Making our health care model pay
AS THE review of the island's primary medical care model continues, it is only right we give the system a thorough health check. Yet talk of phasing out the £12 per appointment States subsidy – which, if the GPs have their way, could see the cost of a doctor's visit leap from £48 to £60 – will be causing concern, distress even, among some islanders. Employment & Social Security has an unenviable task in prescribing the right way forward because, while some things are indisputably wrong with our system, other parts of the operation work extremely well.
It is expensive – desperately so for those without health insurance struggling to pay the visit fee – however the quality of our health care does tend to be extremely high.
Just a glance over to the UK and its 'free at the point of delivery' model shows how that approach, while the social ideal, is now creaking perilously.
What is acutely clear here is that anyone starting with a clean sheet of paper would be unlikely to effectively concede pricing strategy to a small number of 'super surgeries', as currently happens.
Competition, which we have seen work well in Jersey via Co-op Medical Care (and something which might also prove successful here), could potentially meet a growing demand for lower-priced health care, cutting prices and bringing with it more surgeries and GPs.
With the cap of 42 on GP numbers removed two years ago by competition watchdog Cicra, we already have a framework for other operators to enter the market.
Alternatively, not throwing the baby out with the bath water will be crucial for E&S, which will be expected to protect standards.
Islanders tend to have the highest praise for their GPs and the treatment they receive. And none of that comes cheap, with staffing costs and overheads taking a chunk of the appointment charge.
Yet the fact remains that Guernsey's model is flawed, with only those using a GP paying for the island's primary health care.
While that means every patient is treated the same, their ability – or not – to pay will always leave the less well off in our community as constant casualties of the charges.
