Doctors fear health changes could increase GP wait times

DOCTORS have warned of the potential threat of increased GP waiting lists and the loss of individual patient relationships amid a shake up of the health system.

Dr Nigel Minihane (29011480)
Dr Nigel Minihane (29011480)

The Primary Care Body, which represents all Jersey GPs, wants the public to take up what it calls a ‘once-in-a-lifetime opportunity’ – following the experiences of Covid-19 and ahead of the government’s new care model debate – to write to politicians with their views, or to comment on social media.

Both increased waiting times for GP appointments and the difficulty of seeing a single family doctor were complaints made by patients while many doctors helped staff the Hospital’s temporary Urgent Treatment Centre, which closed last month, during the pandemic.

As the Health Minister confirmed he would seek States’ approval for the new Jersey Care Model in October, doctors have warned of the dangers of losing long-standing personal relationships with patients if what they regard as shortcomings in the NHS were to be replicated in Jersey.

‘We have wonderful, traditional community care which requires augmenting with renewed co-funding for patients. Like all things, it requires evolution but not at the expense of the core values of personalised continuity of care that both patients and doctors hold so dear,’ said Dr Nigel Minihane, chairman of the Primary Care Body.

On Monday, [this week] doctors returned to their practices after the temporary agreement which allowed some to be deployed in the General Hospital’s UTC during the Covid-19 pandemic came to an end.

Dr Minihane said that it had been a privilege for them to use their skills on the frontline, whether working in the Hospital, alongside ambulance crews or in the community. But he warned that while the UTC had worked well as a measure in response to Covid-19, GPs had concerns about such an approach being adopted in the new hospital’s operating model.

‘Once the peak of infection had passed, we discovered that the vast majority of patients presenting to the UTC had minor injuries rather than problems we would normally see and influence in general practice. At the same time our depleted hours in surgery, together with the limitations imposed by Covid-19, meant our patients, for perhaps the first time ever, were having to join waiting lists to see a GP,’ Dr Minihane said.

‘Our concern was that there would be a backlog of missed diagnoses and we have yet to determine if that is the case. In addition, the continuity of care on which we have prided ourselves so much was lost. GPs bemoaned this and, it seems, so did our patients, who valued the long-standing relationships they have with their family GP.’

Last week Health Minister Richard Renouf told the JEP that the Jersey Care Model was still evolving and that discussions would take place on its detail with a range of parties, including GPs, once the States had given its approval to the high-level vision.

Doctors support changes to the system and, in particular, further investment to help ensure that vulnerable Islanders – whether for reasons of income, medical condition or social circumstances – are not deterred from seeking medical help.

Dr Minihane added: ‘While many people will know the government subsidises each GP appointment to the tune of £20, they may not know the original intention was for that to cover 50% of the real cost of that appointment. However, each appointment actually costs £65 when you factor in everything, including staff salaries, heating, lighting and all other building costs, meaning the subsidy has not kept up with the reality of running the service. We think now is the perfect time to ask: “Is there a better way to structure the system?”.’ Dr Minihane said.

But doctors are sceptical that the true costs of the Jersey Care Model – which advocates increased care in the community with a corresponding reduction in the size of the new hospital – have been fully established, pointing to the fact that a PwC report commissioned by the government had been revised several times but had yet to be made public.

There is common ground between GPs and Health and Social Services that, under the current system, a significant number of Islanders attend the hospital’s Emergency Department with conditions that would be dealt with more appropriately elsewhere. How that issue is addressed is likely to be central to future discussions.

Now GPs want the public to share their thoughts directly with politicians, or on social media using the hashtag #MyJerseyGP.

‘I am entirely convinced that as a community we can find the answers, and show the sort of smart thinking that was in abundance when medics and government came together to tackle the pandemic,’ Dr Minihane said. He added that the Primary Care Body would collate all online posts.

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