Dr Nigel Minihane said those insurance rates were likely to rise again significantly following a multi-million-pound lawsuit that was settled by the States last week and four more lawsuits believed to be in the pipeline.
Adverts for doctors, which run in the British Medical Journal and industry magazine Pulse, as well as on Facebook, and in the past would have attracted many applicants, are now drawing just one or two CVs, Dr Minihane said. Jersey’s GPs are required to pay for their own indemnity insurance, while recent moves in the UK – where those rates are lower – mean doctors there will be subsidised by £60 million.
These factors, coupled with the high cost of living generally in Jersey, mean doctors are now increasingly looking elsewhere to build their careers.
‘It has become more difficult to recruit new doctors to the Island,’ Dr Minihane said, speaking to the JEP after consulting local GPs, consultants and specialists in medical law.
‘Year on year we have fewer applicants and in some instances no suitable applicants for GP jobs.
‘In addition to the high costs of housing, indemnity costs are already double that of our UK colleagues. We anticipate that this situation will only get worse if appropriate steps are not taken to protect the community from the consequences of the unsustainable high and ever-increasing costs of medical indemnity.’
Indemnity insurance for local GPs averages £16,000 a year. If and when that cost rises again – which is expected following the recently settled lawsuit – an already difficult situation could be made worse, weakening the Island’s healthcare system and challenging its future.
The UK has taken steps to address its recruitment challenges, which, by comparison, will make Jersey less attractive.
‘This year the English government have subsidised GPs to the tune of £60 million – all at the expense of the taxpayer – rather than remediate the problem it has identified,’ Dr Minihane said. ‘Next year, however, the matter is going to get very much worse.
‘The English have recognised that their system has made it impractical to expect doctors to cover the costs of indemnity subscriptions and from 1 April 2019 they will pay all clinical negligence indemnity costs going forward.’
Beyond the high cost of the insurance, however, there is also a fear the medical defence organisations which provide cover might simply cease offering the insurance to Channel Island practitioners.
The situation is not just a threat to recruitment. However, Dr Minihane added that practitioners already in place were questioning their futures in Jersey.
‘Those doctors who are already here are facing the question: how long is it sensible and responsible for me to remain here?’ he said. ‘Most of us have responsibilities to our families and whilst we are devoted to our profession and our patients, these are not reasonable terms of trade.’
Patient waiting times for GPs in the Island have not yet been drastically affected by the challenges, he said.
But according to the most recent statistics for the Hospital, there are a number of specialities carrying waiting times of three months, including diabetic medicine, orthopaedics and respiratory medicine.
Consultants working at the Hospital currently have their indemnity coverage paid for by the States, although they do pay for indemnity of associated private practice.