Primary · Islands Observatory

05 · Primary care — GPs, dentists and the price of the front door

Public lensThe biggest healthcare difference between these islands is what it costs to see a GP — free on the Isle of Man and the Scottish islands, ~£14–25 in Jersey after its growing subsidy, ~£60 in Guernsey after its £12 grant. And behind the price sits supply: one IoM GP now covers 2,689 patients, up 39% since 2012.

Politician lensPrimary-care charging is live politics in all three Crown Dependencies; GP supply is the quieter crisis. The funding-model table shows five different answers to the same question — who pays the GP? — each with a different failure mode (queue, fee, or workforce flight).

Management lensEngland pays ~£107.57 per weighted patient (global sum, 2024) plus QOF and enhanced services (~£164 total, real terms); IoM's only published rate is £120 flat (2020). Jersey has tripled its per-appointment subsidy since 2012. Whatever the model, the binding constraint is GP FTE.

Access & cost — what a standard appointment costs the patient

Funding models — who pays the GP, five different answers

Supply — patients per GP and surgery coverage

Surgery coverage — one surgery per how many square miles?

Experience & performance — satisfaction, referrals, waits

Urgent care pricing — the emergency front door

Close the gaps — what has never been answered publicly

Methodology & data governance notes

Sources. Every displayed figure carries a source string (document + date) reachable by hover, tap or inline chip. The consolidated data layer (observatory_data.js) is generated by script from extraction CSVs in the observatory library; nothing is hand-typed into pages. Primary sources: government/board annual reports and accounts, Audit Scotland/KPMG annual audits, HIS inspection reports, C&AG/JAO reports, DHSC Assessments of Manx Care, Tynwald Hansard and written answers, ONS/NRS/PHS statistics, CAA punctuality statistics, and FOI responses held in the library.

Comparability. Jurisdictions differ in definitions, targets, reporting windows and population bases. Basis lines are mandatory on comparison rows; 3-year rolling averages (small populations) are marked and never silently mixed with single-year rates; derived figures (per-capita, per-1,000, inversions) are labelled derived; DERIVED Sankey nodes state their derivation.

Gaps. Missing data is displayed, not hidden: red chips = no comparable public figure exists; blue chips = published somewhere we have not yet extracted (each maps to a roadmap item). Gaps are findings.

Views. The Public view uses plain language and does not draft formal requests; Politician and Management views expose question/FOI wording and benchmark framing. The view switch changes emphasis, never the underlying numbers.

Corrections. Errors: observatory@coalfinch.com. Build log and change history: see the Roadmap page.