GP fees

2024.06.11

3.3   Deputy I. Gardiner of the Minister for Social Security regarding funding for GPs (OQ.108/2024)

Further to the Minister’s announcement in May that the cost of G.P. (general practitioner) visits will be reduced by £10 following an increase in the government subsidy to G.P.s, will she advise what steps have been taken, if any, to ensure the increased funding is, in reality, reducing the cost of G.P. visits for Islanders?

Deputy L.V. Feltham of St. Helier Central (The Minister for Social Security):

The additional £10 reduction that I delivered in May takes the total amount to £30 from the fee that doctors would normally charge. This is a contractual obligation, and if a practice does not remove £30 they are breaking the terms of that agreement. Each practice confirms the fees that they will charge, so officers can challenge it if it appears that the terms of the agreement are not being applied. Also, practices are required to clearly advertise their fees and show the full extent of the government subsidy on that. We also advertise fees on the Government website.

1. Deputy I. Gardiner :

Thank you, Minister, for her answer. I am made aware about 2 G.P. surgeries that put their fees up to £10 a month or so just before the announcement. How has the Minister explained to the Islanders that £30 of public money - £20 from the previous Government and £10 from the Minister currently - has not led to the meaningful reduction of the G.P. fees for Islanders?

Deputy L.V. Feltham :

Analysts do track the amount charged by G.P.s and can see when prices decrease or increase. Analytics done on the 2022-2023 reduction showed that every surgery had to reduce their gross fee by the £20 at that time. It is early to collate the same figure for this particular reduction but we will be undertaking that same analysis. If the Deputy is concerned about specific G.P.s not passing on the subsidy then I would request that she send me those details in private.

2. Deputy H.L. Jeune :

The Consumer Council has found that there is a significant price difference between surgeries, nearly £20 in some instances. Does the Minister not believe that there should be a fairer overall pricing system to visit a G.P. across the Island and if yes, what steps will she take to encourage this?

Deputy L.V. Feltham :

Taking such steps across overall G.P. fees would be a significant change to current policy. We do, of course, have certain programmes already in place, such as the free G.P.s to children and also the Health Access Scheme, which are separate contractual obligations. We are also currently working on delivering the free G.P.s for students as well.

3. Deputy H.L. Jeune :

Can the Minister advise if she is planning on any further subsidies for G.P.s in the future? Deputy L.V. Feltham :

I would like to undertake further work to look at how we may well provide further subsidies to people who require to visit the G.P. due to specific health problems where they may be required to visit the G.P. more often than others and may have more significant reasons to visit G.P.s. But that work is yet to be undertaken. We are focusing at the moment on delivering the States Assembly commitment to free G.P.s for students.

4. Deputy P.M. Bailhache of St. Clement :

Would the Minister agree that the costs of general practitioners in running their businesses increase, like the costs of any other business, and that it is reasonable for G.P.s to reflect the increase in the cost of living in the charges which they make to patients?

Deputy L.V. Feltham :

Yes, general practices are private businesses and they are responsible for setting their own fees and managing their costs. So it is therefore up to them to set those fees. I would like again to take the opportunity to remind people that G.P. fees should be accessible and obtainable when people are booking appointments with G.P.s, and also again they are on the government website so people should have full transparency about the fees that they are paying when they make a G.P. appointment.

5. Deputy M. Tadier :

Does the Minister agree that if other Members do not think that competition is sufficient to ensure responsiveness in the G.P. market and if they are worried about differentials and G.P.’s fees, or indeed if the current policy is not radical enough for some in the Assembly, does she believe that they are at liberty to bring their own propositions perhaps to make G.P. visits free for all, if they wish to support that?

Deputy L.V. Feltham :

Yes, of course, and I would remind Members that we would not have had free G.P.s for children, free G.P.s for students and the Health Access Scheme if Members had not brought such propositions.

6. Deputy K.M. Wilson of St. Clement :

Can the Minister explain what sanctions she will take or apply to those surgeries that will not pass on or are unable to actually pass on those savings to patients?

[10:00]

Deputy L.V. Feltham :

At the moment, as I said during my answer to the initial question, G.P.s are contractually obliged and that would be a breach of contract if they did not pass on that fee reduction. So if any Member has any evidence to suggest that that has happened, please could they give that evidence in private to me.

7. Deputy K.M. Wilson :

I think the question was about sanctions. Deputy L.V. Feltham :

At present, I am unaware of any instances in which a G.P. has not passed on the reduction. If that was the case then I would indeed need to consider some sort of sanction, but I have not had to as yet.

8. Deputy S.M. Ahier of St. Helier North:

The Minister mentioned that there may be further subsidies. What long-term effect will these extra subsidies have on the H.I.F. (Health Insurance Fund).

Deputy L.V. Feltham :

Ensuring that people can get timely access to G.P.s is a really important part of our health system in order to prevent further expenditure further down the line. The Health Insurance Fund is currently healthy, but of course I will need to ensure that any further subsidies look after the health of the fund as a whole as well and do not have an overall impact on that.

9. Deputy S.M. Ahier :

Does that mean that the Minister intends to increase the contribution towards the H.I.F.?

Deputy L.V. Feltham :

No.

10. Deputy G.P. Southern of St. Helier Central :

Would the Minister inform Members what role the H.I.F. is intended to play in the funding of primary healthcare in Jersey?

Deputy L.V. Feltham :

The H.I.F. is there to ensure that we can subsidise both our primary care and pharmacy costs. Of course, I am aware of further pressure across the health system and will continue to work closely with the Minister for Health and Social Services as we address funding costs across the health system, including primary care.

11. Deputy I. Gardiner :

It has been brought to my attention there is a problem with the £30 reduction for call-outs because it is available only to G.P.s and not to nurses or paramedics. Many practices deploy nurses instead of G.P.s so do not receive the reduction and so do not cut the price. Was the Minister aware about this and what plans, if any, she has to address this?

Deputy L.V. Feltham :

That is the first time that I have heard that concern being brought to me so if the Deputy would like to raise her concerns with me outside of the Chamber I would happily address those.