THE Health Department ‘is set to fail’ to give people with incurable illness the best possible care. Instead of employing a full-time consultant in palliative care, the Health and Social Services Department wants to use an off-island specialist supported by a telemedicine service, which could provide virtual ward rounds and teleconferencing with staff. This option would save thousands each year, but the Medical Specialist Group and Les Bourgs Hospice want an on-island specialist at an annual cost of £470,000

The scheme proposed relies heavily on a telelink which in our experience is often overhyped,’ said MSG chairman Gary Yarwood.
‘It is difficult to organise for all relevant staff to be seated in front of the system at the same time and is of little or no use in assessing a patient.’
Each year between 150 and 200 people die locally from incurable conditions, mainly cancer. The States resolved in 2004, when it debated euthanasia, to act on the reported protracted, painful and undignified deaths suffered by some of those people.
Members supported the idea of a lead clinician in palliative care to offer ‘care of the highest standard’.
In its report back to the States, Health said it could not make palliative care one of its highest priorities. It favours screening programmes, sexual health services and speech and language therapy.
Les Bourgs is prepared to fund the appointment of on-island specialist for an initial three-year term, with a review of funding to follow, but HSSD feels it could not then take over the costs of the post.
Health minister Peter Roffey said: ‘In the light of current cancer epidemiology and calculated need, the second model of medical care, an off-island consultant supported by diploma trained family practitioners, offers better value for money.’
Deputy Roffey highlighted a grave shortage of about 100 palliative care consultants in the UK. Major cities do without.
He also expressed fears that with holidays and study leave, the island would be without the lead clinician for nearly 20% of each year.
Les Bourgs chairman Michael Tanguy said the department had taken a very narrow view.
He added that the exact same difficulties of cover would arise from establishing regular telelinks and coinciding the diaries of a practitioner in the UK, twinned with Guernsey.
‘The skills and experience imported into Guernsey by such an appointment will be invaluable.
‘Even if the appointee should only be in the post for three years, there is a value in getting experience out of such an expert into the primary care practices and within the MSG.
‘The on-island specialist will, as part of the job description, be involved in a training process and, over time, support from other clinicians within Guernsey during periods of absence will provide cover.’

GEP Article by Simon Tostevin

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