States Meeting Transcript - 29th November 2019

STATES OF JERSEY OFFICIAL REPORT

FRIDAY, 29th NOVEMBER 2019

Deputy R. Labey of St. Helier : ................................................................... 4 Deputy J.H. Young of St. Brelade :............................................................... 4 Deputy K.C. Lewis of St. Saviour : ............................................................... 4 Senator L.J. Farnham : ............................................................................ 4 Deputy R. Labey : ................................................................................ 5 Senator I.J. Gorst : ................................................................................ 6

Deputy R. Labey : ................................................................................ 6 Deputy R.J. Ward of St. Helier : .................................................................. 6 Deputy J.A. Martin of St. Helier : ................................................................ 6 Deputy J.H. Perchard of St. Saviour : ............................................................ 7

PUBLIC BUSINESS - resumption .................................................................. 8

1. Government Plan 2020-2023 P.71/2019: Amendment (P.71/2019 Amd.) - resumption 8

1. Connétable D.W. Mezbourian of St. Lawrence : ........................................... 8

1. Connétable J. Le Bailly of St. Mary : ..................................................... 10
2. Deputy I. Gardiner of St. Helier : ......................................................... 11
3. Deputy S.M. Ahier of St. Helier : ......................................................... 11
4. Deputy J.A. Martin: ...................................................................... 12
5. Deputy T. Pointon of St. John :............................................................ 13
6. Deputy J.M. Maçon of St. Saviour: ...................................................... 14
7. Deputy R.J. Ward :........................................................................ 15
8. Senator S.C. Ferguson: ................................................................... 17
9. Deputy G.C. Guida of St. Lawrence : ..................................................... 18
10. Senator I.J. Gorst : ...................................................................... 18
11. Senator J.A.N. Le Fondré: ............................................................. 20
12. Deputy R.E. Huelin of St. Peter : ...................................................... 21
13. Deputy C.S. Alves of St. Helier : ...................................................... 22
14. Connétable S.A. Le Sueur -Rennard of St. Saviour : ................................... 23
15. Deputy M.R. Higgins of St. Helier : ................................................... 24
16. Deputy G.P. Southern : ................................................................ 24

2. Government Plan 2020–2023 (P.71/2019): sixteenth Amendment (P.71/2019 Amd.(16)) .............................................................................................. 26

1.2.1 Senator K.L. Moore (Chairman, Corporate Services Scrutiny Panel): ................... 26

3. Government Plan 2020–2023 (P.71/2019): sixteenth Amendment (P.71/2019 Amd.(16))

– Amendment (P.71/2019 Amd.(16)Amd.) ............................................... 27

1. Senator S.Y. Mézec : ...................................................................... 27
2. Senator I.J. Gorst : ........................................................................ 29
3. Deputy M. Tadier of St. Brelade :......................................................... 31
4. Deputy J.H. Perchard: .................................................................... 32

5. Deputy K.F. Morel of St. Lawrence : ..................................................... 33
6. Connétable C.H. Taylor of St. John : ...................................................... 34
7. Connétable R. Vibert of St. Peter : ........................................................ 34
8. Deputy J.A. Martin: ...................................................................... 35
9. Deputy L.B.E. Ash of St. Clement : ...................................................... 36
10. Connétable R.A. Buchanan of St. Ouen : .............................................. 37
11. Deputy R.J. Ward : ..................................................................... 37
12. Senator K.L. Moore :................................................................... 38
13. Deputy G.P. Southern : ................................................................ 38
14. Senator J.A.N. Le Fondré: ............................................................. 39
15. Senator S.Y. Mézec : ................................................................... 40

LUNCHEON ADJOURNMENT PROPOSED ................................................... 43 LUNCHEON ADJOURNMENT .................................................................. 43

16. Deputy S.M. Ahier : .................................................................... 43
17. Deputy S.M. Wickenden of St. Helier : ................................................ 44
18. Deputy K.F. Morel : .................................................................... 44
19. Senator S.Y. Mézec : ................................................................... 46
20. The Connétable of St. Ouen : .......................................................... 46
21. Deputy J.A. Martin: .................................................................... 47
22. Deputy J.M. Maçon: ................................................................... 48
23. Deputy R.J. Renouf of St. Ouen : ...................................................... 49
24. Deputy J.H. Young: .................................................................... 50
25. Deputy S.G. Luce of St. Martin : ...................................................... 51
26. Deputy S.J. Pinel of St. Clement : ...................................................... 51
27. Deputy G.J. Truscott of St. Brelade : .................................................. 52
28. The Deputy of St. Peter : ............................................................... 52
29. Deputy G.C. Guida: .................................................................... 52
30. Senator J.A.N. Le Fondré: ............................................................. 53
31. Senator K.L. Moore :................................................................... 54

4. Government Plan 2020–2023 (P.71/2019): ninth Amendment (P.71/2019 Amd.(9)) – third Amendment (P.71/2019 Amd.(9)Amd.(3)) ......................................... 56

1.4.1 Deputy C.S. Alves : ....................................................................... 57

5. Government Plan 2020–2023 (P.71/2019): ninth Amendment (P.71/2019 Amd.(9)) – second Amendment (P.71/2019 Amd.(9)Amd.(2)) ....................................... 59

1.5.1 Deputy G.P. Southern of St. Helier : ...................................................... 59

6. Government Plan 2020–2023 (P.71/2019): ninth Amendment (P.71/2019 Amd.(9)) – second Amendment (P.71/2019 Amd.(9)Amd.(2)) – Amendment (P.71/2019 Amd.(9)Amd.(2)Amd.) .................................................................... 60

1. Deputy K.F. Morel : ....................................................................... 60
2. Deputy S.M. Wickenden: ................................................................. 61
3. Deputy J.A. Martin: ...................................................................... 61
4. Senator S.Y. Mézec : ...................................................................... 64
5. Deputy M. Tadier : ........................................................................ 65
6. Deputy K.F. Morel : ....................................................................... 66

7. Government Plan 2020–2023 (P.71/2019): ninth Amendment (P.71/2019 Amd.(9)) – second Amendment (P.71/2019 Amd.(9)Amd.(2)) - resumption ........................ 68

1. Senator S.Y. Mézec : ...................................................................... 68
2. Deputy S.M. Wickenden: ................................................................. 69
3. Deputy K.F. Morel : ....................................................................... 69
4. The Connétable of St. Ouen : .............................................................. 70
5. Deputy M. Tadier : ........................................................................ 71
6. Deputy R.J. Ward :........................................................................ 72
7. Deputy J.H. Young: ...................................................................... 72
8. Deputy G.P. Southern : .................................................................... 72

8. Government Plan 2020-2023 (P.71/2019): ninth Amendment (P.71/2019 Amd.(9)) - Amendment (P.71/2019 Amd.(9)Amd.) .................................................. 75

1. Deputy K.F. Morel : ....................................................................... 75
2. Deputy J.A. Martin: ...................................................................... 76
3. Senator S.Y. Mézec ....................................................................... 77
4. Deputy K.F. Morel : ....................................................................... 78

9. Government Plan 2020–2023 (P.71/2019): ninth Amendment (P.71/2019 Amd.(9)) – third Amendment (P.71/2019 Amd.(9)Amd.(3)) - resumption .......................... 80

1. Deputy M. Tadier : ........................................................................ 80
2. Deputy R.J. Ward :........................................................................ 81
3. Deputy J.A. Martin: ...................................................................... 82
4. Deputy G.C. Guida: ...................................................................... 83
5. Senator S.Y. Mézec : ...................................................................... 83
6. Deputy S.M. Wickenden: ................................................................. 84
7. Deputy L.M.C. Doublet of St. Saviour : .................................................. 85
8. The Connétable of St. John : .............................................................. 86
9. Deputy C.S. Alves : ....................................................................... 87 Deputy K.F. Morel : ............................................................................. 90 Senator S.Y. Mézec : ............................................................................ 90 Deputy G.P. Southern :.......................................................................... 90 Deputy M. Tadier : .............................................................................. 90 Senator L.J. Farnham : .......................................................................... 91 Deputy R.J. Ward : .............................................................................. 91 Deputy R. Labey : ............................................................................... 91 Deputy K.F. Morel : ............................................................................. 91

ADJOURNMENT .................................................................................. 92

The Roll was called and the Deputy Greffier of the States led the Assembly in Prayer. Deputy R. Labey of St. Helier :

Sir, if I might address you on procedure. I hope to do this as simply and quickly as possible so that we can resume the debate on Deputy Southern 's Proposition without too much delay and I apologise in advance if I am messing around with Members. After our meeting last night and having slept on it, I have got this to propose. I think there is broad and general agreement among Members that our next continuation day should be on Monday next week. We have a continuation day on Monday. Also, last night, Members voted 26 in favour to sit until 10.00 p.m. tonight. That was before we decided that we should have a continuation day on Monday and I think it is fair for people to feel if we are meeting on Monday, why have the late sitting before that, although we have an awful lot of business to get through. In this set of circumstances, although 26 is a majority, it does not suffice, because it is unfair to a lot of Members who have got functions tonight and will feel aggrieved and disenfranchised through no fault of their own. So, Senator Farnham , who made that Proposition, is welcome to re-propose it if he wishes to. I do not want to propose that at this stage, so all I am going to do is propose that the continuation day be on Monday. I am going to spend today taking soundings from Members about, if we need more time, where that time should be taken. I would ask simply tonight at 5.30 p.m., before the adjournment is proposed, if I could assess the situation and just put it to Members, depending on where we are in a debate that, like with the case yesterday, we might continue until 6.30 p.m. at the maximum if the end to the debate we are currently having at that time is in sight and we could finish by 6.30 p.m. It will be for Members to decide at 5.30 p.m. when I do that, but for the moment I am proposing that the continuation day be on Monday.

Deputy K.G. Pamplin of St. Saviour :

Sir, could I raise the défaut on Deputy Maçon? The Bailiff :

Firstly, do Members agree the défaut is raised on Deputy Maçon? Yes, very well. Is that proposal seconded? [Seconded] Then the first matter for the States to consider is whether, or not, there will be a continuation day on Monday. That does not mean the States cannot sit late tonight. That will be a separate Proposition if somebody wishes to make it.

Deputy J.H. Young of St. Brelade :

I was concerned last night, in an unofficial discussion, that there were other commitments next week that were unavoidable. I have now got the full details of that and I have to advise the Assembly that on Monday we have a very important summit conference with the Isle of Man and Guernsey, involving 5 Ministers and a very large civil service delegation on the whole issue of climate change, because we are already advancing very fast. Frankly, it would be discourteous in the extreme for me not to be there and I know Senator Gorst , as Chief Minister, is opening that session. [Laughter] As far as I am concerned, sorry, I ask why we cannot do this on Tuesday? I will obviously have to vote against the Proposition of the Chairman of P.P.C. (Privileges and Procedures Committee), but I would go for Tuesday, if we get a chance.

Deputy K.C. Lewis of St. Saviour :

Ditto. I am also attending the convention with the Isle of Man and Guernsey and many officials. It would be very discourteous not to arrive.

The Bailiff :

Does anyone wish to make any observations on the suggestion that the continuation day is Monday? Senator L.J. Farnham :

When I made the Proposition to sit until 10.30 p.m., that was to be basically on the grounds that we would be in with a chance of finishing tonight, without having to come back next week. I still think that is a possibility, albeit a remote one and I think we need to revisit that later. For me, I am not involved with this summit on Monday, but I do have, as Ministers do after a week in the States and Members, a very busy diary. I personally would prefer a Tuesday. That is all I wanted to say.

Deputy R. Labey :

My  understanding,  from  discussions  last  night,  was  that  the  climate  conference  was  mainly officer-led and that Ministers - I know it is inconvenient - could nip in and out of it. When we are at the States with continuation days being decided at such a late stage, the fairest thing to do would be for the States to continue with this debate at the next scheduled sitting on 10th December, but I do not think Ministers would prefer that. There is not one single continuation day between now and 10th December, on which every single Member of this Assembly will be able to attend, so it is a compromise and I think Monday is the best one for now. Possibly we could work late Monday, but, for the moment, I would like to consult with Members on that. I maintain the Proposition that we have a continuation day on Monday.

The Bailiff :

Those in favour of continuing .. the appel is called for. Senator S.W. Pallett:

Can I raise the défaut on Senator Moore , please?

The Bailiff :

Do Members agree to raise the défaut on Senator Moore ? Yes, the défaut is raised. The appel is called for. I ask the Greffier to open the voting. Deputy of Trinity , you obviously cannot vote because you are at the moment en défaut.

Senator I.J. Gorst :

I am very grateful to the Chair of P.P.C. for suggesting that we could decide whether to remain until 10.00 p.m. at 5.30 p.m., dependent on the debate. Could I implore him, rather, to come back after lunch and make that decision then, so that Members know where they are, rather than at 5.30 p.m.? [Approbation]

The Bailiff

I think that having discussed matters with the Greffe and with others it would be helpful to know as early as possible whether the States wish to sit late this evening, because, obviously, not only Members, but others need to make arrangements as well. It would be helpful, I think, if that were possible, without in any sense forcing the hand of the Assembly, of course.

