Primary health care faces many challenges

It’s now launched a new survey seeking the views and experiences of islanders in accessing primary care services.

The survey covers quality and availability of service of primary care, including visits to the GP, trips to Accident & Emergency, nurse consultations, telephone consultations with a doctor, and good old-fashioned service and advice from the pharmacist. It moves on to discuss health insurance and even the new development of social prescribing.

Yet it would be a major surprise if the results revealed anything other than the major issue being the cost of primary healthcare. How many people have been put off from seeking medical attention because they could not afford more than £50 to see a GP? And that includes a £12 discount that those who are eligible receive from a seriously outdated States initiative of some 30 years ago.

With representatives of both Citizens’ Advice and Age Concern on the Carewatch committee, it is highly likely that it will already be aware of cost concerns.

The Channel Islands’ competition regulator did a survey of 1,000 people in 2015, which revealed that 88% of islanders thought GP services were good or very good, but half of them had been put off attending because of the cost.

A few years ago a UK think tank proffered the Guernsey model as a solution for the NHS, recognising the value in the ‘gatekeeper’ role of leaving islanders responsible for the cost of their primary care, and removing some of the financial pressures on taxpayer funded services.

It is estimated that about half of all islanders have health insurance, while some 13% have doctors’ fees paid by the States. Many of those outside of those groups might well be in the 'squeezed middle', or old age pensioners.

Faced with issues over equity of access, as alluded to in yesterday’s editorial, and fast-approaching demographics, the primary care system might serve us well, but it also has serious challenges.