax, etc.

The UK government is also borrowing billions to support the NHS and their welfare system.

Jersey is heading the same way, the States cannot afford to change the current system

Mario

So that'll be 20% GST then.

Jim

Should help the queue of people trying to see a Dr for free at A and E then!! Anyone who has been in there knows what I mean.

no emergency!

absolutely - Its disgusting - people going to A&E for a headache, or something else trivial. All because they dont want to pay for their GP. We do have a problem with GP prices for sure, that is not in question, but come on people please! - respect that A&E is for guess what? Accidents and Emergencies!!!!- how would you feel is someone couldnt treat a member of your family sooner because they were busy with someone who had a sore tooth or ear?

Ive sat in A&E before with friends who have broken bones, watching people come in and blatently sit there and say im not paying for GP, when its free here. SHAME ON YOU!

polyanthus

I think you would find that most doctors are cross because the proposals contain nothing that will help patients with the cost of visiting a doctor or reduce waiting times at the hospital. There is a proposal to spend lots of money on extra managers and proposals like a 'citizens portal' that no-one has any evidence will actually improve peoples health.

Scrutineer

Maybe, but I am not paying your IT support fees! Pity those that do. My simple support contract costs a lot less than that. I do agree, though, that doctors' fees are about reasonable taking into the average time taken writing referral letters.

roombay42

Doctors' fees seem quite reasonable compared tp lawyers' fees.

Kate

And scaffolder's fees seem quite reasonable when compared to chimney sweeps.

puffin

So the States want to follow the UK and use the same health model as the NHS...surely after following the UK's benefits system which is now destroying our island, that this would ring some warning bells in their silly little heads? Unbelievable!

And by the way I had a hospital appointment this morning, and there were two other people waiting with me. Neither of these people spoke English and they were given a translator each, so how many full time translators work at the hospital and how much is this costing the tax payers?

peddler

The Health Minister should stand by her reform ideas.

GP's over here are ripping people off and these reforms will put a stop to that, it really is that simple.

How anyone other than a GP can complain about the changes is staggering, they are ripping YOU off, how can anybody defend this position?

Where is the loyalty to the Hippocratic oath to treat people and not make a killing off the back of it?

CC

The Hippocratic oath also states that a doctor must be a man. Do you also believe that we should abide by this part in modern times to as that's what Hippocrates would have wanted?

I'm sure anyone reading my comments must have guess by now that whilst I'm not in medicine myself, I do have family members who are, hence my defence of the profession, but it is exactly that, a profession - one which each doctor devotes a huge part of their life and many many hours of hard work to achieve. What would you suggest instead? They get paid maybe the same as a mechanic? Who in their right mind would put in all that effort if there was no additional reward to that of entering the workforce a decade earlier?

Hilary

The fact remains that doctors swear an oath. That is a serious matter. If they do not to intend to follow the oath, then they should not swear it.

Perhaps the imminent sound of ringing tills somehow subjugates the conscience of those prospective doctors who do not think that the ever so slight matter of treating patients is something which they would swear to or otherwise take seriously.

peddler

Really CC?, that is an interpretation and modern doctors believe in the principle of the oath rather than the exact wording.

You speak of GP's in the UK being paid more than Jersey GP's, utter tosh. Did you not read propaganda's link above? Doctor 41 earnt a fifth of a million pounds in one year purely from Social Security, this does not include his surgery fees for seeing patients or dictating letters for his secretary to type.

You are defending the indefensible.

Comparing GP's to a mechanic is actually relevant; if the mechanic was knowingly ripping people off with overinflated prices and also receiving a subsidy from a government that he had over a barrel.

Bring in the UK model, pay them a fixed fee and make them accountable to, and part of, the Health Service.

PhD

An interesting argument presented by "CC".

Part of the Hypocratic oath pre-dates the advent of women physicians so, on your argument, the entire oath is something to be disregarded.

That would, naturally, include the major parts of the oath and its "raison d'etre", namely the overriding duty to treat patients and to uphold the ethics of the medical profession.

As you have admitted on this thread, you are well acquainted with several doctors and with the medical profession in general. Your comment regarding the contempt in which the hypocratic oath is clearly held must therefore be something which you have based upon what was been recounted to you by the doctors with whom you live and socialise. It is also a value to which you apparently subscribe.