Deputy R. Labey :

Yes, of course. I am not proposing, nor will I propose at any time today, that the Assembly sit until 10.00 p.m., because I have heard from too many Members who have too many functions that they cannot break. I think the Reform Party has a function tonight, an event tonight and a lot of other Members have commitments. I just think it was too late to go to 10.00 p.m. to make that decision and I think it disenfranchises too many Members. The only thing I would propose is that we would stay tonight to a maximum of one hour, until 6.30 p.m. if in the circumstances at the time it seems likely we will finish the debate we have started, because I think it is important to do that. So, that is all I would ask Members to do. If the Assembly wants to propose something different that is fine, but that is all I would ask Members to do at the time is possibly stay to a maximum of 6.30 p.m. to get through one item.

Deputy R.J. Ward of St. Helier :

I think it is important to say, I agree we have to think about the well-being of the Greffe and the staff who need to be here too. [Approbation] We cannot just dismiss that and I think it is very important we take that into our consideration.

Deputy J.A. Martin of St. Helier :

Did the Chair of P.P.C. make a formal request? I think it is sensible. I think he is knocking at an open door that it can be 5.30 p.m. if we can finish at 6.30 p.m., but staff need to know that now, the arrangements.

The Bailiff :

I think the slight difficulty is it is predicated upon whether there is any chance of finishing the debate, so we cannot know that, I would have thought, at this point.

[9:45]

Deputy R. Labey :

I am very happy to make the proposal that we sit until 6.30 p.m. this evening, bearing in mind that we may not need to, because it would be pointless starting another debate at 6.10 p.m. But if, for certainty, Members want to make the decision now that we could go to 6.30 p.m. if circumstances dictate it would be sensible to do so, I will make that Proposition.

The Bailiff :

If the States adopt that Proposition, there is nothing for a Member to move the adjournment at any time after 5.30 p.m. if it is clear that the debate will not finish, it seems to me. So, you propose that. Is that seconded? [Seconded] Does anyone wish to speak on that particular Proposition? Those in favour kindly show. Those against? Yes, quite clearly that is adopted. So, the position then is there is a continuation day on Monday and that the States will sit today until 6.30 p.m., unless Members agree to adjourn at some earlier point after 5.30 p.m. if it is clear that the particular debate in train at that time will not conclude. Does anyone else have any other points to make in connection with timing?

Deputy J.H. Perchard of St. Saviour :

I do not know if Standing Orders allow for this, but would there be provision for us to shorten our lunchbreak today from 1.00 p.m. to 2.00 p.m.?

The Bailiff :

Standing Orders provide that at 12.45 p.m. I am required, absent any other decision by the States, to ask the States whether they wish to continue, or to stop at that point. It seems to me that if there is a reason to truncate the lunch hour, that is perfectly acceptable and indeed if Members want to make that decision now, equally that is something that could be resolved on a Proposition so people know where they stand. In other words, yes, it is possible for the Assembly to resolve to do that.

Deputy J.H. Perchard:

May I propose that now, Sir, or is that something that would come later? The Bailiff :

All I am saying is that I would have to ask, in any event, at 12.45 p.m. if Members wanted to continue, but you could propose now, if you wanted to, that we do.

Deputy J.H. Perchard:

May I propose that we shorten our lunchbreak from 1.00 p.m. to 2.00 p.m. today? The Bailiff :

Between 1.00 p.m. and 2.00 p.m. Is that seconded? [Seconded] Does any Member wish to make any observations on that? Those in favour of that Proposition kindly show. The appel is called for. I invite Members to return to their seats. I ask the Greffier to open the voting.

The Bailiff :

Very well, the Assembly will sit between 1.00 p.m. and 2.00 p.m. [Laughter] Sorry, it has been a long week for the Presiding Officer, as well as everybody else. The Assembly will have lunch between 1.00 p.m. and 2.00 p.m. and will sit either side of that.

PUBLIC BUSINESS - resumption

1. Government Plan 2020-2023 (P.71/2019): Amendment (P.71/2019 Amd.) - resumption The Bailiff :

We now resume the consideration of Deputy Southern 's first Amendment of the Government Plan. Does  any  other  Member  wish  to  speak?   I  had  listed  to  speak  last  night  the   Connétable  of St. Lawrence .

1. Connétable D.W. Mezbourian of St. Lawrence :

I think I have been losing my train of thought listening to what has just been going on, so I have to gather my thoughts. I have an elderly parishioner, who, when I met him recently - he is in his 90s - told me that he does not sleep very well. He is a former farmer and he is used to getting up early and he is up at about 4.00 a.m. When I asked him what he does at 4.00 a.m. - because I cannot for the life of me imagine ever getting up at that time - he told that he reads the J.E.P. (Jersey Evening Post) at 4.00 a.m. [Members: Oh!] so they will be glad to know that somebody reads it. [Laughter] But then he added: "And I always look for your name and I look to see whether you are supporting that Southern ." That is a quote. So, clearly - and I know his political views - this elderly gentleman does not support what Deputy Southern brings to this Chamber. Over the years, I have been known to support many of Deputy Southern 's Propositions and Amendments to various budgets and M.T.F.P. (Medium Term Financial Plan), because I have to make my decisions based not upon the person who is bringing forward the Amendment, or the Proposition, but on the content of what is being proposed. It is quite clear to me that I must support what is in front of us today and there are a number of reasons for that, not least of which this is proposing to help many of the more vulnerable in our society. Contrary to what Deputy Southern has suggested in his Report to his Amendment, he is not, in the wording of his Amendment, specifically targeting any particular group within our society. The wording is quite clear. He is suggesting in the summary table: "Benefits and other expenditure should be increased by the sum of £0.9 million and the estimated closing balance decreased to meet the cost of providing G.P. (general practitioner) consultations at a reduced charge for certain groups." Maybe he has done himself a disservice by then trying to help the Minister and his civil servants by identifying some of those vulnerable groups who could be helped, if we supported his Amendment. When I look at the comments from the Council of Ministers, it is clear that they have recognised, in his wording, that he is referring only to certain groups, but then they go on in their first sentence to say these being people aged over 65, children aged under 5 years, taking the words that Deputy Southern has used in his report. When they then go on to say: "Supporting reduced fees for pensioners, irrespective of their income, does not represent good use of public money and would require a sustainable funding stream, as the population ages", I agree with that comment – as, no doubt, we all would agree, because, using our heads, that is correct - but Deputy Southern has not, in the wording to the Amendment suggested that we support all pensioners over the age of 65, although he mentions it in his comments. So, this is a head and a heart situation for me because, thinking back to the early 1960s when I was growing up - my memory is not as good as it used to be - what I do remember is growing up in a working-class family, with very little money, we were only taken to the doctor essentially if we had a limb hanging off. I say that, but believe me it is absolutely true. Unless there was something clearly visibly wrong with us, we did not go to the doctor, because we could not afford to go to the doctor. I know, when I fell off my skateboard in the then Le Squez School playground and my ankle swelled up like a balloon, it was only then, 2 days later, that I was taken to the doctor, or then to A. and E. (Accident and Emergency), because we would not even go to A. and E. So, I digress. Then, Deputy Southern not only kindly tries to assist the Minister and his Department, in reminding them and us of the vulnerable groups in our society, but he also reminds those of us, some of whom are long in the tooth and have been here for many years, that we have had all these promises made to us in the past and he cites us the report from 2011, Caring for each other, Caring for ourselves. Are we caring for each other? We have not delivered on that. Then he reminds us that, a year later, Health and Social Services brought forward A New Way Forward. I am not sure what they have done in between, but now we are presented with the Jersey Care Model. We are being promised everything in the Jersey Care Model. How much confidence can we have that that will be delivered, based on the track record of non-delivery and promises and assertions that things will be done to improve healthcare for the vulnerable in our society? I have been rapidly losing confidence. The Comité des Connétable s regularly has presentations from groups that wish to advise us of what is happening and what impacts on our parishioners. I have lost track of the number of times that they have been to us to say: "We want to work with the Parishes, we want to take healthcare out into the community." That is what is being proposed in the new healthcare model, but it is not new. They have been telling us this for years and we are still waiting. I went to Health some years ago and said: "I have a building here, which I think would be suitable for use by your Department. You can utilise it as you see fit, but let us sit down and see how, as a Parish, I can work with you to deliver services to my parishioners and those from St. John , St. Mary and other Parishes and let us begin to make this happen." They went away to think about it and I am still waiting for their response and this was years ago. I do not know who I have lost the most faith in. I do not want to apportion blame on to civil servants, who were there to deliver the policy of the Minister and I am certainly not doing that, but - and I wondered whether to say this - I have lost faith in some people and I have a prime example. A couple of weeks ago, the Comité had another visit from Health, a senior delegation from Health, to speak to us about the Jersey Care model. We were chatting about the hospital and all the wonderful things that are going to be delivered and I asked those present to remind the Comité who sits on the political oversight group for the hospital. Who sits on it? The clue is in the word political'. I was expecting to have every politician who sits on that group named but the name that I was given was not a politician. It was the name of a senior civil servant.

[10:00]

I have mentioned this to the Minister, because I was clearly disappointed, frustrated, annoyed, aggravated, cross that the politicians, who are there, were not even considered. This person could not name the politicians who sat on the political oversight group, political steering group, whatever it is called. In fact, 2 of the Constables who sit on that group said: "I sit on it" and the other one said: "I sit on it" and I said: "No, you do not say. I do not want you. I am not asking you to say who sits on that group. I am asking this officer from the Health Department." To me, that is a real disappointment, but it is a prime example of why I have no faith, or very little faith, in this new Jersey Care model being delivered, as we have been told and the track record does not support their assertions that they will deliver and it is very sad to me. I hope I am not straying away from the Amendment, but I feel I need to make these points. I will go back to the comments of the Council of Ministers, who support the overall aim of the Amendment to reduce the cost of primary care to well-targeted groups. Why do they not just accept it and deliver that reduced cost to those well-targeted groups, because they can choose who those well-targeted groups are? If we support this Amendment today, we are sending out the story, or the message, from the elected politicians of this Island that we want the vulnerable to not have to worry about going to the doctor, because they cannot afford to pay for it. I do not want to think that there are other families out there .. I know there are, but I am doing my best, with Deputy Southern , to reduce the number of families who worry about taking their kids to the G.P., because it could be a choice between paying for the doctor or, as in the case of my family years ago, putting food on the table. It was as bad as that for us and it is as bad as that now for members of our society. So, the Council of Ministers collectively supports the aim of the Amendment that Deputy Southern has brought, although they say it is poorly targeted and they can deal with that. The Jersey Care model has made significant progress and will be validated and developed further by external planners. We need to send a message from this Assembly that .. and I mentioned this in a speech, earlier in the week, the Council of Ministers has had very few Amendments carried against it, if any, this week. I cannot remember how many have been won by those valiant scrutineers, who have spent months working on this Government Plan and have come up with evidence-based proof that some things need to change, yet we are quite happy to ignore much of the evidence that has come forward. So, why do we not think very carefully on this and take the opportunity to send that message to the Council of Ministers and to the public of this Island that we are not an Assembly who completely disregards the vulnerable? Maybe we have not supported reduction in alcohol and fuel prices. They are clearly different to supporting this Amendment, which is there to make sure that no one, who lives in Jersey, is worried about going to their doctor because they cannot afford the bill. I normally do not speak as long as this, but it is something that means a lot to me and I really am keen to urge all Members to give due consideration to this, because the Council of Ministers supports the overall aim. Let us vote for this Amendment, which they support and then it is in the hands of the Minister and his Department to decide how to apportion those funds, who the most vulnerable are, maybe not all pensioners. I am a pensioner and while I am working I would not need to have any assistance, but let us send the signal to the Council of Ministers and to the public of this Island that we do care. We care and this is our opportunity to show it. So, I have to say to my elderly parishioner that I support Deputy Southern when he brings something to this Chamber, to this Assembly, that is clearly of benefit and I have no hesitation in supporting this Amendment.

The Bailiff :

To assist Members with timekeeping, that was 11 minutes.

1. Connétable J. Le Bailly of St. Mary :

I am disappointed that Deputy Southern has brought this Amendment, because he should not need to do so. Access to a doctor, if someone is ill, is vital. The patient should not have to consider whether, or not, they can afford to go. If they have to do that then, clearly, this Government have failed. The Members in this Assembly have failed, because they were only elected to this Chamber by promising the electorate that they would support them. The first point of access, if you are ill, is a doctor, which, for many people, is an expensive process that may only require a prescription. Many people avoid this, because they simply cannot afford to go. However, if you are seriously ill, the ongoing process is free, because you are then referred to hospital. A simple process would be to have a means test. We do not have that. The Minister for Health and Social Services says that plans are in progress to assist this and other possibilities, which may be 6 months away, or may be 2 years away. Can we wait that long? No, we cannot. This needs to happen now. Some people have paid into the system all of their lives, only to find that they cannot get the basic care when they need it. The Deputy 's approach to this may not be the right one, but at least he has identified a problem and is attempting to deal with it. It allows a solution, in waiting for a better alternative to be put into practice by the Minister for Health and Social Services. This Amendment is like a stitch in time. The sooner the problem is diagnosed, the more cost effective it is to fix. I shall be supporting the Deputy 's Amendment, as it may save a life.

