A shortage of GPs and other staff has forced most practices to limit the number of new patients they can take and has led to a sharp increase in wait times – what one doctor has described as an “extraordinary” situation.
GPs have expressed concern over the challenges of recruiting staff, saying the situation is at least as dire as that faced by the Health Department for hospital functions, with some islanders waiting three to four weeks for routine appointments.
A straw poll by the Primary Care Body, which represents GPs, showed the majority of the island’s 13 practices had restrictions on new patients, either closing their lists entirely or only accepting those who were relatives of existing patients or were new to Jersey.
The number of vacancies across the island has reached the equivalent of nearly 15 full-time positions for GPs, the survey found, with only two of the 13 practices having no vacancies.
dr Ed Klaber, GP at Health Plus and director of the PCB, said the fact that many practices – which operate as private companies – turned down potential clients was “extraordinary”.
He said: “When I came to Jersey five years ago, practices were competing for every new patient and trying to grow their business.
‘If anyone had thought of closing a list [to new patients]you would have thought they had gone mad.’
dr Klaber added: “We know that many of the problems that GP practices face are the same for other industries, so we’re not saying, ‘Look at us, we’re the worst off’ – but healthcare is for people in extremely important Jersey.
“It’s not that far-fetched that in the coming years one of the practices could close and their patients have nowhere to go because other practices don’t have capacity.”
Islanders who are used to being able to secure an appointment with their family doctor at short notice now have to wait significantly longer for appointments.
dr Klaber said: “Sometimes there are three to four week waits for routine matters – doctor’s offices have to keep space for urgent appointments on schedule, and receptionists have 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 the surgeries are pressured and that’s the result.”
Earlier this week, the government responded to a Freedom of Information request from the JEP by confirming that recruitment problems were a key factor in the island’s annual bill for on-site doctors, which reached an estimated £6.3million this year, up from 65% compared to 2018.
dr Nigel Minihane, a senior GP who is also part of the Primary Care Body, said practices in Jersey are struggling to compete with their UK counterparts for staff.
He said: “The majority of UK employers can offer much better packages, including in some cases ‘Golden Hello’ payments, and we cannot compete with that.”
Some NHS organizations in England have offered job applicants up to £20,000. This follows a survey by industry magazine Pulse this summer showing that one in six full-time GP positions in the UK was vacant – the highest level in at least four years – and a think tank report claiming that more than a quarter of doctors and nursing positions in GP practices could be vacant within ten years.
Medical practices in Jersey looking to fill vacancies also faced the same problems as many employers in terms of the high cost of living and the difficulty of finding affordable housing, added Dr. Added Minihane.
While potential recruits for hospital roles had the option of joining the government employee pension scheme, Dr. Minihane that GPs would have to make their own pension arrangements and would often have to invest in buying a stake in the company they are joining.
Attempts to reduce the number of vacancies in Jersey are likely to be influenced by the number of GPs approaching retirement age.
“As some of the older doctors retire in the next few years, we could look to another 15 vacancies,” said Dr. minihane
Another problem is that general practitioners do not belong to an officially recognized category of key workers. The government has pledged to increase the number of housing units for key workers by at least 100 by the end of 2023, but the definition of what constitutes a “key worker” has yet to be clarified.
The challenge of hiring new staff and the resulting impact on waiting times has also led to price increases, with most practices now charging in excess of £50 for a personal consultation.
dr Klaber said patients would have to bear the brunt of the price hikes without the rebate given by the government being increased by health insurance companies.
The size of the rebate has been set at £20 per appointment since 2012, which was criticized last year by a former Social Security chief officer. Ann Esterson said the freeze caused “unnecessary hardship” and accused the government of using the HIF to fund other health-related projects.
Although the PCB may raise concerns in talks with the government, Dr. Klaber that the situation was complicated by the fact that two separate departments were involved.
“We have long raised our concerns with the government, but it affects both health and social security and there is no direct line as to who is responsible for it in government,” he said.
The JEP has asked to discuss the matter with Health Secretary Karen Wilson after next week’s State Assembly meeting.