Proposed Government Plan 2024-2027 (P.72/2023): twenty-ninth amendment (P.72/2023 Amd.(29)) – amendment. Funding of Acute Cardiac Nursing.

STATES OF JERSEY

PROPOSED GOVERNMENT PLAN 2024- 2027 (P.72/2023): TWENTY-NINTH AMENDMENT

FUNDING OF ACUTE CARDIAC NURSING

Lodged au Greffe on 28th November 2023

by Deputy A. Howell of St. John , St. Lawrence and Trinity

STATES GREFFE

2023  P.72 Amd.(29)

PROPOSED GOVERNMENT PLAN 2024-2027 (P.72/2023): TWENTY- NINTH AMENDMENT

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1  PAGE 2, PARAGRAPH (h) –

After the words "Appendix 2 – Summary Tables 5(i) and (ii) of the Report" insert the words –

", except that, in Summary Table 5(i) –

1. the Head of Expenditure for the Cabinet Office should be reduced by £100,000, such reduction to be made from the Revenue Expenditure Growth Head of Expenditure entitled Vaccine Scheme'; and
2. the Head of Expenditure for Health and Community Services should be increased by £100,000 to allow for additional nursing resources for acute and chronic cardiac conditions".

DEPUTY A HOWELL OF ST. JOHN, ST. LAWRENCE AND TRINITY

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 2024 – 2027 specified in Article 9(1) of the Public Finances (Jersey) Law 2019 ("the Law") and specifically –

1. to  approve  the  estimate  of  total  States  income  to be  paid  into  the Consolidated Fund in 2024 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;
2. to  refer  to  their  Act  dated  30th September  2016  and  to  approve  the application of existing resources for work on the development of user pays' charges  in  relation  to  all  aspects  of  waste,  including  commercial  and domestic liquid and solid waste;
3. to approve the proposed Changes to Approval for financing/borrowing for 2024, as shown in Appendix 2 – Summary Table 2 to the Report, which may be obtained by the Minister for Treasury and Resources, as and when required, in line with Article 9 (2)(c) of the Law, of up to those revised approvals;
4. to approve the extension of the use of the existing Revolving Credit Facility to include the provision of funds that would otherwise be implemented through bank overdraft or bank overdraft facilities under Article 26 (1)(a) of the Law, should they be needed, subject to the limits outlined in that article;

5. to approve the transfers from one States fund to another for 2024 of up to and including the amounts set in Appendix 2 – Summary Table 3 in line with Article 9(2)(b) of the Law;
6. to approve a transfer from the Consolidated Fund to the Stabilisation Fund in 2024 of up to £25 million, subject to a decision of the Minister for Treasury  and  Resources  based  on  the  availability  of  funds  in  the Consolidated Fund as at 31 December 2023 in excess of the estimates provided in this plan, or from budgeted underspends identified before 31 December 2024;
7. to approve each major project that is to be started or continued in 2024 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;
8. to approve the proposed amount to be appropriated from the Consolidated Fund for 2024, 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, except that, in Summary Table 5(i) –
   1. the Head of Expenditure for the Cabinet Office should be reducedby  £100,000,  such  reduction  to  be  made  from  the  Revenue Expenditure  Growth  Head  of  Expenditure  entitled  Vaccine Scheme'; and
   2. the  Head  of  Expenditure  for  Health  and  Community  Servicesshould be increased by £100,000 to allow for additional nursing resources for acute and chronic cardiac conditions;

9. to  approve  the  estimated  income,  being  estimated  gross  income  less expenditure, that each States trading operation will pay into its trading fund in 2024 in line with Article 9(2)(h) of the Law and set out in Appendix 2 – Summary Table 6 to the Report;
10. to approve the proposed amount to be appropriated from each States trading operation's trading fund for 2024 for each head of expenditure in line with Article 9(2)(i) of the Law and set out in Appendix 2 – Summary Table 7 to the Report;
11. to approve the estimated income and expenditure proposals for the Climate Emergency Fund for 2024 as set out in Appendix 2 – Summary Table 8 to the Report; and
12. to approve, in accordance with Article 9(1) of the Law, the Government Plan 2024-2027, as set out at Appendix 3 to the Report.

Page - 3

P.72/2023 Amd.(29)

REPORT

The Government have recently appointed a nurse who is a specialist in preventative cardiology. This appointment is excellent news for the Island and this amendment is not intended to take away from this appointment or detract from the preventative work that is going on.

This  amendment  seeks  to  acknowledge  that,  whilst  we  improve  our  preventative measures, we still need to ensure there is sufficient funding and sufficient staff in roles to support those who are already dealing with cardiac problems.

And it has to be accepted that acute cardiac problems are a major issue on the Island. The data below, taken from the 2022 multi-morbidity report show the prevalence of cardia issues on the island -

Put another way and as clearly explained on the Gov.je website Heart Conditions page –

Heart conditions affect around 1 in 3 people in Jersey and heart attacks remain the most common single cause of death on the Island.

The amendment seeks to allocate funding from the Public Health growth bid for the Vaccine Scheme. The Public Health function has grown at a fast rate over the last few years and there is an ongoing lack of clarity about the funding of the service. In particular the vaccination process, as GPs already have significant infrastructure in place in relation to vaccinations.

In conclusion, this amendment seeks to reallocate funds from a service that has large amounts of duplication embedded and apply those funds to providing funding for one of the most needed frontline services.

Financial and staffing implications

The financial and staffing implications are detailed within the amendment itself and there should be little further implication outside of the business as usual recruitment processes.