2. Deputy I. Gardiner of St. Helier :

Yesterday, when Deputy Pamplin went through the G.P. costs, which was very important, it was mentioned there are some no cost, or really low cost for the children, but there was not any reduction for our elders there. On the one hand, we are encouraging our elderly people to go to regular check-ups and on the other hand we are making this unaffordable for them. When we had this in question time, I asked the Minister for Health and Social Services about my parishioner, who was moved from the hospital check-ups to the G.P. check-ups and his annual bill went up by £200-plus and I am talking about a parishioner who lives in social housing accommodation. I was told it will be sorted out: "We will move the budget from the hospital to the G.P. It will be paid." I hope it will be paid, but the question is when it will be paid and my parishioner has to continue to pay this £50-plus every 3 months for a regular check-up to get his prescription. I went online today and I said: "What is the conditions that require doctor's visits?" Arthritis, kidney-bladder problems, dementia, Parkinson's glaucoma, Lyme disease, osteoporosis, enlarged prostate, Alzheimer's disease, depression, cardiovascular diseases. Basically, I think all of us would agree that an elderly population will have at least one of these conditions, that will require regular monitoring, so basically all of our elderly population need to go every 3 months for regular check-ups at the G.P. and pay £200-plus a year. I do not want to see my elderly constituents postponing going to the doctor's, because it would be dangerous. I do take into account Deputy Wickenden's comment that we are negotiating with G.P.s and a decision of the States on the way of negotiation and, from a business perspective, I realise that some decisions can get underway with G.P. negotiation. At the same time, Deputy Southern does not tell what needs to be done with G.P.s. He is saying: "Please make it affordable, whichever way it will go." Maybe we need, as a Government, to create a G.P. surgery in town that will be visited twice a week by elderly from all over the Island. I do not know what the decision is, but what I do know from business is if I would hear from the Government: "This will be done by June 2020, you know what, by January 2021 it will happen", I probably would support that, but with all this uncertainty around, I would like to have certainty that by October 2020, in one year's time, Government will decide and hopefully the care model will .. it is not against the care model. Everybody agreed that the care model is going in that direction. It is just that certainty that Government and the officers for one year would work that something would happen and it would not be an excuse that we did not put in the budget this year that it will happen in 2021. Basically, what Deputy Southern is asking is: "Let us put 900 this year of this money to help this" and maybe just to have a pilot. Maybe I am wrong, maybe I am right, but I feel responsible to have some certainty for our senior citizens to have affordable visits to a G.P. and not put their lives in danger.

3. Deputy S.M. Ahier of St. Helier :

This Amendment is not ideal and it would not achieve my ambition of a medical drop-in centre, based at the hospital with a nominal charge to relieve the pressure on the A. and E. But it is an interim measure that can alleviate the hardship of some of the most vulnerable members of our society, who find it an impossibility to afford basic healthcare, such as the parent whose child is taken ill, the senior citizen who is struggling on a state pension, or people with long-term health problems, who cannot afford any additional expenditure.

We, as a wealthy Island, should make it a priority to ensure that people, who need medical treatment and cannot afford, it should always be able to access it. It is a basic human right and, therefore, I will be supporting this Amendment.

4. Deputy J.A. Martin:

The last 2 or 3 speeches have, on the hoof, designed the new care model and also said: "But there is nothing better on the table, so support this in the interim" and Deputy Southern says even "temporary". I do not want to play on semantics, because Deputy Southern has only put a few words in the heart of his Proposition and then spent 25 minutes yesterday describing exactly who he wants to help - over 65. If you look on Reform's page, Senator Mézec , what Deputy Southern 's Amendment does is help over-65s pay £10, pregnant women, the under-5s and people on income support and it will cost £0.9 million next year. It is only next year, because we are going to have to take officers away from my Department, officers away from the new healthcare model and try and cobble something together that looks like this, but Deputy Southern does not really mind. On page 47 of the Government Plan there is money. There is a statement that says we will help the vulnerable with healthcare costs. Now, all my team, the Health team, the new D.G. (Director General), there were G.P.s around the table, we went to discuss this at least twice and we were like, as Deputy Southern said before: "If it is not right, why did you not amend it?" Because they were saying we are so close, we are shining the torch. This talks about G.P.s. It does not go anywhere near the model we need. An elderly person needs to go and have their bloods done at least 2 or 3 times a year. They do not need to see a doctor and if there is something wrong they get a call back, absolutely. In the U.K. (United Kingdom) it does not cost you £10; it is free, but you do not see a doctor. So, we are designing something here and everyone says: "I think we should support this and it is temporary, nothing else on the table." I absolutely refute that. Why I am speaking is because Deputy Southern .. it lost by 2 votes and I admit I was one of them, on P.82 there was a part (c), we need a sustainable funding mechanism for health, which we have never got. So, now what we are doing .. and I have said to Health, my officers, policy officers have said: "If you need a pump prime, there is a bit of money in the H.I.F. (Health Insurance Fund) at the moment. If this can get going, it can get it going next year, it can get people out in the community, it can help where we want, absolutely you can have the money." But I cannot spend it twice and I want to hear from these economists, who are coming in, I want them to be shining the light on to all our services and saying: "This should be done, this should be done." Now, is he targeting .. I do not really want to get into the target, but the G.P.s out there have got businesses now. They do do it for under-5s and is it over-65s we should just be making free, because, as I say, we have only got one bit of money. I have got one bit of money and if everything stays the same we are now £40 patient, probably £20-something social security, £10 patient, £50 social security per payment. Will it all stay the same? I know what we want, we want more people to go and get tested, but not to an expensive G.P. We are doing the model. Deputy Southern , in his opening remarks, said: "I want to stop 30,000 people attending A. and E. unnecessarily, because they cannot afford it." Think of our model and this is set out in the table. What have we got after 5.30 p.m. and at weekends? What have we got? We have not got a 111; we have not got anyone to ring. We have got a walk-in up to about 8.00 p.m. and other than that all you have got at weekends is A. and E. It does not matter whether you can afford it, you have got A. and E. This model, that I am hearing the views of what it is going to do, sounds fantastic. We have got to just hold our nerve. We have just got to get over this, where it is going to go and who is it going to help and not just say today: "It is only going to be temporary. It is going to be £3.5 million," but it is not, because it is only going to grow. It has no sustainable funding mechanism behind it, only the H.I.F. and the H.I.F. can only take it for a few years. We are not putting any more money in the H.I.F.; the H.I.F. is what it is. It pays the co-payment at the moment. They want to turn that on its head and make it, instead of £20, £50 for everyone who goes and must see a G.P. Now, as I say, Deputy Southern knows what the G.P.s said, because I gave Deputy Southern this job when he was

my Assistant Minister and I said: "Sort this out. We are all pushing an open door. We want to make it much more accessible" and there he was talking with the G.P.s, but when Deputy Southern took this model on the radio, with one of the G.P.s, even that G.P. who represents a lot said: "No, not this, please. It is not right." You cannot absolutely .. I listened to the radio and I relistened and I am not going to mention the doctor's name, but Deputy Southern was on live with the doctor and he has been round the table as well and he knows the G.P.s have been, not for the fact that they have run as private, various things that cost them money. The young G.P.s want to do much more. They want to specialise. They want to specialise in mental health, they want to do different things and they want to do it differently. They want to bring in practice nurses. Today, if you want to kill the new care model, you want to spend the H.I.F., you can only spend it once, support Deputy Southern . I am telling you now, the money is not sustainable. The model is in the wording, but please look at really what they want to do. The actual last sentence of Senator Mézec 's Reform says: "And we are coming back to make it more accessible for the rest of the population next." No money. No money. Now, let the healthcare model get to grips. This is the bashing you should have given us next year. If we have not done anything, bash us and I absolutely would accept it. Not now, not when we are so close. We are nearly over the line and we have a fantastic model, new staff and I am sorry that the Constable of St. Lawrence is so depressed with our civil servants. We have got a new team at Health and I am absolutely impressed and also they are working so closely with Social Security. You design the model, I will give you the money and let us get on with it. Do not support this today. Do not let your heart rule your head.

5. Deputy T. Pointon of St. John :

I have just listened to my colleague's rant about funding. The Bailiff :

I think that is ..

Deputy J.A. Martin:

That is OK, Sir. I can take it.

The Bailiff :

The fact that a great number of people can take things does not mean that they should necessarily form part of the ordinary descriptions used for another person's speech in the Assembly, but if you would like to carry on.

The Deputy of St. John :

I will withdraw that remark. My colleague talked about the 2 efforts, the effort to fund fees and the effort to provide a viable community and hospital service, that are going on in Health as if they were both mutually exclusive. Quite frankly, the care model that is in train at present - I am very close to this, because I am in the Scrutiny Panel looking very closely at the model - is going to change the relationship we have with general practitioners. It is going to change the way that we fund general practitioners, at least that is the aspiration. It will involve Social Security spending rather more money on provision of G.P. services, whether it be to groups of people with particular maladies, or whether it be individuals who cannot afford it. We have a situation here, in which a number of people are advocating a rejection of an Amendment that will lay the ground for that care model to be set. It will be an integral part of the care model. This is not money that is going to be spent separately. This is money that will be spent anyway. It will, as part of the care model, be needed to fund G.P.s. I have a problem with rejecting this Amendment, because the public, that rely upon us to take decisions on their behalf have seen us time and again pussyfoot around provision for healthcare. We have P.82/2012. It has taken an awful long time to get to implementing those recommendations and now there is active work going on to introduce the recommendations that were made at that time. There is a new side on the game. What I am concerned about is that the public have just been distributed a

leaflet to every household on this Island, telling them that there is a new care model on the way. They now see us debating provision for people who are in need, not specific people, but the Amendment is quite loose about why the money should be released. It would be going on to the Minister and it would be going on to the people working on the care model to decide how that money should be used. If we were to adopt this Amendment today, we will be sending a message to those people out there, who are disappointed that there has been so much inaction over the years. Adopting this Amendment would send the message that, yes, we do care and, yes, we do mean to implement the new care model. I think it would be a tragedy to reject this Amendment for many people who are watching this today and listening.

6. Deputy J.M. Maçon of St. Saviour :

I speak with both my hats of Assistant Minister for Health and Social Services and Social Security, to this debate and I would like to respond directly to the Constable of St. Lawrence and other Members who have said: "Let us see the evidence, what is the evidence?" and, thankfully, in Deputy Southern 's Amendment - if Members want to turn to page 7 of his Amendment specifically - what it does is it shows the actuarial review of the Health Insurance Fund, the actual money that we have got to play with, or not, as the case may be. May I remind Members that, under that review, the Health Insurance Fund starts dipping in 2025. That is 5 years away and that is on what we already pay out for, not any improved services, what we are doing today. It is out and exhausted by 2035; that is 15 years away. So, for Members to say that the Health Insurance Fund is a pot we can just raid is not correct. It is not sustainable today and I get very annoyed when Members say I do not care about people. I do, but do you know who I also care about? The taxpayers of the future. My generation and those who will come after me will then have to pay extra on their social security funds, which we know we are going to have to do anyway, in order to get this fund going. The question is how should it be paid for when we get there. For example, in this, when Deputy Southern knows that the Health Insurance Fund is going to run out, why was there not an Amendment to include H.I.F. contributions? It is easy to spend money, not so easy to bring it in. All those Members who said: "Yes, we want to do this", which of them has brought an Amendment to bring money into the H.I.F. when they would have read Deputy Southern 's report and would have known that it runs out in 15 years? This is why we are moving on to the new care model, because we know that the current arrangements through G.P.s are not sustainable, so we need to do something. I have got a direct question for Deputy Southern . I would like to know in this Amendment - a direct question - how many pharmacists he spoke to, whether he spoke to Family Nursing and Home Care, all those people who contribute to the new health model.

