GPs target non-payers

Guernsey GPs are owed about £1m. in unpaid fees. And patients at one practice who are considered 'hardened debtors' and want to see their doctor are at risk of being sent away to find the cash mid-consultation.

They also face home visits being refused unless there is a medical risk.

Patients at St Sampson's and L'Aumone who have made no effort to pay their fees are also being labelled with a 'double star' on their files to indicate they owe money.

As a result, the practice has found that patients are starting to pay up or at least make a contribution to what they owe.

Now both other practices - the Healthcare Group and Queen's Road - are looking at the system.

Dr Paul Williams, primary care chairman for the three island practices, said: 'I think very slowly we are tightening the net, but it is not a sudden, dramatic thing.'

Dr Williams stressed that doctors would always 'err on the side of safety' and would never withhold necessary treatment.

But the joint £1m. debt to GPs was high and equated approximately to the cost of one consultation for every paying adult in the island. Dr Williams expected a good proportion of the money to 'trickle in'.

The six-month debt relates to seeing GPs at the surgery, A and E and on home visits and includes debts built up by patients who have never paid fees.

Dr Williams said that St Sampson's and L'Aumone had been taking a new approach to bad debts for the past year.

'They will have been informed in writing that they have to pay for their consultation at the time and before they see the doctor.

'If they do not bring the money with them, they will be assessed and sent out to get the money because they have been forewarned.

'If they have been told they have to pay at the time, there is no excuse. They know the situation. These are people who are refusing even to liaise with the accounts department.'

Dr Williams said GP home visits were not available in many countries. 'Therefore if a patient is not willing to pay, they are not going to get it. They will have the basic service and not the luxury service.'

Dr Williams added that some patients who owed thousands of pounds had asked their doctor to administer travel vaccinations to far-off destinations.

'It does grate a bit,' he said.

'A common scenario is when the earner in the family is squandering the money on alcohol, cigarettes and gambling and is not providing for the family to pay for medical bills and, possibly, other necessities.'

People regarded satellite television and holidays as priorities over medical bills.

Dr Williams said no doctor would deny treatment to patients who needed it.

The scheme was targeting only those who had already received several letters about their debts and yet had made no effort to pay bills.

Bad-debt patients receive a total of five letters before cases are referred to the Petty Debts Court, he said.

This had been streamlined from six or seven letters. It gave people an opportunity to make an offer to pay. Small amounts were acceptable, even if it took years to pay off the debt.

Dr Williams said: 'The letters are all slightly different, with higher levels of pressure.'