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Inquiry demand for GPs where patients feel 'unsafe'

BBC Katrina is sitting in a room full of people, wearing glasses and an orange coat, looking at the camera. BBC
Terminal cancer patient Katrina Hughes feels frightened by the lack of doctors at her GP practice and said clinicians at her hospice "cannot believe" the situation

There are demands for an inquiry into doctors surgeries being run remotely by a private GP management company.

Safety, staffing and supply concerns at surgeries managed by eHarley Street were revealed by BBC Wales last month and prompted questions in the Senedd.

Now patients, some with terminal illnesses, have said they have difficulty accessing appointments and treatments.

The partners who run the surgeries and eHarley Street said they had invested nearly £400,000 into the practices and were committed to addressing "challenges".

"It frightens me - I don't feel safe," said Katrina Hughes, 69, a terminal cancer patient who struggles to get an appointment or see the same doctor at Brynmawr Medical Practice in Blaenau Gwent.

"There's no continuity of care at all," she said.

Katrina has bone cancer which is causing her spine to crumble and feels like "I haven't got a doctor".

She was among around 100 people who attended a public meeting to discuss services at Brynmawr Medical Practice - many said they struggled to get appointments or were waiting for medication and test results.

Brynmawr Medical Practice is contracted to two GPs, the same two GPs run eHarley Street, a GP management company based in Leicestershire that supports nine Welsh practices.

Ralph Morgan is sitting in his living room wearing a navy polo T-shirt, looking straight ahead at the camera. Behind him is a dining table and chairs and a house plant
Ralph Morgan said Aberbeeg Medical Practice staff go "above and beyond", but now faces a Christmas with no treatment and reduced mobility

Ralph Morgan, 69, a patient at Aberbeeg Medical Practice, which is also managed by eHarley Street, said he struggled with his knees and it was "worse in the winter".

The retired postal worker has been treated for high blood pressure and needs regular knee injections to help him walk.

Ralph has been a patient at Aberbeeg for more than 25 years, but said the service had declined since GPs linked to eHarley Street had taken over.

Ralph said he had been told the surgery could only offer "12 routine appointments" every week and it "does not know" when he can have his next injection.

"I live in the valleys - up hills - it's a lot easier when you've got the knee injections," he said.

"Now I'm being denied it - I feel trapped."

Mr Morgan wants the Welsh government to investigate and has written to Aneurin Bevan health board to complain.

He said an investigation should take place "immediately".

Sian Squires Sian Squires is wearing a bobble hat, walking in the park with her uncle, Stephen who is wearing a flat cap and red rain coat. Both are looking at the camera for a photograph.Sian Squires
Sian Squires is unhappy with the support her uncle, Stephen, a lollipop man received before he died

Sian Squires, 32, from Torfaen, said it was "terrible" getting an appointment at eHarley Street's Pontypool Medical Centre.

She was "disgusted" with the support her uncle, Stephen, 70, got before he died in September and struggled with an appointment for her nine-year-old son Noah, even though his notes state he requires "emergency appointments".

"I got told five, six times, we're really sorry we've only got one doctor," she said.

A picture of Brynmawr Medical Practice, which is a low, wooden building set in front of a large metal building.
Locum GPs have refused to work at Brynmawr Medical Practice because they have not been paid, making it difficult for patients to get appointments

Last month BBC Wales revealed locum doctors - who temporarily fill GP rotas - had refused to work at Welsh practices linked to eHarley Street because they said they were collectively owed around £250,000 in unpaid wages.

The partners who run the surgeries and eHarley Street said timely care for patients "remains a top priority" and it was "offering, on average, one session of clinician time per 200 patients", which was the "agreed level of clinical cover".

It categorically denied the concerns raised last month.

The health board said it had "enhanced monitoring arrangements in place" and would continue to do "further work".

About 100 people are sitting on chairs and in wheelchairs facing a table of councillors. The walls are all painted white and the carpet is grey
About 100 people attended a public meeting to discuss services at Brynmawr Medical Practice

Welsh surgeries linked to eHarley Street are:

  • Brynmawr Medical Practice
  • Blaenavon Medical Practice
  • Pontypool Medical Centre
  • Bryntirion Surgery, Bargoed
  • Tredegar Health Centre
  • Aberbeeg Medical Practice
  • Gelligaer Surgery, Hengoed
  • Lliswerry Medical Centre, Newport
  • The Corporation Road Surgery, Cardiff.

There are also 15 practices in England and the company's website says its team of experts believe in "liberating" medical professionals from "managerial burden" to provide "high standards of patient care".

Dr Samantha Jenkins is wearing her medical scrubs and stethoscope and is posing for a picture with the countryside behind her.
Dr Samantha Jenkins said she would no longer work at surgeries linked to eHarley Street because she is owed thousands of pounds

"We've still not been paid", said Dr Samantha Jenkins, who is owed nearly £10,000 for work at the Brynmawr and Blaenavon practices - she backed calls for an inquiry.

She and other doctors intend on using the small claims court to recover their wages.

Patients and doctors have also questioned the due diligence carried out by the health board ahead of awarding the GP contracts.

The partners who run the surgeries and eHarley Street accused locum agencies of "driving up prices to unsustainable levels" in Wales, but said there was a plan "to ensure all overdue payments are made in full".

They said they had invested £383,000 in the Welsh practices but still faced "eye watering" losses.

Member of the Senedd (MS) Alun Davies, who represents Blaenau Gwent, recently raised the issue in the Welsh Parliament.

He said his priority was "patient safety" but believes an inquiry should take place into "why this company is failing our people" and feels either the Welsh government or the health committee "have a responsibility to look into this".

Alun Davies MS is wearing a suit and tie will posing for a photograph in the Senedd. He is wearing a royal blue suit with a white and blue checked shirt and a pink tie with a blue pattern on
Alun Davies MS raised the issue in the Welsh Parliament after concerns were revealed by BBC Wales

Mr Davies said it was "appalling" that GPs had still not been paid and called for the practice manager at Brynmawr Medical Practice, Amy McCrystal, to be reinstated after she was made redundant with no warning.

South Wales East MS Delyth Jewell also called for answers from the Welsh government after concerns were raised with her about the Brynmawr practice, and Bryntirion surgery in Bargoed.

The partners who run the surgeries and eHarley Street claimed the comments by politicians were "untrue" and said they had "reached out" to local councillors.

In a statement from their solicitors, the partners who run the surgeries and eHarley Street said they operated several Welsh GP practices which "came under their management through open application processes".

They said they faced "significant financial constraints" but were "committed to addressing these challenges" to ensure practices "continue to provide high-quality care to patients while maintaining a sustainable working environment for staff".

The Welsh government said it was aware of the concerns and that the health board "continues to provide support and is in close contact with the managers and GP partners to seek assurances on compliance with their contract".

The health board said it did not hold any General Medical Services (GMS) contracts with e-Harley Street and all GMS contracts within its area were held with named GPs.

It said it was aware of concerns and was "meeting regularly with the GP partners to ensure they are operating in line with their contractual obligations".

It added: "The health board has already undertaken focused reviews to seek immediate assurances as part of the enhanced monitoring arrangements in place and we are continuing to do further work in light of the local concerns that have been raised.

"We are committed to working with and supporting our GP partnerships to provide sustainable and reliable services for our population."