[10:30]

Why is that important? Because, in the new model that we are looking to do and when Deputy Gardiner spoke, when we talk about people who we might give this money to, exactly the first people I thought were people with chronic conditions who have to take those many visits to the G.P. But these services do not necessarily have to be done by a G.P., they could be done by a pharmacist. If you have got a skin condition, that can be done by a pharmacist, but we do not do it today, because the funding mechanism does not allow it, so that has all been wrapped up in the new care model. So that means you can still have someone getting their treatment, but not paying £40 to a G.P., maybe £10 to a pharmacist and still receiving the same amount of care and that is what the Council of Ministers are looking to do, but this Amendment concentrates and focuses again on the old model of putting everything into G.P.'s hands and we need to move away from it. Practice nurses, again, when Deputy Gardiner spoke, things like taking your blood, things like doing your blood pressure - which mine seems to be accelerating a little bit today - all that type of stuff can be done by a practice nurse, so instead of paying £40 to the G.P., you could pay £20 to a practice nurse, for example. That is how you can still achieve the same quality of care, but without having to fork out as much on behalf of the taxpayer, those putting money into the scheme. May I remind Members, when they want to

compare us to the U.K., they also pay a large amount more by way of national security, compared to our Social Security Fund. So, do not think that there is a pot of money here which we can just throw around and this proposal is sustainable. It is not. We have the further problem of what we would like to do under the new funding model, is we know we need more nurses, we know we need more community nurses. Therefore, we cannot double-run the Social Security Fund, getting those practice nurses up, getting those community nurses up if we are spending it in different ways. So, if we can deliver care to the community for longer term, then surely that is what we should be focusing on. May I also remind Members, the model to the actuarial report also factors in that we have an additional 700 people on this Island every year paying into that fund. Who knows where these people are going to live because, yet again - yet again - this Assembly is passing the buck on to future generations. Have not tackled housing, have not tackled immigration and now we have had the Ponzi schemes, which means that our institutions going forward do not have the funding. So, do not tell me that I do not care about people in my community, I absolutely do. There are different ways to deliver care in the community, it does not have to be through a G.P., but what I would implore Members to do - and we will have these debates looking at the Long-Term Care Fund and the Social Security Fund going further - do not put it on to future generations when there are other models which are cheaper, which are available which can be done, or at least do not put it up as much as it needs to be. Why put it up to 3 per cent, when we can embrace the new model and it only needs to go up to 2 per cent? We know that my generation and generation rents are looking at a lower standard of living than the current working generation and pension generation. We know, when Deputy Ward stands up, he is also looking at the ecological issues that those future generations are also dealing with. How can we be saying, on one hand, we must be looking forward and protecting future generations if we know, by passing these type of systems, which we know are not sustainable, which rob the money from the pot, which someone else is going to have to pay for, namely my generation, so it would make more sense if there were extra contributions to the H.I.F. Now, what I also want to talk about is there has been this criticism of the Minister for Health and Social Services responding to the report of Deputy Southern . So, Deputy Southern outlined these potential groups and the Minister's response to the problems with those potential groups. Well, what exactly is the Minister supposed to respond to, if not what is in the report of the proposer? Because, of course, the rationale for the proposed Proposition will come in the report alongside it, so it is absolutely nonsense. Can I also say what Members are forgetting: G.P. practices are private business, they are not part of the health model where we can control their prices. So, 2 things to say here: first of all, why are we looking to correct a problem, which the market is already dealing with, such as reduced G.P. visits for children already happening in the market? We have talked about that time and time again. So, why are we looking to correct that problem, when the market is already dealing with it when we know we have got other people we need to look at and I have already mentioned people with chronic illnesses. I must labour this point, as Deputy Wickenden mentioned yesterday, because we do not have any type of contractual agreement with the G.P.s there is absolutely nothing to stop them changing their fees if we agree this. Nothing. Absolutely nothing. So I know that previous Ministers for Social Security, for example, thinking: "Right, let us help the population by increasing the contributions to the H.I.F., in order to bring down G.P.'s payments." What happened? G.P.s put up their fees in line with the subsidy that went from the taxpayer. So, unless we have those contracts in place in order to properly regulate, have a service level agreement with the G.P.s going forward, which is what we are trying to achieve in the new care model, then there is absolutely nothing that will say: I am a States Member, I can vote for this, knowing that my elderly parishioner is going to get a £10 fee. Absolutely no guarantee of that happening whatsoever and from a depleting fund. This Amendment is not sustainable, it does not work technically and it robs from future generations. I will not be supporting this Amendment.

7. Deputy R.J. Ward :

Well, there we are. First of all, I would like to start off by thanking the Connétable of St. Lawrence , who brought the level of debate up a level in terms of talking, not about personalities, or perception of what she thought a group would do, because of being open with their policy, but looking about what this was about. It is very interesting to me that across this Assembly, from whatever political spectrum people come from, there is an agreement that the issue we have with G.P. fees and access to the G.P. right now and since, Lord knows when, if I may say that .. am I allowed to say that?

The Bailiff :

Goodness knows when. Deputy R.J. Ward :

Goodness knows when, thank you, Sir; goodness knows when, it has been there and we have not addressed the issue. There are so many things that need to be made clear here and there needs to be some clarity. If I can add a little more clarity from what was said by the Connétable . We are convoluting 2 completely separate issues here. The new healthcare model, we are being told, will be in place soon, it will be in place next year and we will have a go at it and it will all be great and I think it is very promising. I sit in the Scrutiny Panel that talks to the Political Oversight Group and I have been very impressed by the ideas and the notions that are coming forward. Great. But the point of the matter is, this Amendment gives the opportunity to make a change to people's lives now and, as that model develops, it will feed into that model. Now we are saying that the H.I.F. will be gone in 15 years' time. What is that doing? Is that pre-loading us to be ready for the fact that the healthcare model will not be available in 15 years' time? Are we going to need to rely on it? The money will be rolling down, because all the talk that we are talking about today from the Council of Ministers means: we will put you off now and we will put it off and by the time we come back to it there will be another election, so it will be different people anyway. We cannot continue to do that. There are people out there who are struggling to go to the doctor's. Do you know, I think about this and I was not going to say, but my dad is not around anymore but I can imagine .. he was very tight with his money. My wife says I inherited that; I think it is unfair, but the concept of paying £47 for the doctor would have just been horrendous for him. I know what would have happened, I would have said: "Oh, it is OK, Dad, it is free" and I would have paid it and I would have had to lie to him to get him to go to the doctor. That is the sort of ridiculous situation we have here, that is the reality of people's lives. That is the reality of day-to-day lives now in people's homes. Not the paperwork that says: we are going to get something done in this time and, have you spoken to this and have you spoken to that? Yes, the future healthcare model that came through to all of our doors looks great, but the other thing that we need to do is we need to convince people that this will work. At the moment, people are not convinced that the healthcare model will work, because they have seen P.82. I had to ask my colleague: "When was P.82?" because I thought it was a couple of years ago. It was 2012 - 2012 - and it has just not been implemented and we are at the same argument again; it is like Groundhog Day. We still have not made the great leap forward. We just have not and this is an opportunity to make a small step and take control and for this Assembly to make a really clear message to the people in Jersey and say: "We are going to make a change now that impacts." What Deputy Southern has done is incredibly pragmatic and said to the Minister for Health and Social Services: "Look, let us do this, let us get the Assembly to vote for it. You can target the areas; here are some suggestions in the areas that we all know need to be targeted." Let us talk about those areas: children, pregnant women, the elderly who cannot afford it, well it is a no-brainer. We know these groups are suffering and we need to do something about it now and the nonsensical argument, I am afraid I have to say, of this notion of the fund will be gone by 2035; yes, if we continue with the current failed model and do not do anything about it, of course. But we have a model that we are developing and this is an opportunity to build some faith, dare I say, in what we are doing as an Assembly and the future possibility of that healthcare model. What we have, we seem to have 2 parallel conversations going on. We have an increasing number of this Assembly, who are starting

to realise that, yes, we do need to do something and this is a real opportunity, both for young people, older people, those who just need access and care. But then we have this parallel, which is completely separate, of it will destroy the healthcare model that we want. No, it will not. It is like - what is the phrase, a great line? - it is like talking to the taxman about poetry. They are 2 completely different mindsets that we are in and we need to do something about that, so let us focus back on what we are talking about today. The Council of Ministers support this, in principle. I mean this in the nicest possible way, the Council of Ministers support a lot in principle and it is lovely to see. It is very reassuring. But what this is, is not principle, it is practical. It is saying to people in our society, we recognise from this Assembly, in these seats, elected people they came out and voted for, are saying to these people: "We recognise you are struggling and we recognise the new healthcare is good. We want to convince you of that. Honestly, we are going to do something about it and we are going to do something about the hospital." We were quite a long way in and nobody said the word "hospital" yet. Anyway, we are going to do something about it, but at the moment we are going to say to you: "We are going to intervene in our society and we are going to do something about the access for people who really need to get to the doctor to begin with." All of the other issues around pharmacy and primary healthcare in lots of different ways, of course, they need to be developed. They will do, in due course and I accept that. This does not form an obstacle to that. I would say this: if the cost of £3-and-a-bit million over the duration of this process is going to stop the entire new healthcare model, then I am afraid the entire new healthcare model is doomed for failure from day one, anyway, because it relies on a lot more money, a lot more investment and a lot more intensity in what we are doing than that. So, the arguments are flawed and it is the same argument again and again. It is not jam tomorrow, it is hope tomorrow. Well, I do not want hope tomorrow, I want to do something now and I can see that a growing number of Members of this Assembly are also saying: yes, let us do something now and let us build a hope for tomorrow, as well and let us move away from that closed approach that we have had for too long; so the scaremongering, it is nonsense. I was very concerned from the Minister for Social Security and the Assistant Minister for Social Security when they talked about their officers. It seems to me that their officers and what they are doing were more important than the people of Jersey, who cannot get access to the doctors: "But we would have to use our officers for something else." Yes, but if those officers are enabling people to get access that they need, that is way more important. It is called a civil service, it is a service to the people of this Island, it is not the other way around. What we need to do is make change. I will finish with this: if we go away from here today without voting for this Amendment, I want everybody to look in the eye of their constituents and say: "Yes, I did not vote for cheaper G.P. fees for people who are vulnerable and really need it, because of some hope in the future. Sorry about that. Tough." I am not willing to do that. I want to be able to talk to my constituents and say: "I did my best with people."

[10:45]

We are not natural bedfellows in terms of politics in this Assembly, but we all agree on one thing: we need to have an impact now, not just wait yet again, so I urge you to support this Amendment.  

8. Senator S.C. Ferguson:

I am not going to say much, except that I helped with the distribution of David Kirch's vouchers some years ago and I was appalled at the number of people, who rolled up to pick up their vouchers in their Jaguars and their Mercedes. This is why David Kirch now has a means test, so that the vouchers go to the people that need it and I think the same with the fees for the doctors. A means test, yes, to support the people, who cannot afford it; my pensioners, who are having to choose between heating and eating, that sort of thing. But, please, this sort of blanket, everybody can go free to the doctors, I am sorry, you have got to think of the doctors and the fact that they are having to work quite hard - in fact, very hard - to support their families and so on. It is a very much more complex situation than various speakers would have you think. It is a complex one and it affects all sorts of people's lives. So, please, reject this and let us do it properly.

9. Deputy G.C. Guida of St. Lawrence :

First of all, it is funny, because we keep going back to the same thing. We get this extraordinary really good Amendment, all born of frustration and impatience. Now, how do the backbenchers, how do Scrutiny think that Government feels? We have been spending the last 18 months planning, instead of doing, with one hand tied behind our back, standing on a beach ball, sitting on quicksand. That is how it feels, having done the Government Plan. The Government Plan is in front of you today, it has not started yet, we have not signed it off yet. It is not even started, we have not been allowed to do things and yet we criticise about things that have not happened. Give us the starting shot, let us get on with it, in 6 months' time you can come back with every single one of these Amendments and I will vote for them if we have not started on them. Yes, even the vote. Even, the vote; I will vote for the vote if we have not started doing something positive about climate change within 6 months, but now is too early. It really is. Let us get on with it. We have done more work, I believe, than many Governments before us in preparing. We have fantastic plans, but we need to execute them. Give us a couple of weeks to get started, sign off the Plan, let us get on with it. Second thing, a little bit of business sense. Yesterday, we refused a Proposition, which was also extremely good. It was really good by saying: when you have a saturated market, a saturated sellers' market, putting more money into it raises prices. It does not make things more affordable, it makes things less affordable. If we put £4 million a year into G.P.s, G.P.s' costs will not be £45, they will be £55, or £65. We will not be helping. This is wrong, it is a private business, we cannot do anything about what they charge. Every other country, that has a more integrated system like the N.H.S. (National Health Service); the French are like that. When you go to a G.P., the G.P. has a precise cost that he can charge, depending on the work and it has been set by the Government for decades and there is no change. We need to negotiate something like that. If we want to control G.P. prices, we need to negotiate something like that. That is not easy, that is a lot of work. There is no indication that they are going to be happy about it and just say: "Well, that is fine, we will just cap off the price to £50 and you can give us £40 of that." If that was possible, I would be very happy to spend £4 million a year on this. That would work well, that would be perfect and that would help everybody. I do not think it is possible. Talking about Business 101, if you are going to negotiate with somebody, the one thing you must never, ever do is come into the room dragging a big bag of cash behind you, that is really not the way it works. So, again, those Amendments are so right, this is such an important thing, but this is not the way to do it. This is going straight to failure, so I will oppose this Amendment.

