Select a region
The Government has come under fire over plans to withdraw large sums of money from the island’s Health Insurance Fund – against a pledge from a previous Minister.
The primary purpose of the Health Insurance Fund (HIF) is to subsidise the cost of islanders' doctors' appointments, though the fund has also, somewhat controversially, been used for other purposes in recent years.
Sir Philip Bailhache, Deputy Chair of the Health and Social Security Scrutiny Panel, yesterday said there had been a “serious breach of the Ministerial undertaking” as he grilled Health Minister Deputy Karen Wilson on proposals in the draft Government Plan for an additional £12.5m to be transferred from the HIF for the purposes of the Jersey Care Model and the associated Digital Care Strategy, totalling £22m for 2023 and 2024,
The extra HIF spending featured in the Plan despite the previous Minister of Social Security having said that no more money would be taken out of the fund until a sustainable healthcare funding model was found.
“Is this appropriate given that the actuarial review of the HIF has not been undertaken since December 2017 and is due at the end of this year?” Sir Philip asked Deputy Wilson.
Sir Philip's concerns were echoed by Panel Chair Deputy Geoff Southern, who said that it is “quite a serious issue” to propose that “we can carry on as we are, taking money from HIF with no alternative on the board and precious little time to ask for anybody else to examine what that might be”.
Deputy Wilson defended the spending, going on to suggest that the “commitments that were made by the [previous] Assembly” only carried forward until she was appointed Minister in the summer and decided to suspend the Jersey Care Model.
Pictured: Minister for Health and Social Services, Deputy Karen Wilson.
She said: “The agreement that was made by the Assembly to fund aspects of the Jersey Care Model happened before I was in post and have continued for those elements of work that have actually brought patient benefits.
“One of the things that is quite important is that when you start work that affects the clinical designs or the clinical service and the impact that has on patients, the money has to continue to deliver that service element to the patients.”
Deputy Wilson added that there are “concerns about the way in which the Jersey Care Model has been funded” and “a lot of confusion about what the HIF should be about”.
She explained that purpose of undertaking a review of the Jersey Care Model was to “provide some clarity, some openness and some transparency about the position that we are in”, clarifying that the Health Insurance Fund will not be funding new projects under the Jersey Care Model, but only ones that were already in progress.
Caroline Landon, Director General for Health and Community Services, described the Jersey Care Model review as a “complicated piece of work that we need to get right”.
She said that £7.4m had been withdrawn from the HIF this year, against an estimated £17.9m, adding: “We do not envision that we will be continuing to withdraw money again until the Minister has concluded her review of the Jersey Care Model.”
The questioning comes around one week after the Primary Care Body - the group that represents GPs - wrote to the Scrutiny Panel to express their own concerns about the use of the HIF.
"Capital projects and their ongoing operating costs should be met through HCS budgets and money should not be diverted from supporting patients in accessing care," they said.
"The benefits of secondary care IT changes to patients in primary care are likely to be limited and this investment does not reduce costs to Primary Care providers or allow for community IT solutions to be rolled out more widely."
The group added: "The Government Plan has no specific proposals on how General Practice and wider Primary Care will be funded and no specific proposals as to how the HIF will be maintained. Indeed, the PCB have previously raised concerns in this regard.
"Furthermore, although Government proposes to consider sustainable funding and the funding of General Practice and wider Primary Care during 2023, any changes are not likely to be implemented for several years thereafter.
"Although the recently introduced time-limited wage support scheme for allied healthcare professionals allows practices to evolve their workforce to reflect modern practices (as first proposed in the government paper "A Sustainable Primary Care Strategy for Jersey 2015-2020"), we have yet to see any proposal in support of the statement that "money will follow the patient" to allow transfer of care to the community in the longer term. In addition, the need for associated infrastructure and its cost has not been addressed.
"In the meantime, diverting funds will inevitably further reduce the sustainability of the HIF and its ability to continue to support patient benefits.
"It should be remembered that the principle of the HIF is to support patient access to Primary Care services. As such, HCS budgets should not be supplemented by the HIF."
Comments
Comments on this story express the views of the commentator only, not Bailiwick Publishing. We are unable to guarantee the accuracy of any of those comments.