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2015.06.02
4.11 Senator Z.A. Cameron of the Minister for Health and Social Services regarding complaints made against G.P.s (general practitioners):
What process was used to assess whether complaints made against G.P.s were of sufficient severity and concern to warrant investigation by the Primary Care Governance Team?
Senator A.K.F. Green (The Minister for Health and Social Services):
Anyone with a concern about a G.P. should feel able to express that concern and be confident that the issues raised where appropriate are fully investigated and acted upon. The P.C.G.T. (Primary Care Governance Team) is able to receive complaints directly from patients, from relatives, carers or healthcare professionals. As I said earlier, a complainant is always encouraged in the first instance to use the G.P. practices own complaint procedure but if they feel they are not able to do this or have already exhausted that procedure then the P.C.G.T. will consider the complaint. An investigation will be instigated only if there appears to be an issue that might be of concern. If it appears that there may be a concern then the P.C.G.T. is obliged to start an investigation. It is difficult to give examples of when a complaint would be deemed serious enough to be taken further but the principle would be anything that gives potential concern about patient safety or the professionalism of the G.P. This could include the attitude of the doctor or their clinical judgment but might not include, for example, where a patient wanted a treatment that the G.P. was not licensed to give.
[10:45]
- Senator Z.A. Cameron:
As the Minister has already confirmed that none of the investigations conducted by the primary care team necessitated disciplinary action being taken against any of the G.P.s concerned, does he consider that the £320,000 spent on the team represents value for money for the taxpayer?
Senator A.K.F. Green:
The Senator, maybe unintentionally, is potentially misleading the House. She knows full well that the money spent on the governance team is very little of the expenditure of investigations. It is ensuring the good governance of G.P.s and the registration of G.P.s and the ongoing training of G.P.s and it is not about investigating G.P.s.
- Senator Z.A. Cameron:
The Minister has suggested that I am possibly paranoid, but rather than assume that this is the case, would he undertake to conduct a study on the processes applied by the Primary Care Governance Team by an expert in employment law that also considers the impact on the mental health, productivity, engagement and morale of local G.P.s subject to investigation to ensure that the processes are proportionate and not resulting in any unforeseen consequences to patient safety?
Senator A.K.F. Green:
We have an independent Medical Director appointed and working as a G.P. in the U.K. who carries out appropriate investigations and ensures good governance. I am advised that the number of complaints that we get, that this jurisdiction compares very well with other jurisdictions. If the Senator is asking me do I want to have a system where it is not safe for patients to raise concerns and they are ignored and swept under the carpet, no, I do not. I think patients should be able to raise their concerns safely and have them properly investigated. That said, I will always acknowledge that we have an excellent G.P. service in Jersey.
- Senator Z.A. Cameron:
I think the Senator is misrepresenting me. I am saying that it should be safe for doctors to be able to raise concerns about patient safety within the organisation. The Medical Director is answerable to that organisation. He is not independent. Can the Minister confirm who the Medical Director is answerable to and who he is employed by?
Senator A.K.F. Green:
Clearly, the Medical Director is employed by Health and Social Services but in order to provide some independence, that is why the Medical Director works as a G.P. in Dorset and carries out the role here separately. He is professional; he is properly trained in this role. As I said before, we have an excellent G.P. service but we must ensure that it is safe for patients to raise concerns and, to specifically answer the question that the Senator also raised, it must be safe for G.P.s to raise concerns themselves. In fact, they have a professional obligation to do so.
- Senator Z.A. Cameron:
Would he consider the recommendations made by organisations such as the N.S.P.C.C. (National Society for the Prevention of Cruelty to Children) that says that mandatory reporting should be by the organisation rather than the burden of the individuals concerned?
Senator A.K.F. Green:
The reporting of incidents that people have concern about must come from organisations and individuals. That is how it works in an open, mature culture where it is safe to raise issues, have them properly investigated and learn from the errors of the past.
Senator Z.A. Cameron:
I am very reassured by that. Thank you.