10. Senator I.J. Gorst :

I am pleased to follow Deputy Guida; however, unlike him, if all these Amendments come forward in 6 months' time, I am not sure I am going to be persuaded to vote for them, then, either. The Constable of St. Lawrence , I sensed in her speech, is feeling frustrated. To be honest, she is right to feel frustrated. I feel frustrated, because transforming the health service, to make it more affordable, deliver it at the point where it gives the best health outcomes, where Islanders need it and want it and would like it, has taken - and is taking - far too long. I do not think anyone would suggest anything other than that. If Members vote for Deputy Southern and I have always thought there were some good parishioners in St. Lawrence , other than the ones in this room and the Constable quoting her parishioners shows that there are other good, sensible parishioners in St. Lawrence , as well. But if we vote for this proposal today, we heard Deputy Ward say: "Well we have got to do something." We have got to do something and this is doing something. If we vote for this Amendment today, we will not be solving the problem that Members of this Assembly and parishioners want solved, we will be simply adding to the frustration. The reason we will be adding to the frustration is because of what Deputy Guida explained. This is a simple Proposition. Deputy Maçon was criticised across the Assembly when he said that the Minister was right to comment on the report of Deputy Southern and somebody said he should have been commenting on the Proposition, so I will comment on the Proposition. It simply says: "Take this money to meet the costs of providing G.P. consultations at a reduced charge for certain groups." The problem with that is, first of all, there are a number of Islanders currently, because of the way that the healthcare system is structured, going to see their G.P.s and, as Deputy Maçon said, they should be going to other health providers in the community to receive the care and the medication and the attention they need. So, this simply perpetuates the frustration of receiving the wrong care at the wrong place for what we all accept can, at times, be expensive, nor does it tackle the issue of how one provides a reduced cost consultation by simply giving G.P.s a greater subsidy. So, Members know that when we go to the G.P. we sign, they are able to provide that evidence to the Social Security Department, the G.P. asks us for however much it is that they ask - they do not all ask the same amount, either; there is another interesting market dynamic - and they get the refund from the Health Insurance Fund that Islanders contribute to as part of the social security contribution. So, is the Deputy proposing that rather than the roughly £20 that we currently give back to G.P.s for every consultation that, if we go to a surgery that charges £50, then the Health Insurance Fund gives back, not just the £20 but the £40 as well to practice A? Practice B that charges only £30 on top of the £20, we only give them back £20? Who is the arbiter? Who is the one that decides? Deputy Maçon also reminded us of a very uncomfortable home truth - and I do not want to be critical of G.P. practices, they are private businesses, that is the structure of primary healthcare that we currently have in our community – but, some practices in the past, where the subsidy coming from the Health Insurance Fund and the Social Security Department has been increased, have not reduced the co-payment that they ask the individual person, who is having the consultation, to pay; that they structure their practice in the way that they think best, makes them a profit and provides healthcare to their customers. To my mind, it is a recipe for the Constable of St. Lawrence being even more frustrated. Of course, a parishioner will be frustrated, because he will look down the list and see that she has voted with whatever the phrase was, but those parishioners that think, as Deputy Ward tried to indicate, that by voting for this Amendment we are going to reduce the cost of visits to the G.P. simply by voting for this Amendment, they will be frustrated. Members will go home feeling a nice, warm glow inside, because they have shovelled a bit of money and they think they have done the right thing, but Islanders, turning up to their G.P. practice thinking it is going to cost them less, there is no mechanism in order to reduce that cost in this Amendment. It is going to lead to frustration, it is not going to deliver the policy outcome that Members of this Assembly want to deliver when, as the Minister said, they agree that we need to work on a new healthcare model to reduce the cost for vulnerable Islanders attending the G.P. We do not just need to do that, as others have said, we need to encourage people to have other forms of health provision. It is easy for Members to support this Amendment to do something. The problem I have with this Amendment is it does not get us nearer. It has been suggested that this is just a pre-cursor to the new healthcare model. It is not, there is no evidence to suggest that in this Amendment at all. It is going to lead to that reduction in the Health Insurance Fund, so there will be less money to deliver the new healthcare model and we will go back around being frustrated and not making the change, because we have not got the money to do it. It will lead to frustration, because it will not reduce the cost of Islanders and vulnerable Islanders attending their G.P. surgery and it will do something that we are going to hear more and more about, I think, over the coming closing days of this debate. You have heard of Abenomics, you have heard of Corbynomics, today we are seeing again an example of - Chief Minister is looking at me, frowning - of Reformonomics and that is we will spend the money today, we will spend the money today and we will never quite get round to telling you that tomorrow we will have to come and ask it from you back again. What we are going to go on and hear, not in this debate, because this is just a: "We will spend the money today" debate, we will get on to the: "Do not worry, we will provide this service and somebody else will pay, somebody else will pay." That is not how it works.

[11:00]

So, we will be giving this money, thinking that we are going to reduce the cost of G.P. provision to Islanders and yet what we will really do is simply add to all of the frustration that Members in this Assembly feel and Islanders feel. We hear the commitment of the ministerial team in a joined-up way, like we probably have not heard before, the ministerial teams at Health, the ministerial teams at Social Security, who have got records and rightly are proud of their record of supporting vulnerable Islanders. I do not doubt their commitment to delivering a new and a better way of delivering healthcare where there is a reduced cost in primary care at the point of accessing that healthcare. They should be, as Deputy Guida said, allowed to get on with that and start to bring it forward, rather than simply supporting this Amendment.

11. Senator J.A.N. Le Fondré:

I thought it might be helpful, it will be similar to what Senator Gorst has said, but I want to elaborate on a couple of things and just again to reinforce some points that have been made during the debate. Let us start at the very beginning. Deputy Ward said this will change things now and I think we just need to express why it will not change things now. You can deduce it from the wording in the Proposition, because it talks about £900,000 as being the Amendment in the Government Plan, but the overall impact is £3.6 million annually. Deputy Southern has done a degree of work on this, obviously. He clearly states: "Since this Amendment to the Government Plan can only be put in place with considerable time and effort". Those are the words in his report on page 9 and he says: "It is envisaged that the start date of the scheme will be 1st October 2020," so it will not happen now. If it does happen, bearing in mind he has envisaged 1st October 2020, it will be a number of weeks before the debate on the next Government Plan has taken place. What I want to do, because it has been referred to a bit, is let us talk about what is happening. There has been some frustration around P.82 and the fact, as also Deputy Ward stated, it was debated in 2012. If you look at how the Jersey Care model has come in with the new team that is in Health now, they have really pulled out the stops to get that in place in the last few months. The energy and enthusiasm - and I do not want to use the words: "work ethic" because that is the wrong expression and sounds derogatory to previous, or other, people - but the sheer effort and focus that is happening in that team I think is huge, is incredibly well-deserving and we should be noting that. I take the point that the Connétable of St. Lawrence has made in terms of not being able to name someone. I do not know the nature of the question, but I will say that my impression of that Director General is that that person is absolutely superb in terms of her commitment to changing this health service. That is what I am seeing. She does know who I am, she definitely knows who her Minister is and she knows who is in charge, as well, so I do not know where that comment has come from. What I will say is that, from my impression, her experience and her commitment is second to none in any of the people I have previously experienced. There is a focus as to what has been happening. What I have understood - and bear in mind I am not medically qualified in any shape or form in terms of things that have happened - diabetic supplies are now free, smear tests have been free for a while. Diabetic care is planned to be free through G.P.s and nurses during 2020, so there will be changes of support to vulnerable groups that are going through; that will be changes that will impact many people. It is not just a plan; there will be implementation going through. The difficulty on this Proposition is that there is no mechanism to require G.P.s to only charge £10. That is the point that has been made. There is no structure in place to be able to do that. I think, again, it was Deputy Ward who said if we carry on with the current model it will fail, I think were the words he used and that is the concern. If we just throw more money into this system, without having changed the system, one has not achieved the changes we want to see. I was about to say long term, but bearing in mind what we have talked about, that the intention is that there is to be a broader range of professionals, not just G.P.s providing the services, knowing that there is, I would say, significant progress taking place on the Jersey Care model, there is a head of steam that is happening on that. We also know that health costs overall are going up. We have got the ageing demographics. You name it. We need to get a wider range of people providing the services, so that we can then get the costs going to the right places. By 2021, the systems will be in place to address the issues that Deputy Southern wishes to address. Essentially his Proposition, which he recognises, is not going to affect the people between now and October at the earliest next year, but the systems we are trying to get in place will be bringing that benefit very shortly thereafter. It is relevant. It is in Deputy Southern 's report. There are 2 things. One is the sheer decline in the H.I.F. going forward and that is predicated on a certain population increase, which is why, as I said yesterday, if it was simple we would be doing it immediately. That is why you have got to take these things into account. Secondly, taking another £3.5 million out of that H.I.F. without having the funding mechanism in place is going to put some severe dents in it. The final comment, which is also what Senator Ferguson was referring to, if one looks at the back and there is this argument that also my Connétable predecessor referred to, in the Proposition it talks about certain groups, but in the report and it is a political theory, as I understand it, at the very back he lists everybody, including all O.A.P.s (old age pensioners). I must admit, when I first came to the States, I was very sympathetic to all O.A.P.s but the bits that Senator Ferguson has pointed out in terms of the very generous voucher system and who came up to receive it is the point about targeting the benefit to the ones that cannot afford it, but not giving it to the people who can. That is our overall responsibility. I do not need to go on much longer, but I just wanted to summarise that and maybe give a slightly different perspective. We are doing that model now. People are working on it, people are joining the teams literally in the next couple of weeks to help finalise matters. We are in a programme of meetings with the G.P.s now. These are not plans for the future. This is happening. One of the concerns is that if one has to shift across to essentially redesign something as a result of this Amendment, that then delays the implementation of what we consider to be a better scheme that will be coming through. I absolutely agree with Deputy Guida: if we are not seeing significant progress by the time of the next Government Plan that comes through, we are all going to be supporting the changes, because our frustration levels will have reached that point. This is the difficulty we have been seeing and Senator Gorst , I think, is equally frustrated. He has seen these positions and how long it takes to get through the system. I see a head of change and a head of steam coming through about getting those changes. As Deputy Guida rightly pointed out, this is our Plan. We have not even started it yet. Approval of this Plan gives us the ability to implement and deliver. That is what it is about. I am going to stop there. Hopefully it is clear that the Council of Ministers and this Minister is not supporting this Amendment. It is not because we are not sympathetic. That is what we have said. It is not about that we agree with it in principle. That is not quite what we said. I am just trying to find my page, which has now disappeared off. What we said is we support the overall aim, which is to reduce the costs of primary care to well-targeted groups, but we do not think that this achieves that aim. I reiterate, the earliest that it gets implemented is October next year. It is not going to make things better, as has been said by Deputy Ward , for people now. That is the difference. We believe that we can get the things in place, that we can achieve the aims of Deputy Southern within a very similar timescale and in a more targeted manner. On that basis, I really do ask Members not to support this.

12. Deputy R.E. Huelin of St. Peter :

After the elections of May, June 2018, I was asked to sit on the Hospital Policy Board. I spent my whole summer reading files and files of documentation about the build-up to the decision as to how the previous attempts to build a hospital were taken. The crux of that was P.82, about 35 pages of really good stuff, discussing changes in primary care, modernisation of I.T. (information technology), mental health integration. It is a really great document and it is still valid today. In it, it had one little line that said: "We are going to build a hospital." Now, I do not want to knock what went on in the past, but it seemed to me that the frustrations that we have today are borne by trying to do that one line and build a hospital and not do what the rest of P.82 was to say, to totally modernise our care system. What we have today is a Minister for Health and Social Services who, within 18 months, has delivered, or is delivering, albeit a policy document for the care system for the future of this Island. I personally think it is a great piece of work. Obviously, it has been validated by healthcare professionals and it has been validated by health finance people, to ensure it is deliverable. I really want to wait and support that. Part of that I am hoping and what I am seeing is going to be a

means-tested deliverable for primary care into this particular Island. Means-tested is very different to targeted. This particular targeted model is going to increase the demand, by Deputy Southern 's admission, of an extra 35,500 people, who are going to be able to go and see a G.P. for a tenner, as opposed to the traditional prices. It is worthy. We want to go in that direction. There are a large number, I get it, of vulnerable people in this Island who are not going to the G.P. They are kicking a can down the road, their problems are manifesting themselves. Their illnesses become serious and it is costing more money socially, financially, et cetera. It is the right model. Nobody can deny it. However, what are we asking our G.P.s to do? Have we asked our G.P.s how they are going to resource up, in order to take this new demand? I do not know if I have ever mentioned it in the past, but I used to live in London up until about 4 or 5 years ago. It might be new to some of you, ha ha. However, let me give you how a G.P. works in Raynes Park, which was where my G.P. was in a very large and modern practice. If you want to go to the G.P. - and I only went when I really wanted to go - the first thing you do is you ring up reception. The triage is a telephone lady on reception with no medical skills. You have to convince her that you want an urgent appointment, otherwise your appointment will be about 10 days away. When you have eventually blagged your way through, because you really want that appointment now, you get an appointment at a time that is not convenient to you. I can understand that, but you accept it, you do not go to work, you go to that particular appointment. You go in there - and I am not trying to trivialise the situation by using the example but it is one of my favourite expressions, you go in there because you have got a dislocated eyelash

- and you sit down and you consult on your dislocated eyelash and at the end of that you turn around and say: "Well, thank you very much. Thank you for the prescription. I am sure that will fix it but, by the way, I have got an in-growing toenail." "Sorry, no, your appointment is just for the dislocated eyelash. Go home, go and make another appointment, come back in 10 days' time to consult on your in-growing toenail." That is how brutal it is over there.

