Maintenance of a suitable number of GPs

22.04.25

14 Senator S.Y. Mézec of the Minister for Health and Social Services regarding

maintenance of a suitable number of GPs (OQ.71/2022)

What plans, if any, does the Minister have to ensure that a suitable number of G.P.s is maintained in the Island over the coming years so that all Islanders can have timely access to their G.P. when they need to see them?

The Deputy of St. Ouen (The Minister for Health and Social Services):

Primary care is certainly an essential part of healthcare and, as Minister, I recognise the importance of maintaining a skilled healthcare workforce in the Island. This includes all healthcare workers within and external to H.C.S. As such, the department has undertaken 2 concurrent pieces of work to support this. Firstly, the health and care workforce strategy, which will include the G.P. and primary care workforce. Secondly, research and the preparation of a report with options on sustainable healthcare funding for Jersey, and this piece of work will come before this Assembly for debate; that is the intention and feed into the 2024 Government Plan. As the Senator is aware, G.P.s in Jersey are private businesses and, as such, like all commercial organisations, carry out their own recruitment to ensure the sustainability of their practices. The private nature of the practices has enabled Jersey to maintain good access to G.P.s thus far but if it is found that G.P. practices are unable to recruit, this will need to be considered in the pieces of work I have outlined.

1. Senator S.Y. Mézec :

Does the Minister monitor the numbers of G.P.s that there are in those practices in Jersey and does he have any ability to anticipate future numbers of G.P.s, bearing in mind that as the years go by some G.P.s will retire and we may wish to see new G.P.s enter the system to maintain the access to primary care in Jersey? What is his understanding of those numbers and the directions they are going and what challenges he may need to help them with overcoming to make sure that we do have enough G.P.s here?

The Deputy of St. Ouen :

The numbers are monitored and, of course, on a national scale there are numbers available as to how many people are entering training. But as to how many people are available to come to Jersey in the future that is more difficult. I understand that there are still a good number of G.P.s but the ways of working within private practice are changing and as indeed they have in many other professions. Many G.P.s now wish to work either on a part-time basis or fewer hours and not all of them are interested in the model of partnership that traditional G.P. practices have issued and would prefer to be salaried and more flexible in that way. Like other professions have - I know this has been the case in the legal profession - the traditional ways of working have changed and this is happening within the medical profession and we need to assist G.P. practices to make that change.

2. Deputy G.P. Southern :

I was very disappointed to hear the first answer aimed at 2024. Does the Minister not accept that we have shortages of G.P.s now? They have closed their lists in many cases and we have got a list of some dozen or so potential retirees in the next year or so. Will the Minister accelerate his process to assess how we can deliver primary care in the short order, rather than before 2024; that is too late?

The Deputy of St. Ouen :

I do feel the Deputy is being unnecessarily alarmist. We are working, have worked and will continue to work closely with primary care providers over the recruitment of preventative services, multi- disciplinary working within primary care. For example, so many healthcare needs could be met by a visit to the pharmacy rather than a G.P. attendance but G.P.s are also able to engage practice nurses or physiotherapists. We are also developing intermediate care services to support general practice by keeping people living independently at home. We are in regular discussions with the G.P. workforce about the changing demographics of the Island and their profession also.

3. Deputy G.P. Southern :

Surely one of the factors that should be involved in the short term is to plug the gap because we are about to see our numbers of G.P.s absolutely sink through the floor and that we have a matter of urgency if we are to preserve our primary healthcare system in some form or other.

The Deputy of St. Ouen :

I do not agree with the statement that our numbers are about to sink through the floor. What I do understand is that there are changes in this profession and that G.P.s who are new to practice are not necessarily wanting to work in the same way as those who are about to retire. That means that, like all of us and all workforces, they have to adapt and those discussions are continuing as to exactly how primary care can be delivered in the Island. There is much work being done and has been done.

4. Deputy K.F. Morel :

Just for the purposes of clarity, would the Minister advise the Assembly as to whether the number of G.P.s has increased, decreased or stayed the same over the past 5 years?

The Deputy of St. Ouen :

I am not sure about the last 5 years but my information from discussions last week was that the current numbers, essentially, are the same. What is happening is that G.P.s are wanting to work in different ways from those they had previously.

5. Deputy K.F. Morel :

If the number of G.P.s is, essentially, the same but we know the Island's population is rising, does the Minister accept that means each person, each patient in the G.P.'s surgery is receiving, effectively, less of a G.P. than they did 5 years ago?

The Deputy of St. Ouen :

That assumes that only a G.P. can provide healthcare. As I have said, primary care is about much more than visiting a G.P. It is possible to receive primary care services through practice nurses, through occupational therapists, other therapies and indeed pharmacists are highly-trained professionals who are able to assist to a far greater extent than I believe we give them credit for in dealing with primary healthcare issues.

6. The Connétable of St. Brelade :

Given that on a recent routine visit to my G.P., I was told that they were given only a day's notice to respond to consultation on the Care Model, would the Minister agree that it is important to maintain a good relationship with G.P.s if the numbers are to be continued and certainly if G.P.s are to be discouraged from taking early retirement?

[11:30]

The Deputy of St. Ouen :

I entirely agree it is important to maintain a good relationship. I know that in H.C.S. we have regular that is not myself but members of the executive have regular monthly formal meetings with the primary care body and there is contact at all other times on a very regular basis. I know that also happens in that Customer and Local Services have regular formal meetings too. As to receiving a day's notice to respond to a consultation, I would be surprised at that because the criticism that is often levelled at me is that the Jersey Care Model is proceeding too slowly, so I am surprised we are asking for consultations at a day's notice. But I can look into that if the Connétable wishes. But communication is important and that is recognised and does happen.

The Connétable of St. Brelade : I thank the Minister for his answer.

7. Deputy M. Tadier :

I wanted to ask if the Minister would circulate the figures that he talked about in response to Deputy Morel . I do have another question but that is my first.

The Bailiff :

You can ask a supplementary question in response to the answer. Deputy M. Tadier :

Thank you, Sir, that is an aside. It is my understanding that there is only one G.P. who is on the primary care panel. Would the Minister confirm what the total number is of that panel and whether he thinks it is sufficient representation that there is only one G.P. represented on that?

The Deputy of St. Ouen :

Yes, I can circulate the details of our records of the numbers of G.P.s on-Island. I am not sure what panel the Deputy is referring to though, I apologise.

Deputy M. Tadier :

It is the governance body. The Deputy of St. Ouen :

The governance body, yes. There may be one G.P., that is the way the governance body is set up so clearly there is a representative of the G.P.s.

8. Deputy M. Tadier :

Would the Minister circulate more detailed information about that as well; what the make-up of that body is and whether he thinks in that case it is sufficient representation for G.P.s?

The Deputy of St. Ouen :

I think the issue is probably set out in legislation but I will circulate details of membership.