Is £340,000 a year fully justified?
ON FRIDAY this column welcomed the Channel Islands Competition and Regulatory Authorities' interest in introducing competition to GP fees and quoted figures which suggested some of the salaries enjoyed by doctors under the current set up are lavish to say the least.
ON FRIDAY this column welcomed the Channel Islands Competition and Regulatory Authorities' interest in introducing competition to GP fees and quoted figures which suggested some of the salaries enjoyed by doctors under the current set up are lavish to say the least.
Since then, a former GP has been in touch demanding that we explain how such calculations were arrived at, which we will happily do during the course of this week.
One of the points that column was also trying to make, however, is the discrepancies in the funding models between GPs and secondary care provided by the specialists.
An independent report a little over a year ago highlighted what it called the perverse way incentives operate in the healthcare system.
Doctors get paid only when they have patients in front of them. Consultants employed by the Medical Specialist Group get paid by the States irrespective of whether they see anyone or not.
As Sector Treasury Services Ltd said in May last year, 'The fees are paid monthly, based on the number of consultants actually employed, but there are no requirements on hours worked or what the consultants actually do.'
That means each month, in excess of £1m.-worth of public funds are remitted to the MSG with no clear agreement on what islanders get for it.
This is not to criticise the standard of care provided but, as Sector intended, to point out the deficiencies of the current contract, which will be renegotiated in 2017.
When it was last looked at, Sector also noted that the States assumed that around 10% of time was spent on private patients, 'but there are no controls on private work either'.
The wider context is that every penny spent on healthcare in the island – public or private – needs to be properly targeted because irrespective of whose pocket it comes from, it is limited.
In the case of the MSG, the specialists there received the equivalent of nearly £340,000 p.a. gross before adding any income from private work.
As consultants Scope observed, consultants here 'are relatively well remunerated' compared to similar jurisdictions.
The work of the competitions regulator and others is to ask whether that can be justified.