[11:15]

You do not get the opportunity to sit down and consult your entire healthcare in one consultation and that is why the consultations over here are 15 minutes and even longer. That is why I normally wait to see my G.P., because he is so caring. I think that is too much, by the way. I think it is over the top, however there is somewhere in the middle that is required. What I am really concerned about is that the G.P.s will not be able to resource up in order to take the additional demand that will be put on them. They will not be able to deliver the service that they really want to do. That is why I did not want to speak, but if I do not say why I will be voting against this Proposition then St. Peter will think I am an uncaring Deputy . I am certainly not. I just want to support the Government, do it absolutely right, put the platform in place for the healthcare model for the sustainable future, not for one year and not for 2 years but for 40, 50, 60 years in this Island. Get it absolutely right. I believe this is the foundation to do that.

13. Deputy C.S. Alves of St. Helier :

I am probably the only person in this Assembly that has worked in a G.P. surgery. I started working in a G.P. surgery in 2002, when I was still at school and this was talked about then. When I am hearing comments like: "It is too early. It is too quickly" from the Minister for Health and Social Services, it really worries me, because what I want to say is it is too late. Over the course of about, probably, 10 years I have helped out at various doctors' surgeries, translating. I have seen a lot and probably too much. I have experienced this first-hand. I have seen people end up at the debt collectors, because they have run up debts that have become unmanageable. They have ended up blacklisted and this has affected their life in other areas, not just their health. One of the things that has been mentioned here is that this Amendment will stop work going on in other places. Are we not capable of doing things simultaneously? I do not understand why this would stop other work going

on in other places. The Minister for Health and Social Services mentioned cervical screening. Cervical screening was always done in G.P. surgeries. It was also done in the Le Bas Centre, but there was a charge to the patient and I remember that. Now there is not, so, obviously, there was some kind of process that happened there, so that now that charge is not in place for the patients. I am not sure what the process was, but, obviously, there was some kind of negotiation that happened there, so that all G.P.s are paid a flat rate for cervical screening. Why can we not apply that process here with this Amendment? The Listening Lounge has been quoted as a great example of what can be achieved and, yes, it is a great example. That was achieved in the space of 6 months, after we released our mental health report in March. Why are we still waiting to make G.P.s accessible to parts of our community who find it difficult? It has been mentioned that this is a stopgap. Yes, maybe it is, but what is wrong with that? I cannot see anything being in place by October that will have a direct impact. I keep hearing it is not needed at the current time, let us wait. I have just done a quick Google search and Senator Gorst has been in Government since 2005. I was working in a G.P. surgery in 2002 and this was spoken about. Doctors then were talking about having nurses in to do thing like blood tests. It still has not materialised. This is almost 20 years down the line. The reality is - and this might sound a little bit dramatic - people's lives are at stake here. If we invest now, we make long-term savings. Deputy Southern 's report does make suggestions. It makes suggestions about the groups that could be targeted here, but there is nothing in there to say that that cannot encompass a means-testing system. He has not ruled that out anywhere. There was a mention about resources and officers and things like that. Does the Department for Social Security not have data that they can use about people's income? Does the Tax Department not have data that they can use about people's income? What has happened to OneGov? What has happened to the joined-up thinking? Surely this is something that could be implemented a lot quicker than we are being led to believe. Given all of those points, I think I have probably covered a bit of everything, I would urge Members to support this Proposition. Quite frankly this has been going on for far too long.

14. Connétable S.A. Le Sueur -Rennard of St. Saviour :

I will not keep everybody too long, but I would just like to say that there is a lot going on at this moment about pensioners, who are wealthy and should not receive any benefits. I tend to think that if you are a pensioner you have paid into the system, so what do we do now? We say to people: "Well, I am wealthy. I will not need you in my old age, so I am not going to pay into the system." I know a pensioner, who is slightly over what they are able to earn and yet they have cancer, they have diabetes and they have been to the doctor 3 times within the last fortnight at £45 a time. They contacted me and they said: "I am not sure if you are going to get a Christmas card this year. I can afford the Christmas card, but I cannot afford the stamp, because I am not well." Yet that person has paid into a system all their working life and we are sitting here saying: "Well, you are not entitled to anything you have paid into," so I think the rich people, who drive their Jaguars and whatever they are driving should turn around and say: "Well, I will not need you in my old age, so I am not going to pay into your system" so where are you going to get the money from then? There is a lot more to this. We have had Scrutiny Panels, who have put Propositions through and they have been crushed because the Council of Ministers keep promising that: "It is in the pipeline. Stay with us and in 6 months' time all this is going to be fine." Well, I am sorry, I am sick to death of waiting. I am tired of my parishioners contacting me and saying they need this, or need that or, to be honest with you, are just fed up with what is going on in this Assembly. I am going to vote with the Proposition, because I think we need to take the bull by the horns and make a decision and say to the people who voted for us - and in my case they did not, because they did not put anybody up against me, but they still believed in me to carry through what they want. This is what I am going to do and I think to penalise people because they have a few shillings extra in the bank is disgusting. They have paid their social security, they have paid their tax and it is now time to reap back some of the money that they have paid in, that they are entitled to.

15. Deputy M.R. Higgins of St. Helier :

I will be very brief. I have listened to the arguments and I have decided that I am going to support Deputy Southern , the reason being I have now been in the Assembly, I think, 11 years and have heard the same things time and time again and also it is jam tomorrow. I do not disparage the Council of Ministers on this. I think the current Council of Ministers are trying their best and they will be bringing things forward, but the question is we all know that implementation takes much longer than anybody ever thought. I do not want, in the next 2, or 3 years, having to support other attempts like this to try to get an affordable medical system. Many people that I have met simply cannot afford to go to a doctor and we have not even mentioned dentists. To go to a dentist is even worse, I think, in some respects. I do feel the time is right to go out there and try to get support for those who really need to go to see the doctor and doing it now. I shall support the Proposition.

The Bailiff :

Does any other Member wish to speak on the Proposition, or the Amendment, I should say? I call on Deputy Southern to respond.

16. Deputy G.P. Southern :

We have, eventually, had an extensive and worthwhile, I believe, debate on this particular topic. I am left with 2 things. One, this attitude of scaremongering. If we proceed with my Amendment, it is said, everything else will come to a crashing halt. We will not be able to do one single other thing, we will not be able to get on with the vastly complex renegotiating of contracts with G.P.s. That is a real problem. That is a real problem, whether we accept my Amendment, or we do not. That is a big task to take. The question is, at the end of the day, do we want a similar level of provision in our Island, or will we accept lower standards from the U.K.? The answer must be we have to renegotiate contracts and make sure that we retain quality on the Island. That is the reality, but it will not come to a crashing halt if we pass this Amendment. What will happen if we pass this Amendment is that we will put in, admittedly, a short-term benefit that can be immediately seen, felt and touched now, in the coming year, not waiting for the next review, as Deputy Guida seems prepared to do and vote for it this time, or the 6 months' delay that the Chief Minister says. That is the sort of delay we are going to get, things in place by then. It is hope over experience, I am afraid. We are sitting here, saying we hope to get this done, the Jersey Care model and delivered in the next 18 months. We hope. We have had that hope since P.82/2012, 8 years ago. That is the end result of P.82, that is what the formula says and we have not had it delivered, yet. If you have that faith, that hope that it will be done in the next 6 months, or 18 months, then vote against this Amendment. If you do not have that certainty, then please vote for this Amendment, which does something to alleviate what is becoming a case of hardship in the Island. We are not looking after our residents, our population, properly. We know that, because the system is breaking down. Just briefly, I will say thank you to the Constable of St. Lawrence for her speech. I think she was close to tears at the end and, indeed, the first time for an age I may have been as well. This is not just about grandstanding, or point scoring, as one particular Member said yesterday. If it was point scoring, I would not spend weeks on end writing a Proposition, researching a Proposition and committing wholeheartedly to a Proposition, in order just to have it fail. It is not about point scoring. It is about deeply held beliefs and that we should be assisting the vulnerable in our society to deal with illness. Nobody should be paying for illness. That is my reality. Briefly, I want to make 2 additional points. First of all, let us examine this sustainability issue. The fact is we are, in the next 5 years, going to have to review the Health Insurance Fund and the funding which goes from the hospital, or from Health, into community services.

[11:30]

The whole thing has got to be shaken up and re-examined. That is the reality. I think that is going to take longer than 18 months, but never mind. The fact is, for the moment, the Health Insurance Fund is in a healthy state. Look at the table on page 6, if you have got your documents there, but if not annual growth year-on-year for 2020 £9 million. For 2021 estimated £9,600,000. For 2022 £9,200,000 and the same figure for 2023. So, it is growing and I propose to take £3.5 million out of that, out of that growth, in order to fund this particular Amendment, to give access at a reduced rate to G.P.s for some of our vulnerable people. Just the last word, for those who, despite their years in this Chamber, still have faith and hope that things will be turned round in periods like 18 months, I will just take you through this particular passage from the Jersey Care model, which talks about connecting care for children, so this is back to the first words I said yesterday, looking after our children. Listen to the verbs: "We aim to deliver. We will improve continuity. This will address high rates of paediatric emergency. We will be working with local G.P.s. We aim to transfer specialist knowledge from hospital paediatricians, who will work closely with G.P.s. We will establish direct access. We will also increase education events. We will also work closely with our partners in Children, Young People, Education and Skills. We will build in our early help approach and will ensure that our functions and services are closely aligned." Listen to the verbs: "We will, we will, we will", 14 of them in total on one side of A4 paper. If you think that, in 18 months' time, those statements can be transferred from: "We will" to: "We have, we have established, this is what we have done" then, by all means, vote against my Amendment. Otherwise, vote for it. It is the chance you have and I will say it, to show that we do care and to deliver something real to our people.

The Bailiff :

The appel is called for. I invite Members to return to their seats. Members have returned to their seats. I ask the Greffier to open the voting.

2. Government Plan 2020–2023 (P.71/2019): sixteenth Amendment (P.71/2019 Amd.(16)) The Bailiff :

We now come to Amendment number 16, brought by the Corporate Services Scrutiny Panel and I ask the Greffier to read the Amendment.

The Deputy Greffier of the States:

Page 2, paragraph (h) – After the words "to the Report" insert the words ", except that, in Summary Table 8(iii), the income in the line entitled "Proposed changes to Long-Term Care Charge" shall be reduced by £11,500,000 by reducing the proposed increase in contributions to the Long-Term Care Charge to 0.5 per cent with other affected lines in Summary Table 8(iii) to be updated accordingly".

1.2.1 Senator K.L. Moore (Chairman, Corporate Services Scrutiny Panel):

Let us start with a brief overview. It is difficult because, as the Assistant Greffier just read out, we are asking for a reduction in income; however, we feel, as the Corporate Services Panel, that this is an important consideration for the Assembly and one that can change in time, because, of course, this is a year-on-year Government Plan. I would ask Members to consider this very seriously today and particularly with a view to the fact that it can be revisited next year, or again the following year, or even the year after that. What are we proposing exactly? We are proposing to reduce the increase in long-term care charge from one per cent to just 0.5 per cent. This reduces income, as we have said, by £11.5 million, but it is in line with the long-term care scheme's actuary's report of last year, which suggested only a 0.5 percentage point increase to the long-term care charge. However, the Government Plan proposes a one per cent increase, on the basis that it will avoid the need for a further increase for a number of years, as has already been suggested by the Fiscal Policy Panel. Why do this? As we have already said in earlier speeches, the attention of our focus groups and also of C.I.P.F.A. (Chartered Institute of Public Finance and Accountancy) was in our deliberations on the Government Plan that there are elements of this Government Plan that are inflationary. There are elements of this Government Plan that cumulatively increase a burden disproportionately on certain elements of the population. Already, the Government Plan raises the upper earnings limit from £175,000 to £250,000. I agree that is a large and sizeable income, but it still takes money out of the economy. Let us remember that by moving that upper earnings limit up, it takes the one per cent that is already charged for the long-term care charge up to that upper earnings limit, so adding 0.5 per cent in addition to that, that 1.5 per cent of the difference between £175,000 and £250,000 is £1,125 out of a household's income. If the Council of Ministers' view is adopted and 2 per cent is charged on that differential between £175,000 worth of income and £250,000, that is £1,500 of income. That is £1,500 taken out of the economy and put into a fund that is already well-balanced and already has an element of longevity in it. It is something that the Council of Ministers can revisit at a later date, without putting an inflationary burden on the community by piling on various cumulative charges to members of the public at this time. We are very conscious, as a Panel, of the F.P.P.'s (Fiscal Policy Panel) comments regarding the possibility of a downturn in the economic cycle. I must remind Members to consider that, because our counsel is, is it wise at perhaps a peak in the economic cycle, to be taking these measures and removing money out of the economy at a time when we may be about to see a downturn? Just look at the recent Business Tendency Survey to see that there are indications that that downturn is coming. This is sensible, it fits in with the actuary's report and evidence and guidance that has been provided to the Council of Ministers. It can be revisited at a later date, but it eases the burden that the Council of Ministers is imposing on higher earners and I propose the Amendment.

