Proposed Government Plan 2022-2025 (P.90/2021): fifteenth amendment. (P.90/2021 Amd. (15)) – amendment. Health Insurance Fund funding

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STATES OF JERSEY

PROPOSED GOVERNMENT PLAN 2022- 2025 (P.90/2021): FIFTEENTH AMENDMENT (P.90/2021 AMD.(15)) - AMENDMENT

HEALTH INSURANCE FUND FUNDING

Lodged au Greffe on 7th December 2021

by the Health and Social Security Scrutiny Panel

STATES GREFFE

2021 P.90 Amd.(15) Amd.

PROPOSED GOVERNMENT PLAN 2022-2025 (P.90/2021): FIFTEENTH AMENDMENT (P.90/2021 AMD.(15)) - AMENDMENT

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1 PAGE 2, PART 1

For the words "Regular updates on these workstreams should be regularly reported on to the independent JCM Programme board and the Health and Social Security Scrutiny Panel." insert the words–

"Regular updates on these workstreams should be regularly reported on to the JCM Programme board; the Independent Oversight Board and the Health and Social Security Scrutiny Panel'

HEALTH AND SOCIAL SECURITY SRUTINY PANEL

Note: After this amendment, the 15th amendment would read as follows – 1 PAGE 2, PARAGRAPH (I)

After the words "as set out at Appendix 3 to the Report" insert the words–

"except that, on page 168 under "Health Insurance Fund" the following words be inserted:

The following safeguards and transparency measures will be put in place in relation to the establishment of the Jersey Care Model:

• The independent non-executive board (establishment of which was approved in P.114/2020) will be supported to publish a review of the Tranche 1 and the use of 2021 funding by the end of March 2022 at the very latest; and

• The digital health team within Modernisation and Digital establishes a protected, separately resourced sub-team (that includes a Manager grade role), to focus solely on the delivery of the Jersey Care Model digital systems, and the Digital Care Strategy. Regular updates on these workstreams should be regularly reported on to the JCM Programme board; the Independent Oversight Board and the Health and Social Security Scrutiny Panel.

The following safeguards and transparency measures will be put in place in relation to the operation of, and any transfers made out of, the Health Insurance Fund:

to the Minister for Social Security relating to the costs incurred on the Jersey Care Model that require a transfer of funds from the HIF;

• The Minister for Social Security will publish a report, within 2 weeks of any transfer, to detail how any funds transferred out of the HIF for the purposes of the JCM or its related digital strategies costs have been verified;

• An actuarial review of the Health Insurance Fund (HIF) is prioritised in 2022 and will include:

specific analysis of the use of the HIF for the purposes of the Jersey Care Model and its related digital strategies;
Consideration of the impact of all withdrawals on the fund since 2020; and
The future of the HIF, should withdrawals take place as per envisaged by P.130/2020.

• As part of the wider review of sustainable healthcare funding to be undertaken in 2022, there will be a specific consideration to repaying the HIF (from the Consolidated Fund) for funding withdrawn for the establishment of the Jersey Care Model and its related digital strategies if no sustainable healthcare funding is operational by 2025.

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

THE STATES are asked to decide whether they are of opinion

to receive the Government Plan 2022 – 2025 specified in Article 9(1) of the Public Finances (Jersey) Law 2019 ("the Law") and specifically –

to approve the estimate of total States income to be paid into the Consolidated Fund in 2022 as set out in Appendix 2 – Summary Table 1 to the Report, which is inclusive of the proposed taxation and impôts duties changes outlined in the Government Plan, in line with Article 9(2)(a) of the Law;
to approve the Changes to Approval for financing/borrowing for 2022, as shown in Appendix 2 – Summary Table 3 to the Report, which may be obtained by the Minister for Treasury and Resources, as and when required, in line with Article 9
1. of the Law, of up to those revised approvals;
to approve the transfers from one States fund to another for 2022 of up to and including the amounts set in Appendix 2 – Summary table 2 to the Report, noting that the transfer from the Consolidated Fund to the Technology Fund is subject to the Assembly's approval of a proposition to create such a Fund in 2022, in line with Article 9(2)(b) of the Law;

