Doctors visiting patients at home if they have flu symptoms, is it necessary for doctors to produce triplicate versions of signed paperwork in order to claim their fees, will a simpler approach to minimise their already large workload

3.11  The Deputy of St. John of the Minister for Social Security regarding doctors' home visits to patients with flu symptoms:

Given that doctors are being asked to visit patients at home if they have flu symptoms, will the Minister advise whether it is necessary for doctors to have to produce triplicate versions of signed paperwork in order to claim their fees and, if so, will he undertake to implement a simpler approach so as to minimise their already large workload?

Deputy I.J. Gorst of St. Clement (The Minister for Social Security):

I am pleased to confirm that no G.P. (General Practitioner) has to produce a triplicate version of any paperwork to obtain the special medical benefit that has been approved

by the States to do with home visits connected with the flu pandemic. G.P.s complete

one copy of a one-page form. This can be sent directly to the department or, if they prefer, they could submit the details electronically on a spreadsheet. The G.P. records the name and Social Security number of the patient, the date and time of the visit and whether the visit was to check for flu or to treat someone displaced from the hospital. Officers are working very closely with the Deputy Medical Officer of Health and G.P.s to ensure that the payment of both medical benefit and sickness benefit will continue as smoothly as possible throughout the course of the pandemic.

1. Deputy G.P. Southern :

Will the Minister assure members of the public who are supported by income support that house visits by G.P.s for flu or other illnesses will all be supported either through a H.M.A. (Household Medical Account) clearly or through special payments?

Deputy I.J. Gorst :

This question is about the doctors' visits for the flu pandemic. As the Deputy is aware, people in receipt of income support with H.M.A.s, yes, those will be charged to the H.M.A. Those other individuals who are in receipt of income support who are outside or do not have the H.M.A. provisions, there is facility for those payments to be met through the special payments provision.

2. The Deputy of St. John :

Given that doctors are currently working fully stretched, running their private practices and having to visit suspected flu patients, what standby arrangements are in place when one or more doctors fall ill? Have the G.P.s been contacted individually to get their views on the extra workload and, if so, who did the negotiations? Because the feedback I am receiving from many G.P.s, they have not been asked themselves to put all this additional time in and to arrange for backup in the event of the pandemic getting worse that they cannot get out to cover their general patient practice.

Deputy I.J. Gorst :

I thank the Deputy for his supplementary question because he raises a very important point. The scenario that he is outlining there is one which has moved from the containment phase to one where the pandemic is in, shall we say, unfortunately, full flow. Those provisions are within the remit of the Health and Social Services

Department; they will have provisions in place. I cannot remember off the top of my head exactly whether it will be nurses visiting or people phoning a bank of nurses but we will move away from the general G.P. provision which is expected under this containment phase.  There were a lot of questions that the Deputy asked, I am not sure if you are going to allow me time to answer them one by one, or if he wishes to propose them one by one.

The Bailiff :

This is not a debate, Minister, you must be very, very brief. Deputy I.J. Gorst :

Well with regard to the negotiation, as the Deputy is aware, these regulations were drafted at very, very short notice. We consulted with the P.C.B.(?) of which G.P.s are a member; there were 2 members present. They agreed with these provisions, they agreed with the costs, so I do not believe that the Deputy is correct in his assertions.

3. Deputy S. Pitman:

The Minister is aware that a couple of months ago I came to him regarding a constituent who is now paying his doctor's fees after his H.M.A. account has run out. He now says there are provisions within special payments to cover this. I asked the Minister 2 months ago, is he now telling me that this gentleman's G.P. visits can be paid by special payments because I would appreciate an answer from the Minister?

Deputy I.J. Gorst :

It becomes very difficult for me and I do not believe it is appropriate for me to try and engage in debate about individual cases across this Chamber, because I am not aware of which particular case it is. There are many cases; there are many people that the department helps, and I stand by exactly what I said in answer to Deputy Southern .

4. Deputy J.A. Martin:

It is a 2-part, really. Could the Minister inform us how many numbers of home G.P. visits have been required because of flu-like symptoms? Could he undertake in this containment phase to work - I know he is and I am the Assistant Minister for Health - with the Medical Officer of Health to really get the message out there while we are in containment to not go to your G.P., to call them out? I have every sympathy with the G.P.s maybe extra workload, but they will be financially compensated but not by the person: by the taxpayer or by the contributions at Social Security. I am concerned I am getting a different message from the Deputy of St. John; there are many, many people who have a scare and are turning up at all the wrong places. They must know to phone their G.P. for a home visit and they must not be scared of the price. I would like a confirmation that the Minister for Social Security will make this a priority with the Medical Officer of Health to get this loud and clear to the public.

Deputy I.J. Gorst :

I thank the Assistant Minister for her question. I do not have the figures of the number of visits which have taken place but I can hopefully get those and supply them to the Assistant Minister. She is absolutely right. The reason that my department went into overdrive and produced these regulations was to meet that exact need. In the containment phase it is absolutely imperative that if people feel that they have flu-like symptoms that they phone their G.P. and that the G.P. visits them at home. We believed that this was so important that the contributors to the health insurance would meet that cost and would pay for G.P.s to be able to deliver this service. The Deputy of St. John is right that once we have gone through the containment phase, a number of people we will expect to be ill and unavailable for work. That will be a situation which the entire community has to consider and react to. We, however, hope that at that point it will only continue for a short number of weeks but I would reiterate wholeheartedly the message of the Assistant Minister: it is imperative that people who feel they might have these symptoms, they phone their doctor and they ask for a home visit so that the virus can be contained. It is absolutely imperative that we do that until the injection is secured on-Island.

5. The Deputy of St. John :

Is the Minister aware that G.P.s are in fact taking a pay cut by not being able to attend their patients at their surgery fully, given the time they are having to spend visiting patients at their homes?

Deputy I.J. Gorst :

I really do not necessarily understand the Deputy 's mathematics there because what we are paying is a part-payment for a normal home visit based upon the cost of the current home visits. I am not certain if the Deputy is suggesting that doctors, when they perform a home visit, run at a loss. I am certain that members of the public would not believe that. However, if that is the case, that is an issue which needs to be addressed separately from these specific provisions.