The Bailiff :

Is the Amendment seconded? [Seconded]

Deputy J.A. Martin:

I did not want to interrupt the Senator when she was speaking, but she has said in her report and she has said it again - and I know she does not want to mislead the Assembly - she said and repeated that the actuary has suggested 0.5 per cent. There is no figure in the actuary's report at all.

The Bailiff :

I think you must ask whether the Senator wants a point of clarification. You have not spoken, so you cannot be clarifying your speech. Ask the Senator if she would like to clarify.

Deputy J.A. Martin:

Where does she get that figure from in the report? It is not in the report. The Bailiff :

That is a point of clarification.

Senator K.L. Moore :

That is our reading of the actuary's report.

Deputy J.A. Martin:

Where? She will let me know which page.

3. Government Plan 2020–2023 (P.71/2019): sixteenth Amendment (P.71/2019 Amd.(16)) – Amendment (P.71/2019 Amd.(16)Amd.)

The Bailiff :

There is an Amendment to the Amendment lodged by Senator Mézec and I will, therefore, ask the Greffier to read the Amendment.

The Deputy Greffier of the States:

Page 2 – For "£11,500,000" substitute "£6,500,000", and after "0.5 per cent" add the words "and abolishing the cap".

1. Senator S.Y. Mézec :

Like, no doubt, yourself and every Member of this Assembly, I am currently absolutely gripped by the U.K. election coverage, not least because I still have a vote in that election and Members will be racking their brains trying to work out who I will be voting for. [Laughter] One of the issues that I am paying particular attention to, in that election, are the tax promises that different parties are making. I find that particularly interesting, looking at the intricacies of how these policies operate and who gets affected, who are the winners and losers of these policies. You have a Labour Party which is saying it will raise tax on those earning above £80,000 and nobody below that and there is some controversy over that, because of one of the intricacies of their marriage allowances, which show that might not be the case. Meanwhile, you have got a Conservative Party which is rolling back on many of the promises it had made on tax cuts for people below £80,000 and tax cuts for corporation tax. The reason that I find that particularly interesting is because it is a type of debate that we do not really have at all in Jersey, certainly not during election times. Of all of the Jersey elections that I have witnessed time and time again, we see candidates who will stand for election pledging that they do not want to increase tax on their voters. If you look at the historic documentation to do with the foundation of the long-term care charge, you can dig deep and you can find the documents from its foundation which say right from the very outset that L.T.C. (long-term care) was going to have to go up in the future, that when it was established at the 0.5 per cent rate initially and then raised to one per cent that was not the end game. It was always going to go up at some point, to keep the Long-Term Care Fund in a position where it could pay out to support our population. That introduction happened around about the time that marginal relief was cut from 27 per cent to 26 per cent, so you can completely forgive the public for not really noticing there, because their outgoings would not have changed too much. I think the fact of the matter is that, this time around, doubling the rate from one per cent to 2 per cent, as is proposed in the Government Plan, will be noticed by people. I suspect there will be a great deal of resentment from people, who voted in that last election, presuming they were voting for people who had said: "Vote for me and I will not raise your taxes," as most candidates in each election in Jersey say. So far in this Government Plan debate, I have given Scrutiny a bit of a hard time and not supported them, but I have to say, reading their report to the Amendment and listening to what I thought was an excellent speech from Senator Moore just before, they have touched on something really important with their Amendment. In their report, they used the words "cost of living" which is important and a phrase that has not really come up too much in this debate, or certainly discussions leading up to this debate on L.T.C. We have been focusing mainly on the Long-Term Care Fund and making sure that that is healthy into the future and viable. We have not looked too much at the issue of cost of living. I remind Members, we find ourselves in a situation where, for the last decade, real-term earnings have essentially been frozen and while poverty has risen, the number of people in Jersey earning above £1 million a year has quadrupled. It has quadrupled in that decade, while many people find their lives becoming more difficult, there are a small number of people who have never been doing better.

[11:45]

In the C.S.P. (Common Strategy Policy), which this Assembly adopted unanimously, we decided that we would have, as one of our top priorities, to reduce income inequality and improve the standard of living, yet we have a proposal, in the unamended Government Plan, which will have the effect of reducing the disposal income of most taxpaying Islanders, while preserving a privilege for the portion of our society that has never been doing better, that has seen its income multiply and multiply at a time when others have been getting worse and that poverty has been rising in Jersey. Let us, hopefully, not have a debate on this next point that I will make, because this should be universally accepted, because it is simply a fact, but the long-term care charge is a regressive tax. The Minister for Social Security shakes her head. I will give the definition of a progressive tax. The definition of a progressive tax is a tax where the rate increases as the taxable base increases; therefore the definition of a regressive tax is a tax where the rate decreases as the taxable base increases. That is the L.T.C. That is what it does, because the more you earn, the rate you pay decreases. When you hit that cap and you do not pay a penny more above that cap, your effective rate goes down. That is a regressive tax. End of story, that is the definition; it meets it. Regressive taxes are unfair, because you ask those, who are least able to afford more, to pay proportionately more than those who are most able to. This is about funding a vital service, a service that, in a civilised society, we cannot do without, because it is about supporting people into their old age. We have to make sure that the L.T.C. Fund is viable. It was a big moment for the Island introducing that and we cannot roll back on it, because we would be letting down future generations. To have that discussion and that debate about how we increase funding revenue into that fund is essential, we do have to do it and credit to the Minister for Social Security for coming up with a proposal that will do what it is meant to do. It will keep that fund healthy for a significant period of time into the future, but what the Scrutiny Panel have recognised is that this means increasing tax and, therefore, reducing the disposable income of working people in the Island, who all of the statistical evidence that we are shown demonstrates have become worse off in the last decade. Now, if we are going to have a debate about increasing tax on the population to support our public services, I, for one, do not shy away from that debate. That is an important debate, we must have it and if the conclusion we reach at the end of it is that people have to pay more tax, but they will get more for their money in the provision of services, I do not think that would be a bad thing by any stretch, but what I cannot tolerate - and I made this view perfectly clear in Council of Ministers' meetings, as we discussed what would be our proposal here

- that I think it is morally wrong to increase tax on working people, without asking the wealthiest people to pay a corresponding rise. It is simply not right to do that. I have the benefit of being absolutely crystal clear in my election manifesto. I put the quotation in the report to my main Amendment to the Government Plan, which achieves the same thing, so I am simply doing what I told the public I would do. I ask Members of this Assembly to consider, or think back, to what it was they told their voters when they stood for election. Which Members here knocked on doors, went to their hustings and said to voters: "Just so you know, a rise in the L.T.C. is coming and if you vote for me, you can expect me to support doubling your contribution, but I will maintain that exemption for the wealthiest Islanders"? I suspect - and I would be delighted to be proved wrong by any Member here - nobody had that conversation during that election, because the inevitability of the L.T.C. rise is a bit of a secret in Jersey. It is in the founding documents for the L.T.C. It is there, but nobody has read them, nobody has dug deep into it and certainly not the ordinary voters of the Island. Nobody out there, in the big wide world, or the big wide Island, goes to mark their cross on a ballot paper thinking: "Yes, it is a given that this candidate is going to vote to increase my tax by the L.T.C. increase." Nobody knows that. What I ask Members to do with this Amendment is to provide some sort of comfort to those Islanders, who are struggling with the cost of living, that we will have an amended version of this proposed L.T.C. rise to say we will ask those, with the broadest shoulders, to carry more of the burden and we will shelter those ordinary Islanders from the full extent of a tax rise, which was never transparently put to them in any election, which every member of the public can be forgiven for not realising is to happen at some point in the future and by asking those with the broadest shoulders to proportionately pay the same, not more, but proportionately pay the same. We can put off for years the next stage of increase in L.T.C. and keep that fund healthy, keep it paying for the services that we rely on. I see no down side to that. It will improve the standard of living for people in the Island by sheltering from a tax rise and maintaining an essential public service that, until a few years ago, we did not have. It reduces income inequality, because reducing income inequality is not just about trying to put more money in the pockets of those at the bottom, it is also about asking those at the top to pay their fair share, as well. I think that this policy ticks all of those boxes, it enhances what the Scrutiny Panel is trying to do, which I think is completely understandable and I think they made a good case for it. It leaves us with a fairer Island, a secure L.T.C. fund for the future and I urge Members to accept my Amendment to this Amendment and I make that Amendment.

The Bailiff :

Is the Amendment seconded? [Seconded]

2. Senator I.J. Gorst :

I want to speak simply about this Amendment, which is about raising the cap and we will come back to the Amendment, which reduces the contribution rate from the proposed one per cent to 0.5 per cent. There are a number of Amendments around social security contributions that we will be speaking to during the course of today and Monday. To be clear, I did not support the income inequality strategy aim in the Strategic Plan. I felt and I argued my case - and I was outvoted - that that element of the Strategic Plan should really be focused on supporting Islanders around the cost of living, but there we are, just to .. the Senator wants us to put the record straight. It is also perhaps not fair, because when I published those founding documents and when I went on parochial roadshows to create the founding legislation for the L.T.C. charge, those roadshows indicated to Islanders - and it caused quite a lot of consternation at the time - that contribution rates would have to rise substantially. I think we were suggesting that, even by now, they may have had to have risen to 3 per cent. We will not get into all of the reasons why they have not, because they are unpopular as well. More people making contributions mean that there is more money in the fund and the drawdown, or usage, of the funds remain broadly as projected, but that will only increase with our ageing society, of which we all in the room are and will be a part of, so we are not, as we are

sometimes accused of, being unkind to existing pensioners. They are not the problem of the ageing society, it is us in the room. Well, not all of us, the majority of us in the room will be that ageing society issue into the future. I think it has been clear. I have stood on platforms, saying that we needed to increase .. be it find better ways of funding healthcare. I might say this in this Amendment, the current 4-year Plan before us, to my mind, does not put enough money into healthcare. That will be a challenge that the remaining 3 years of the Government Plan will need to deal with. I know my colleague, here to my right, is not here; she would contest that it does not either put enough money into education. They will be other areas that Ministers will have to come back to. I do not think it is fair to say that the elections are fought in a vacuum of discussing tax rises. We have those conversations. It is no surprise to anybody in this room that I support a contributory-based increase to provide extra money for healthcare and I have voted as such in the past, it is just that others have not accepted it. There we are. So, there is not a vacuum in the way that the mover of this Amendment suggested, but when we were creating the L.T.C. scheme, this was not a problem that was solved while I was Minister for Social Security, it was while the current Minister for Treasury and Resources was the Assistant Minister for Social Security and former Senator Le Gresley was the Minister for Social Security, which was you can have a system which combined, or was very much a contributory- based system on one's income and used the theory of the social security contributions as a base, but in order to mitigate the full effect of those contributions, it was decided to collect it by the tax system. Now, that was important, because what that does, it means that rather than the one per cent that we all talk about for the L.T.C. charge currently - and then we will come and talk about whether it should be an increased ½, or one, later - rather than the full one per cent, the majority of taxpayers are paying .. because they pay their tax at the marginal rate, they are paying smaller than 1 percentage. The mover of the Proposition is shaking his head. He knows that. The one per cent is only paid by those who pay the standard rate, which is 20 per cent and they only pay it up to the .. based on the social security cap limit. The Minister is proposing that we scrap the cap altogether, so that 5 per cent of taxpayers, they are already paying - let us remember this - 32 per cent of all personal tax revenues, 5 per cent of taxpayers that pay at that standard rate. The Minister has understood and recognised that those people could be paying a bit more and her proposals in this Plan ask them to pay a bit more, so it is not fair to say that they are not being asked to contribute more to the L.T.C. scheme. They are and they are being asked to pay more by a raising of the cap in that respect. What the Minister is saying is: "Let us scrap the cap altogether" and overnight .. well, not overnight literally, this afternoon he is asking this Assembly to totally change our income tax rate, that has been in place since the 1940s.

[12:00]

He is dressing it up with a nice little argument about: "Do not worry, as I signalled earlier, this is the second part of Reformonomics. Somebody else will pay for these services" and he is targeting these somebody else's: "Do not worry, anybody, it is not going to be you people in this room, this is going to be somebody else and they will provide extra money." But what he is doing - and I know he personally does not shy away from this - is driving a coach and horses through the standard rate of income tax that has been in place in our community since the 1940s. I would ask Members to think very carefully before, on a whim, deciding simply to do that, because that is what you will be doing. That is what Members will be doing if they vote for the Minister's Amendment today. We know that we trade on certainty, we trade on tax certainty and we will be driving that away. We would not just be doing it for the one per cent or the 0.5 per cent - we will come into that - we would be doing it for the full 2 per cent, because we would be taking the existing one per cent, adding this one per cent to it, so we would be going from a standard rate of income tax in Jersey overnight. I spent a pleasant evening in another place. They would be laughing behind their hands if this Assembly votes for this Amendment today, because they would be picking up the phone as soon as we pressed our red buttons and we had had our names read out and shamed, they would be picking up the phones and they would be saying to their introducers: "You know what has just happened in Jersey, do you not? The standard

rate of income tax, that has been in place since the 1940s, it has now just jumped to 22 per cent overnight, on the back of a Government Minister's proposal. Would you believe it?" No certainty, no certainty in Jersey, no certainty for investors, no certainty for businesses wanting to continue to attract high-calibre skills. We should not do it. The Minister has recognised asking individuals, who earn more, up to that cap of £250,000 .. but she will talk about that. The Minister has recognised the need to ask those individuals who earn more to pay more, but she is rightly cautious, she is rightly considering all of our community, all of our economy in making prudent, informed, rational, thought-through proposals that she brings to this Assembly. I for one support her. It is not officials, as somebody else tried to say in another debate. She is no person's fool. They are her proposals and I stand with her, for all the reasons that I have explained, so I ask Members not to remove this cap and overturn something that has served our community well since the 1940s. If we just looked at our 2 fellow Crown Dependencies, they would not dream .. we see that they have increased their caps - they have a cap of liability - over the course of 2019, but one thing they certainly have not done is scrap it entirely and simply believe that somebody else will pay.

