Doctors urge government to revise spending plans to support primary care

Dr Gordon Callander

URGENT revisions to the government’s spending plan are needed to ensure the ‘sustainable funding’ of GPs, the Primary Care Body has said – amid staff shortages which are driving up waiting times.

Dr Gordon Callander, on behalf of the PCB, suggested that the rebate which subsidises the cost of GP visits for patients should be increased as an ‘interim measure’ and that Islanders were ‘painfully aware of the undisputed reality that the rebate has not increased for ten years’ in real terms.

A recent poll by the organisation showed that the majority of the Island’s 13 surgeries had restrictions on new patients, either closing their lists or only accepting those who were relatives of existing patients, or who were new to Jersey, and that vacancy levels across the Island had reached the equivalent of almost 15 full-time GP posts.

In response, Assistant Health and Social Security Minister Malcolm Ferey suggested that widening the range of services that could be provided by health workers – such as nurses and pharmacists – would help reduce the impact of challenges in GP recruitment.

Deputy Malcolm Ferey

He added that while the £20 government contribution made from the Health Insurance Fund towards GP appointments had not increased, overall investment in primary care had risen by 40% in recent years.

Dr Callander, in a letter to the editor published on page 12 of today’s JEP, said: ‘Unfortunately, sustainable primary-care funding was not a priority in the recent Government Plan. This leaves both practices and, more importantly, patients to carry the burden in increasingly difficult economic times.

‘He [Deputy Ferey] makes a statement that government funding of primary care has increased by 40% “in recent years”, but does not give any evidence to support this statement. Our statistics, in fact, showed a reduction in real terms of government support for patients.’

Up to £9 million of government funding for the next three years was announced earlier this year, while Deputy Ferey also raised the possibility setting up some salaried GP posts, rather than using the existing model whereby GPs take a stake in a practice at the time of joining and then sell it when they leave.

Dr Callander added: ‘Deputy Ferey rightly acknowledges the difficulty in recruiting GPs to the Island and importantly recognises the key role they play in the community.

‘Although several practices already employ a few doctors in salaried positions, his suggestion of recruiting salaried GPs to the Island is naive when you consider the recruitment challenges not just locally or in the UK.

‘Employing larger numbers of salaried doctors is unlikely to offer the benefits of sustainability to practices and the reassurance of continuity of care to patients and may not be cost-effective.

‘We would urge the recently elected government to both revise the Government Plan to prioritise the sustainable funding of general practice and wider primary care and, as an interim measure, to increase the rebate with immediate effect to reduce the cost to patients of GP consultations.’

The Government Plan is due to be debated by the States Assembly next week.

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