Calls for free GP visits for vulnerable people

Monday 30 September 2019

The government is being urged to make GP visits free for young people and vulnerable adults amid fears the cost of healthcare is preventing them from seeking help.

The recommendation came from the Independent Jersey Care Inquiry (ICJI) Panel, who stated that doctors have a vital role to play in spotting signs of abuse, and expressed concerns at the low level of domestic violence referrals from GPs in Jersey in comparison to the UK.

Writing in a review released last week following a check-up on the island's care system two years after the publication of a damning report exposing 60 years of failings, the panellists urged the government to implement new policies allowing “free or fully-funded access to GP care and advice for vulnerable groups”.

Pictured: The Care Inquiry Panel released a report on their two-year review last week.

Having spoken to local families and professionals about GP services, they concluded that this was an area where “government policies, traditional practices and approaches may have features and unintended consequences detrimental to the safeguarding of children and vulnerable adults."

The Panel explained that young people and vulnerable adults that do not have access to funds or do not qualify for income support are barred from accessing health services, advice or GP support because they cannot pay for appointments or treatments. 

They also recommended that more work be done to ensure that patients are confident enough “in the sensitivity and confidentiality of their GPs” to be able to share concerns about familial violence.

Pictured: A majority of referrals made to the Independent Domestic Violence Advisor came from the police.

They found that out of over 460 referrals made to the Independent Domestic Violence Advisor (IDVA) for victims at high risk of domestic violence in one year in Jersey, less than 5% came from GPs while the vast majority came from the Police.

“This is concerning because in other jurisdictions police forces are usually the least likely source of referral because of the reluctance of victims to approach them,” they explained. “Conversely, elsewhere, GPs are one of the highest sources of referral to domestic violence support agencies.”

While GPs are aware of the issue and have received training to help spot signs of domestic violence and thus increase the number of referrals, the panel said this “significant issue” that needs a multi-agency-strategic approach. This should involve health services, GPs, the police, the IDVA and others to create “easier access to GPs and more effective pathways to safety and support for victims or those at risk of domestic violence and its impact."

Pictured: Close relationships between local GPs and their patients can sometimes cause challenges.

The Panel has however warned about the unintended consequences of the close relationships local GPs and their patients, as it causes “challenges” for GPs in managing the different strands of such relationships.

“Traditionally, GP practices have built a relationship with families that is a professional and business relationship but which often, through time, becomes a friendly and familiar one,” they said.

“We have heard anecdotal accounts of the interests and wishes of the family head, who pays the medical bills, overruling those of younger and possibly vulnerable family members.”

The recommendation was one of many in the report, which also argued in favour of the closure of 'Greenfields' - a secure school acting as a youth remand facility.

Pictured: Greenfields should be knocked down and small homes built there instead, according to the two-year review.

Instead, the panel said the site should be demolished, and turned into "small homely units" where residential childcare can be provided.