A SHORTAGE of GPs and other staff has forced the majority of surgeries to limit the number of new patients they can accept and caused a sharp increase in waiting times – in what one doctor has described as an ‘extraordinary’ situation.
GPs have voiced their concerns about the challenges of recruiting staff, saying the situation is at least as bad as the one facing the Health Department for hospital-based roles, with some Islanders waiting three-to-four weeks for routine appointments.
A straw poll by the Primary Care Body, which represents GPs, showed that the majority of the Island’s 13 surgeries had restrictions on new patients, either closing their lists fully or only accepting those who were relatives of existing patients or were new to Jersey.
Vacancy levels across the Island have reached the equivalent of almost 15 full-time GP posts, the poll showed, with only two of the 13 practices having no vacancies.
Dr Ed Klaber, a GP at Health Plus and director of the PCB, said the fact that many surgeries – which operate as private businesses – were turning away potential customers was ‘extraordinary’.
He said: ‘When I came to Jersey five years ago, surgeries were in competition for each new patient and looking to grow their businesses.
‘If anyone had suggested the idea of closing a list [to new patients], you would have thought they’d gone mad.’
Dr Klaber added: ‘We know that many of the issues facing GP surgeries are the same for other industries, so we’re not saying “look at us, we’re the worst off” – but healthcare is extremely important to the people of Jersey.
‘It’s not that far-fetched that in the coming years one of the surgeries could close, and its patients don’t have anywhere to go because other surgeries don’t have capacity.’
Islanders who are used to being able to secure an appointment with their family doctor at short notice are now having to wait much longer for appointments.
Dr Klaber said: ‘Sometimes there’ll be a wait of three-to-four weeks for a routine matter – surgeries have to keep space in the schedule for urgent appointments, and receptionists are having to ask a lot more questions when patients call because of the need to assess how urgent each case is.
‘GPs don’t want people to have to wait several weeks – we’d much rather see a patient the next day, but surgeries are being squeezed and this is the result.’
Earlier this week, the government responded to a JEP freedom-of-information request with confirmation that recruitment challenges were a leading factor in the Island’s annual bill for locum doctors reaching an estimated £6.3 million this year, a 65% rise on the 2018 figure.
Dr Nigel Minihane, a senior GP who is also part of the Primary Care Body, said that surgeries in Jersey were battling to compete for staff with their UK counterparts.
He said: ‘The majority of UK employers are able to offer much better packages, including “golden hello” payments in some cases, and we can’t compete with that.’
Some NHS organisations in England have offered up to £20,000 to those who take up posts. This follows a survey this summer by industry magazine Pulse showing that one in every six full-time GP roles in the UK were unfilled – the highest level for at least four years – and a think-tank report claiming that more than a quarter of doctor and nurse posts in GP practices could be vacant within ten years.
Jersey surgeries looking to fill vacancies were also facing the same issues as many employers around the high cost of living and difficulty in finding affordable housing, Dr Minihane added.
Whereas potential recruits to hospital roles had the chance of joining the government employees’ pension scheme, Dr Minihane said GPs had to make their own pension arrangements, and would often be required to invest in buying a stake in the business they were joining.
Attempts to reduce the number of vacancies in Jersey are likely to be affected by the number of GPs who are close to retirement age.
‘When some of the older doctors retire over the next few years, we could be looking at another 15 vacancies,’ Dr Minihane said.
Another issue is that GPs are not part of any officially recognised key-worker category. The government has pledged to increase the number of key-worker housing units by at least 100 by the end of 2023, but the definition of what constitutes a ‘key worker’ has yet to be made clear.
The challenge of recruiting new staff, and resulting effect on waiting times has also seen price rises imposed, with most surgeries now charging more than £50 for an in-person consultation.
Dr Klaber said that patients were having to bear the brunt of the price rises, with no increase in the rebate provided by the government from the Health Insurance Fund.
The level of the rebate has remained fixed at £20 per appointment since 2012, drawing criticism last year from a former chief officer at Social Security. Ann Esterson said the freeze had caused ‘unnecessary hardship’ and accused the government of using the HIF to finance other health-related projects.
Although the PCB is able to raise concerns in discussions with government, Dr Klaber said the situation was made difficult because two separate departments were involved.
‘We’ve been raising our concerns with government for a long time, but it cuts across both health and social security and there’s no direct line for who in government is responsible for this,’ he said.
The JEP has asked to discuss the matter with Health Minister Karen Wilson, with an appointment scheduled for after next week’s sitting of the States Assembly.