to approve each major project that is to be started or continued in 2022 and the total cost of each such project and any amendments to the proposed total cost of a major project under a previously approved Government Plan, in line with Article 9(2)(d), (e) and (f) of the Law and as set out in Appendix 2 - Summary Table 4 to the Report;
to endorse the efficiencies and other re-balancing measures for 2022 contained in the Government Plan as set out in Appendix 2 Summary Table 6 and reflected within each gross head of expenditure in Appendix 2 – Summary Table 5(i):
to approve the proposed amount to be appropriated from the Consolidated Fund for 2022, for each head of expenditure, being gross expenditure less estimated income (if any), in line with Articles 9(2)(g), 10(1) and 10(2) of the Law, and set out in Appendix 2 – Summary Tables 5(i) and (ii) of the Report;
to approve up to £480 million to be appropriated from the Consolidated Fund for the Past Service Pension Liabilities Refinancing head of expenditure, subject to the availability of funding, which may include, in full or in part, use of the borrowing/financing referred in paragraph (b);
to approve the estimated income, being estimated gross income less expenditure, that each States trading operation will pay into its trading fund in 2022 in line with Article 9(2)(h) of the Law and set out in Appendix 2 – Summary Table 7 to the Report;
to approve the proposed amount to be appropriated from each States trading operation's trading fund for 2022 for each head of expenditure in line with Article 9(2)(i) of the Law and set out in Appendix 2 – Summary Table 8 to the Report;
to approve the estimated income and expenditure proposals for the Climate Emergency Fund for 2022 as set out in Appendix 2 – Summary Table 9 to the Report;
to approve an amendment to the policy of the Strategic Reserve Fund to enable that Fund to be used as a holding Fund for any or all monies related to the repayment of debt raised through external financing, with the monies used to offset the repayment of debt, as and when required; and l. to approve, in accordance with Article 9(1) of the Law, the Government Plan 2022-2025, as set out at Appendix 3 to the Report.
to approve, in accordance with Article 9(1) of the Law, the Government Plan 2022-2025, as set out at Appendix 3 to the Report except that, on page 168 under "Health Insurance Fund"the following words be inserted:

The following safeguards and transparency measures will be put in place in relation to the establishment of the Jersey Care Model:

The following safeguards and transparency measures will be put in place in relation to the operation of, and any transfers made out of, the Health Insurance Fund:

• The Minister for Health and Social Services will annually publish a report, which will also be presented in advance to the Health and Social Security Scrutiny Panel, to detail the information provided to the Minister for Social Security relating to the costs incurred on the Jersey Care Model that require a transfer of funds from the HIF;

• An actuarial review of the Health Insurance Fund (HIF) is prioritised in 2022 and will include:

specific analysis of the use of the HIF for the purposes of the Jersey Care Model and its related digital strategies;

Consideration of the impact of all withdrawals on the fund since 2020; and

The future of the HIF, should withdrawals take place as per envisaged by P.130/2020.

REPORT

With the benefit of additional time since lodging the original amendment, the Panel has reflected further on this matter and proposes to amend the amendment to more accurately reflect the naming conventions and structure of the bodies that fall with the envisaged reporting framework. This a largely housekeeping' change and there is no substantive revision to the intent of the amendment. The original wording:

'Regular updates on these workstreams should be regularly reported on to the JCM Programme board; the Independent Oversight Board and the Health and Social Security Panel'.

would be replaced by:

Regular updates on these workstreams should be regularly reported on to the independent JCM Programme board and the Health and Social Security Scrutiny Panel.'

Financial and manpower implications

The Panel does not anticipate that this change will impact on the financial and manpower implications that were detailed as part of the report to the Panel's Amendment (number 15).