BACK in the summer, a retired GP took this column to task for suggesting that some doctors enjoy annual incomes in excess of £300,000 although such evidence as is in the public domain indicates that some do very well indeed.

What we weren’t challenged over, however, is if being a GP is so potentially lucrative, why aren’t they queuing up to get in?

The reason is that the doctors enjoy what amounts to a closed shop because their numbers are capped at 42 by Health and Social Services as a result of a policy that existed pre 1990. It may have made sense at the time but appears to be less relevant today.

As the Commerce and Employment minister said this week in anticipation of a regulator’s report on whether the uniform fee scale charged by the medical practices is anti-competitive, the cap on numbers should be reviewed as well.

However, as a result of a decision by the States last January, HSSD now has the authority to amend the cap and change who is able to admit patients to hospital as it sees fit and may well do so after it has had a chance to consider the regulator’s report on competition and GP fees.

Clearly, any highly skilled and qualified professionals should be free to charge what they like or deem appropriate but they should not operate a virtual monopoly or appear to fix prices.

Equally, the consumer’s best defence against aggressive pricing is competition and it is understood that UK medical practices are interested in setting up in Guernsey but are prevented from doing so because they currently cannot admit patients to hospital or access its diagnostic facilities.

While the original intent of the GP cap was to prevent HSSD costs from rising, it cannot be right that doctors are granted immunity from competition or that patients are denied potentially greater choice.

These are complicated areas but the C&E minister is correct when he says that the area is ripe for review.

The new HSSD board might be wrestling with cost over-runs but it cannot afford to ignore this issue.