Angry doctors owed thousands refuse to work
· BBC NewsJordan Davies
BBC News
Doctors have warned of "dangerous" staffing levels and "potentially catastrophic" supply shortages at practices supported by a GP management company.
Some locum doctors have refused to work at Welsh practices linked to eHarley Street, because they say they are collectively owed about £250,000 in unpaid wages.
One long-standing doctor also told BBC Wales he had seen worrying hygiene issues, and Aneurin Bevan health board in south-east Wales said it was "aware of concerns related to a GP partnership".
But eHarley Street - whose website said it was "putting the joy back into general practice" - categorically denied the claims.
Speaking of one recent day, Dr Mark Wells, clinical lead at Brynmawr Medical Practice in Blaenau Gwent said: "I was the only GP - for a practice of 11,000 patients."
He said the surgery should have the equivalent of five GPs.
He said that locums – who temporarily fill GP rotas – "are basically refusing to work because they know they are not being paid".
He called staffing levels "dangerous" and said the surgery had previously closed early because of the lack of clinicians.
"I had 50 patient contacts yesterday - if there were any urgent calls, that would be impossible for me to handle."
Brynmawr is contracted by the health board to two GPs, and the same two GPs run eHarley Street.
Staff in the surgery said they were told a "central management team" at eHarley Street would take care of HR, finance and book locum doctors.
"There's no guarantee of being paid," said Dr Samantha Jenkins, who is owed more than £10,000 after working at Blaenavon Medical Practice, in Torfaen, and Brynmawr Medical Practice.
Dr Jenkins said she was told to make out her invoices, which BBC Wales has seen, to eHarley Street.
She said doctors were now refusing to work.
"We've got families and homes and mortgages," she said.
Dr Jenkins said there was limited oxygen available "for a couple of weeks" at the Blaenavon practice, which she said was a "huge patient safety concern".
"That's potentially catastrophic if you're in an emergency situation," she said.
The 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; The Corporation Road Surgery, Cardiff, and Lliswerry Medical Centre, Newport.
BBC Wales understands at least 37 clinicians are affected.
Dr Ian Jones, who also worked at the Brynmawr practice, said he was owed more than £2,000, and BBC Wales has seen correspondence between him and eHarley Street about the money.
A further two doctors, Dr Hussein and Dr Khan - who wanted only their surnames used - worked at Lliswerry Medical Centre in Newport, and said they were owed £20,000 each for locum work.
Dr Hussein, a doctor for 25 years, was concerned about the service being offered to patients.
"I feel very, very, very sorry to my patients," he said. "They’re not giving the appointments and services needed," he added.
Dr Hussein said he understood eHarley Street was running the surgery on a day-to-day basis.
What does eHarley Street do?
The company's website says it is "putting the joy back into general practice".
It says it offers GPs "practice management solutions" and its "team of experts" believe in "liberating" medical professionals from "managerial burden" to provide "high standards of patient care".
Each Welsh GP surgery is contracted to individual GPs, but all nine in Wales feature on the "our practices" page of the company website. The company also supports 15 practices in England.
Almost all of the Welsh practices are based in the Aneurin Bevan University Health Board area, and there is also one in Cardiff.
BBC Wales has seen correspondence from a medical supplies company which had stopped its eHarley Street accounts "due to overdue invoices".
"The lack of communication is horrendous," said Simon Juniper, who works for a company supplying locum doctors to surgeries.
He said his business stopped supplying locums to Welsh surgeries supported by eHarley Street because they were owed £25,000.
The GPs contracted to run the surgeries said they had faced financial "challenges", and that some locum payments had been "delayed", but would be settled.
Amy McCrystal, manager at Brynmawr Medical Practice, said the "biggest selling point" about eHarley Street was its central management team where "support could be arranged - about rotas and booking locums".
But she said some staff were still waiting for their October payslips, and waste bill had not been paid, and there were prescription concerns.
“People are going to the chemist and asking for an emergency supply of medication because they haven't been able to get their scripts in time from us," she said.
BBC Wales has also been told there have been difficulties obtaining supplies like wound packs and speculums, and that clinics had been cancelled, causing patient backlogs.
Ms McCrystal said staff had raised concerns with the health board, and visited eHarley Street's HQ in Leicestershire.
'Profits out of health into private pockets'
Plaid Cymru Member of the Senedd (MS) Heledd Fychan raised concerns about eHarley Street in a recent Senedd debate, and said big firms were "starting to step into the market of GP services, buying and running a number of surgeries", with eHarley Street "a clear example".
"This continues with the damaging trend of profits being taken out of the health system into private pockets, and also makes the provision vulnerable," she said.
BBC Wales has learned that local GPs bid for the Brynmawr Medical Practice contract, but were rejected by the health board.
Dr Sadequr Rahman, from Cardiff, a doctor for 25 years, said he had never known a situation like it, and was owed £1,850.
He has worked across the Blaenavon, Bryntyrion, Lliswerry, Tredegar and Aberbeeg practices, and said he had to do waste disposal himself at Blaenavon.
"We had to take the bin out and wrap the plastic carrier bag and put it in the waste disposal area - which was very, very full," Dr Rahman said. "If clinical waste is not being disposed of, that is a hygiene problem."
What does eHarley Street say about complaints?
In a statement from its solicitors, eHarley Street said it "does not hold any contracts for General Medical Services (GMS) in Wales", but that three partners hold "several contracts" for surgeries that "may have been the subject of the complaints outlined".
It said: "The operation of general practice - is currently under significant financial strain," and that "the surgeries operated by the partners have faced similar challenges".
"While some locum payments have regrettably been delayed, the vast majority have been settled, and the partners are confident that no outstanding payments will remain unpaid."
It said Aneurin Bevan University Health Board had "conducted urgent assurance meetings and practice visits" and found the surgeries were "operating within the parameters of the GMS contract, with no concerns identified regarding patient safety, health and safety, staffing levels, or resources".
"The partners strongly believe that many of the allegations originate from two disgruntled employees, without objective basis or corroboration."
A health board spokesperson said it “does not hold any GMS contracts with e-Harley Street Primary Care Solutions” and that all such contracts were with “named individual GPs”.
The board said: "We are aware of concerns related to a GP partnership within the health board region and are meeting regularly with the GP partners to ensure they are operating in line with their contractual obligations".
"We acknowledge the high demand for primary care services across the country, and this is also experienced here... we are committed to working with and supporting our GP partnerships to provide sustainable and reliable services for our population."