Despite the fact that what you report is a most disturbing state of affairs, it is not something which causes any particular surprise. The entrenched nature of self-entitlement and unaccountability that we have seen within the profession is something which will have been obvious to many for some time. Events in recent years would sadly seem to bear that out.

Davey West

In reply to CC

January 22, 2013 at 4:55 pm

Facts would really be useful CC and you don’t give any so lets look at real wages paid to Gp’s you say:

Doctors in the UK on the NHS payroll are getting paid considerably more than doctors in Jersey that are in private practice.

Nothing could be further from the truth.

From the NHS website.

Salaried GPs employed directly by PCTs earn between £53,781 to £81,158,

http://www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-

doctors/

Jersey GP’s earn no less than £58 per visit to surgery, and let us be very flexible rather than ten minutes a visit let us make it fifteen minutes which equates to four per hour over eight hours (this is an average) with some taking longer others like, repeat prescription’s shorter. This gives a gross pay of £1,856.00 per day per five day week gives a gross wage of £9,280.00 times 48 (four weeks for holidays ) gives a gross pay packet of £445,440 per annum. Less a contribution to run the group surgery, tax etc.

Then there are the call out weekend and evening rates, the extra work covering for colleagues on holiday and possibly of sick, all earning extra

money for the doctor.

Regarding your very weak case regarding IT pay, you offer no proof, and there will no doubt be a genius IT person who can fix a major bank IT system failing and be paid accordingly, with your strange way of dealing with facts and logic it is unlikely you are one of them.

Davey

Grifter

The Hippocratic Oath is outdated, Doctors are required to conform to the GMC guidelines nowadays.

S

No. The hypocratic oath is not outdated as long as physicians continue to swear it.

Swearing an oath is a serious matter. A breach of an oath, as well as being a matter of professional misconduct, is something which is likely to end in court.

If, which highly questionable, the oath is to be removed, then it should be replaced with an appropriate other form of legally binding agreement. Discussion with patient groups and other representatives of ordinary people would be a requisite first step in any such exercise.

That agreement would naturally encapsulate the basic tenets of the present oath, including the duty, both professionally and at law, to treat patients and to observe and uphold the ethics of the medical profession.

This is particularly important where over reliance is placed upon the guidelines issued by the General Medical Council. That body, as representative of the medical profession as a whole, will tend to place the interests of its physician members first and, as such, stands as a self-serving entity.

NHS

NHS: Is this what you want?

Satisfaction with the way the health service is run fell from 70 per cent in 2010 to 58 per cent in 2011, the survey published by the King's Fund, found.

Read more: http://www.dailymail.co.uk/health/article-2158053/Public-satisfaction-NHS-falls-20-year-record-low.html#ixzz2ItsbgrOd

Follow us: @MailOnline on Twitter | DailyMail on Facebook

C Le Verdic

Well, there you go! I read the summary of your post on the 'latest comments' page, which merely read:

'NHS: Is this what you want? Satisfaction with the way the health service is run fell from 70 per cent in 2010 to 58 per cent in 2011, the survey pu...'

and thought to myself "Mail or Express?".

I must have been psychic!

Ok, the survey was conducted by the King's Fund but no doubt the worthy newspaper concentrated on the aspects most appealing to its slant.

Happy NHS Patient

Only 1096 people were used for this survey and they did not necessarily have any experience of the NHS.Further in to the article it states that out of 70,000 actual patients 92% thought the NHS was good,very good or excellent.Had they asked me I would also have said excellent.

Mollikins

Doctors do not swear any sort of oath on qualification nor on registration and have not, I believe, for a very long time.

GPs in Jersey pay the full cost of their premises and their support staff; this is not the case in the mainland where a substantial proportion is met by the government. That arrangement also means that things like monitoring blood pressure, diabetic control, etc, etc is done in the mainland by support staff, freeing up doctors' time for face to face work with patients who need them.

Larry

"GPs in Jersey pay the full cost of their premises and their support staff"

I see. So the social security subsidy that goes into the doctors pockets is "scotch mist", is it?

Observant

If, as you say, doctors no longer have to sear any oath then that absence of a binding statement of their duty might explain quite a lot.

Observer

Its obvious that when you bring in 'experts' from the UK to advise you they will simply suggest what they know which is the NHS.

UK institutions may not be scalable for a small Island, but unfortunately Anne Pryke wont be able to understand this as she is in awe of her imported expert help.

This concept of new ideas from outside the Island is flawed - the new ideas are always someone elses old one.

Getting a Minister who is up to the job might be a first step!