The island is facing a crisis in GP recruitment.

The problem has prompted calls from GPs for reform in the provision of healthcare.

Reform is already in the air after a hard-hitting report last May highlighted a dearth of data on quality, performance and costs and a culture of mediocrity in the island’s health and social care services.

The imminent closure of Douglas’s Promenade Medical Centre, with 4,000 patients, has thrown the spotlight on the issue of recruitment that affects all GP practices in the island.

At the Promenade practice, Dr Clare Hillas is to retire leaving just one GP, Dr Helen Greig.

The practice was unable to recruit another GP and Dr Greig couldn’t continue alone.

Several GPs are due to retire in the Isle of Man but practices are struggling to fill their positions.

The problem of GP recruitment is acute in the UK - exacerbated by uncertainty surrounding Brexit and new immigration rules - but more extreme in the island.

GPs said the pay, particularly in smaller practices such as the Promenade practice, is lower than in the UK, plus non-transferable pensions make recruitment challenging if not impossible.

In the Isle of Man, GPs get £120 a patient a year regardless of the number of appointments. In the UK they get between £154.81 and £187.47 per patient per year.

’The Department of Health and Social Care has been aware for years that there is a GP recruitment crisis in the UK generally,’ said one GP, speaking to the Isle of Man Examiner anonymously.

’They have tried to tackle it locally by encouraging practices to train GPs and several practices are doing very well, Peel and Palatine in particular.

’If practices in the island can train and then keep local Manx-born people who will stay here, even better.

’Unfortunately there are not enough of these and so when a practice advertises across there is a terrible, almost zero response.

’This has been made worse by the pension scheme some years ago now being made non-reciprocal.

’Previously doctors could bring their pensions pot with them and vice versa.

’Now this is gone it will put doctors off from coming to the island.’

To make matters worse GPs, who often work 11-hour days, are taking on more tasks previously done at Noble’s Hospital.

’Secondary care is off-loading tasks to primary care and so the GPs are loaded with many more tasks, blood test to organise, prescriptions to sort out and often just seeing patients because they want their appointments expediting at Noble’s.’

Another factor putting a strain on the system is the increasing amount of social - rather than medical - care GPs perform.

This will only increase with an ageing population, the doctor believes.

He said they also soak up an ’acute shortfall’ in support for mental health patients.

’The department has tried to employ government locums to plug the gap in general practice but these seem to have dried up.

’We work long days and are often asked to visit patients at home by worried carers regarding patients where really more social care is needed rather than medical input.’

He added: ’Our practice has managed to find some extra GP sessions recently by employing an extra part-time GP but we will have three partners all retiring in the next few years, two in the next 18 months. We have enough appointments for three consultations (per patient a year).

’The NHS is underfunded but even with more money I am not sure where the new GPs are going to come from. Doctors now seem to look outside general practice for their careers and will often seek work abroad.

’We have a nurse prescriber which helps and finding another nurse that can prescribe is something we are currently trying to do as well as advertising across for new GPs.

’Patient demand is ever increasing with an ageing population and not enough social care provided.’