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Extended limits of co-payments for G.P. consultations: young people and pregnant women (P.80/2020) – amendment [P.80/2020 Amd.]

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STATES OF JERSEY

EXTENDED LIMITS OF CO-PAYMENTS FOR G.P. CONSULTATIONS:

YOUNG PEOPLE AND PREGNANT WOMEN (P.80/2020) – AMENDMENT

Lodged au Greffe on 7th July 2020 by Deputy C.S. Alves of St. Helier

STATES GREFFE

2020  P.80 Amd.

EXTENDED LIMITS OF CO-PAYMENTS FOR G.P. CONSULTATIONS: YOUNG PEOPLE AND PREGNANT WOMEN (P.80/2020) – AMENDMENT

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1  PAGE 2, PARAGRAPH (a) –

In the preamble to paragraph (a), for the words "to review his recent decisions on the level of co-payments to be charged to various groups of patients for the delivery of primary care and" substitute the words "to take such steps as are necessary, for implementation between the cessation of the current agreement between the Department of Health and Community Services and the Island's G.P.s and the commencement of a scheme on 1st January 2021 in accordance with the States Assembly's adoption of Affordable access to Primary Care Scheme' (P.125/2019) on 4th February 2020,".

2  PAGE 2, PARAGRAPH (a) –

In paragraph (a), for the words "extend the age limit for" substitute the words "allow" and for the words "4 years" substitute the words "0 years".

DEPUTY C.S. ALVES OF ST. HELIER

Note:  After this amendment, the proposition would read as follows –

THE STATES are asked to decide whether they are of opinion

to request the Minister for Health and Social Services, in consultation with the Minister for Social Security and the Council of Ministers, as appropriate, to take such steps as are necessary, for implementation between the cessation of the current agreement between the Department of Health and Community Services and the Island's G.P.s and the commencement of a scheme on 1st January 2021 in accordance with the States Assembly's adoption of Affordable access to Primary Care Scheme' (P.125/2019) on 4th February 2020, to –

  1. allow young people to receive free G.P. consultations from 0 years to 17 years of age;
  2. reduce the cost of a pregnancy package' for pregnant women from £120 to zero; and
  3. identify  the  appropriate  source  for  the  funding  of  this improvement.

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P.80/2020 Amd.

REPORT

P.125/2019, as amended, was approved by the States in early February, requested the Minister for Health and Social Services to

"devise a scheme which improves access to primary care by reducing financial barriers for patients who are financially, clinically or socially vulnerable".

In response to the outbreak of the Covid-19 pandemic, the Minister devised a different scheme which reduced the cost of G.P. consultations for all patients, rich and poor alike, and made Covid-19 consultations, along with some other services, free.

As part of this scheme, the consultation fee for children and young people between the age of 4 and 17 was set at £10. This level of fee, whilst welcome when compared to the previous  level  of  £40,  still  has  problems  associated  with  it.  As  the Children's Commissioner points out –

"Any fees to access health care services present barriers to children and young people from accessing their right".

This arrangement for the delivery of primary care was to last for 4 months. This period of time is up on August 9th. As from August 10th the delivery and costs of primary care revert  to  the  pre-Covid-19  levels.  The  cost  the  patient  co-payments  for  a  G.P. consultation, including children and young people, will once more be between £40 and £45 for the 5 month period until the Minister can negotiate a scheme which meets the criteria set in P.125/2019.

For these 5 months (and who knows, maybe longer) we shall be in a position where our primary care system is unaffordable to many and inaccessible to many young people who may be in dire need of G.P. services to address their mental health needs after these months of stress and worry.

Where some who are ill may put off that visit to the doctor until they are so ill that they need far more expensive hospital treatment. For many, the recent times have seen largely struggle and debt as jobs and hours have been lost and family incomes reduced. The last thing we should be doing is to add the stress of high doctor's bills to the anxiety many are suffering as they try to make ends meet in these times of hardship.

Financial and manpower implications

The cost of enabling free access to G.P. consultations for under 18s for 5 months is around £750,000.

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P.80/2020 Amd.