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Night-time GP service under threat of closure

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A ‘VITAL’ night-time doctors service could be scrapped – leaving Islanders without GP cover overnight – unless more money is found to make the scheme sustainable, it has emerged.

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Fees to see a doctor out of hours may have to increase or taxpayers’ money ploughed into the Jersey Doctors on Call service to keep it alive in its current format, according to its chairman.

An extraordinary meeting is due to be held on Thursday to discuss JDOC’s future. Dr Philip Terry, JDOC chairman, said that if a resolution was not reached the overnight service (between 11pm and 8am), which includes a freephone helpline, risks being shut down. JDOC’s evening, weekend and bank holiday cover, which is based at the Hospital, is to remain unchanged.

Dr Terry added: ‘Stopping it is a possibility, yes. But that is not something any of us want.’

Island GPs are not contractually obliged to be part of the out-of-hours Jersey Doctor’s On Call system, which is based at the Hospital. Instead they pay subscription fees to join the service and are allocated evening, night and weekend shifts throughout the year, during which they are able to charge any patients that they may see.

For doctors who cannot cover overnight shifts, they can pay for a locum.

Currently, 36 doctors provide cover during the course of the year but just three are responsible for 50% of all night shifts.

Dr Terry said it cost GPs about £4,000 in lost earnings, if they had to miss surgery the next day after a night shift, extra insurance or locum costs, to provide out of hours care.

‘The service is more of a safety net rather than incredibly busy but if it was not there it would be a big loss. It is particularly vital for the frail and young families with children,’ Dr Terry added. ‘Perhaps a doctor would visit one or two patients per night and take four phone calls – but for those people at that time it’s incredibly important. It is the only service that gives free phone advice out of hours too.’

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JDOC is financially independent from the States. It costs £150 to have a GP visit your home between 11pm and 8am. It is £170 for visitors or seasonal workers.

Dr Terry explained that GPs signing up to the service had to pay more for their personal insurance and those working late night shifts would have to take the next day off and would therefore lose out on earnings.

He added: ‘The pool of doctors continuing to do nights is getting less and less and it is becoming less sustainable. In a year I don’t think it will be feasible at all to get GPs to do this work without more support or income from somewhere.

‘Either we will have to have an increase in fees or have something like a States subsidy to support the service.

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‘In Jersey it costs about £4,000 a year to do night work in terms of lost income but we have chosen to carry on doing it. It is out of a sense of duty, goodwill and a belief that an out-of-hours service is important.’

Health Minister Deputy Richard Renouf said he was aware of concerns about the future of the late shift but stressed that the Health Department did not commission JDOC and had no role in its governance.

He said: ‘JDOC recognise that their overnight services are important for their patients and valued by the public, and they are looking at a range of options for how they can make them sustainable for the future.’

Jack Maguire

By Jack Maguire
author

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