3. Deputy M. Tadier of St. Brelade :

When Senator Gorst speaks, it is quite obvious that there is a divide in this Assembly about whose interests are represented fundamentally and whose interests have been represented over decades in this Assembly when push comes to shove. It is people like Senator Gorst , who are there to represent the super-rich and that that tax model must be protected at all costs, even if it harms the locals that we represent and who vote for us. That might be a credible line of argument, even if it is a despicable one if it were true, but the fact of it that it is not true. Jersey's stability as a finance centre and the business it attracts is - and we know this, because we have been told it time after time - is dependent on tax neutrality, it is dependent on the headline tax rate in Jersey is zero. That is why people find it attractive and businesses use it, for all sorts of purposes, because of that tax neutrality, we are told. The L.T.C. charge is about paying for a long-term issue, which we know is not going to go away and the simple fact is we do already have a 2one per cent rate of tax, a headline rate of income tax at 2one per cent. It was Senator Gorst 's Government and the governments that he was part of that introduced that, so to go on about this 20 per cent rate, which was introduced at which point in the 1940s, which is so sacrosanct, is completely nonsense. What levers do we have in this Assembly when we need to raise money, because we are told constantly - and the penny is dropping - that taxation does need to go up? It is interesting to see the metamorphosis in the language that is used, because we were always told, in the past, that L.T.C. charges were not taxes, they were a contribution, but we are told that they are taxes today. That is fine, because your average punter, your average citizen in Jersey who, even in the upper middle bands, know that they are paying 6.5 per cent contributions and perhaps paying up to 20 per cent tax. They are also taxed on their social security contributions, because the social security contributions get taken out of their wages straight away and then you are taxed on your gross income, so you are double-taxed on that, if you like. What we are saying at the top end is that if you are sufficiently wealthy and your income is above the cap, that does not get taxed. How on earth is that fair? We are not asking for this group, who pay 32 per cent tax and it is a strange argument that is always put forward, but the rich already pay enough tax. They are contributing 32 per cent of our income tax revenues. Well, of course they are, because they are the ones with the money. You are not going to get the people, without money, paying the most income tax and to suggest that the opposite should be true is completely fantasy economics. I am going to call out the hypocrisy of some of this Government, the leadership of this Government, because they signed up to a formula of words in this Strategic Plan, which was then passed and adopted by this Assembly, which said that they wanted to reduce income inequality, not just reduce inequality in some intangible form, but they specifically wanted to reduce income inequality. The only ways you can do that, unless you control all of the wages in your economy itself by employing everybody - and we know that we are not the only employer out there - the way you do that is through your tax and spend model, through your social security, your income system and your tax system. Effectively, this Government is saying: "We are going to give an increase in tax breaks to those at the top, while putting the tax burden .." because we have been told that social security contributions, the L.T.C. charge is a tax: "We are putting your tax up, but our rich mates at the top" and I do not make any apologies for that, because it is a rhetorical device: "are going to be protected from that pay increase, that tax increase." That is completely unacceptable and it is against what the Strategic Plan said. It would have been better had they not put it in there at all, rather than putting empty words into a Strategic Plan that they never had any desire to follow through on, in the first place. On a quite simple issue, we are debating whether this Amendment is better than the Amendment being put forward by the Corporate Services Panel. That is what all Members of this Assembly should be looking at, irrespective of if they, at the end of the day, vote for Senator Mézec 's amended version. So, if it is amended, we are all still free to vote for, or against. It may be that Members in here do not like what is being proposed by Senator Moore , or what is being proposed by Senator Mézec , but the test has to be which is the better of the

2. Now, as I would see it, what the Corporate Services Panel, unamended, seeks to do is to reduce income by £11.5 million and what Senator Mézec is looking to do is to say: "By making this a fairer tax, putting it right across the board .." and it is something that these people should know has been coming for a long time, because, of course, the Minister for Social Security is edging this up and people could be on the phone already saying: "Have you noticed that,in Jersey, the Minister for Social Security is gradually increasing the cap on social security contributions and certainly in this case on the L.T.C. charge, because it is going to be abolished at some point, is it not?" So, if the argument is that abolishing the cap now is somehow going to scare the international community, then it is probably already going to scare them that we are moving in that direction, but I do not accept that argument anyway. I think it is flawed and it is scaremongering. Governments, of course, must be able to use levers, all the levers that are at their disposal. So, when I look at the 2 of these, even if I was not minded to ultimately support Reform Jersey's position that, at the moment, it is not the right time to take the cap off, although it may be in the future, I would certainly be supporting Senator Mézec 's Amendment here, because it makes the Amendment better. It gives you a £6.5 million reduction, a sustainable one nonetheless and we worked out that it would leave the fund sustainable I think it is until 2026, if I remember rightly, but the Senator can confirm that, at which point,by all means, let us have a conversation about then how we proceed. It gives us a great window of opportunity. I would say that the proposals being put forward bythe Corporate Services Panel unamended are not sustainable. I would not go as far as to say reckless, but I am sure some Ministers might, but it just defers the problem and does not deal with the fundamental inequality between those who pay at the high end, what they do not pay and what everybody else has to pay. This is fundamentally a question about equality.

4. Deputy J.H. Perchard:

I was hoping to not speak on this Amendment, as a member of the Corporate Services Panel, but Senator Gorst has provoked me, as you knew he would, I am sure. It is quite apparent from what he said that he did not support the Government's strategic priority to reduce income inequality, as he said himself in his speech. He correctly stated that the majority, but not all of us, in this room will make up the ageing society. That is correct and that demographic is clearly the one who benefits from the cap, so I say to you: "Pipe down, boomer, we all have to pay our way." L.T.C. .. I will retract it, thank you, Sir.

The Bailiff :

No, my concern was rather more it appeared to be not speaking through the Chair rather than: "Pipe down, boomer."

Deputy J.H. Perchard:

I say to him and other boomers that they should pipe down. [Laughter] We all have to pay our way. L.T.C., let us just think about what that is. What is it for? Who is it for? It is for looking after those who need support, who need medical care, who need our attention, who need more than perhaps other people need. Who is it for? It is for everybody in society. Something I would like to deal with is a rebuttal I received when discussing this with someone of the generation above me. I was told explicitly: "The wealthy are those who tend to get private healthcare, so they effectively pay twice." Well, with that logic, perhaps Madam Minister for Treasury and Resources, I do not have children, so I do not really use the education system as much as others. Can I have my money back, please? My household only uses one car and we drive relatively little. Can I have my money back, please? The generation above me are the ones who have caused the environmental problems we now face, so I say to them: "Can I have my money back, please? I do not want to put it into climate emergency, because I did not cause the problem, or I am not responsible." We do not do that in society, because we acknowledge that there are some things to which we all contribute and from which we all benefit. L.T.C. is one of those things. We should all contribute to it equally, because we should all care about looking after people who are sick and who need care, irrespective of how much we are sick and how much we need care.

[12:15]

There are no exceptions when it comes to health.

5. Deputy K.F. Morel of St. Lawrence :

I, as a Member of the States Assembly and as Chair of the Economic and International Affairs Scrutiny Panel, I often have to think about my economic thinking and what economics means to me. The truth is I often find myself .. there is no one style of economics which works. It is a bit like trying to find the equation which tells us the nature of the universe; it does not really exist. So, I often find myself caught between Reformonomics and Gorst onomics, between the 2. Sometimes, I favour one, sometimes I favour another. This is an issue which does exactly that, but, to be honest, I have had some fairly strong conversations recently, precisely about abolishing caps, because I am trying to understand why caps should not be abolished, or at least raised considerably, because to me they are one of the things which create regression in the taxation system. I had a conversation with one Minister earlier this week and it was about the social security caps and the argument was made that - and I appreciate Deputy Perchard referred to this - social security is not a tax, it is an insurance scheme, therefore you are meant to, in theory, kind of be getting out what you pay in and that is why the cap is there, because as you are earning more and more, your health needs, your pension needs do not necessarily increase in that way. So I was: "OK, I am not comfortable with that, but at least I understand the rationale now." The trouble with L.T.C. and the cap on L.T.C. is that it has been stated in this Assembly, I believe - and I stand to be corrected by, I believe, the Attorney General in response to conversations - but it has been stated in this Assembly that the L.T.C. charge is a tax. Therefore, that argument that was given to me about the caps on social security does not transfer across to the cap on L.T.C. L.T.C. is a tax, it is designed entirely to take money from the community to pay out to those who need it. The reality is, most of us will never call on L.T.C. That is the reality. It is not one - many of us will, but most of us will not - that carries that same analogy with social security. You also have Deputy Perchard's argument that: "I may choose to have private insurance. That does not mean that, therefore, I believe I should have a lower rate of tax and so on, it is just I believe that as I am better positioned economically in society, I am happy to make those choices, which mean I will not take as much out of the social community funding as others will." I am happy with that, because I want to help the vulnerable and I want to make sure that they are looked after and I am happy to pay my way. That is where I differ from Gorst onomics and move close to Reformonomics. I have mentioned it before, but I still remember saying: "I am happy to pay taxes" and I know that, in the Gorst onomic world, that is not a position people hold. But I am happy to pay taxes and I am happy to help those more vulnerable and less well-off than I am. Coming back to the cap, I have had strong conversations with people and, yes, raising the cap does affect the wealthier in society, as opposed to the poorer in society. It does mean they will pay more into this scheme, but

I have yet to hear an argument, given that we know L.T.C. charge is a tax .. and please, all of you, if you take nothing else away, never fall for the argument that L.T.C. is not a tax. It has been confirmed in this Assembly that it is a tax. Therefore, I believe that in the way that there is no cap on income tax, there should be no cap on L.T.C. either, so, personally, I will be supporting this Amendment. I will also be, whether the  Amendment fails or not, supporting the Corporate Services  Panel's Amendment, because for very different reasons I am concerned - and this is where I move towards Gorst onomics - I do believe that you should only tax as and when necessary and so pushing the rate up to 2 per cent I believe is not necessary right now. It is something that we can do in 5 years' time, in 6 years' time, to maintain the strength of that fund. So yes, on this issue you will see that I am still someone who stands somewhere between Reformonomics and Gorst onomics, but on this issue I will support Senator Mézec and will be voting to abolish the cap on L.T.C. charges.

6. Connétable C.H. Taylor of St. John :

Just to address a few points, Deputy Perchard said: "We should all pay." If she reads the ministerial response, she will see that approximately 30 per cent of people do not pay the L.T.C. and I think that that is very important. It is only those, who pay income tax, that will pay the L.T.C. As far as income equality is concerned, those at the lower end in society, who are not earning sufficient funds to pay tax, will not be paying the L.T.C., so that needs to be stressed, it needs to be made clear. Senator Mézec made a very interesting comment about him voting in the U.K. elections and taunted the Assembly by saying we can guess how he will be voting. I would like to respond by: "Why is he voting?" but that is another matter. When we look at the actuary's report, the actuary's report did not make any recommendations on the future rate. It did say that the rate would need to increase, but gave no figures. I shall speak once and that is now, rather than rising to speak again after this second Amendment. There is a need to increase it. We can increase it 0.5 per cent now and 0.5 per cent next year, which creates confusion, creates uncertainty. It is better, I believe, to do it in one adjustment and increase it by one per cent now, instead of in 2 steps over a period of time. This is giving certainty to individuals, they know where they stand, they know they can budget, knowing that the increase has taken place and that there are no further increases in sight further down the road. The other reason for a one per cent increase now is to do with intergenerational equality. If we have 0.5 per cent now, then the elderly, between now and the next increase, may have passed on and they will not have contributed to the increase, whereas if it is a one per cent increase now, all those elderly will be contributing more to the fund, thus alleviating the burden on the younger generation, who will not have to contribute so much in the future. I think that that is a very important point and needs to be taken on board. We talk about fairness and that is, therefore, a good solid argument of trying to equalise between generations the burden of charges. I would urge Members to reject the cap and also to reject the 0.5 per cent rise and to stick with the proposal in the Government Plan.

7. Connétable R. Vibert of St. Peter :

The key issue here is that the L.T.C. charge is a charge and while some consider it is a tax, it is all down to the definition of a tax and how that tax might be charged. The L.T.C. charge has a cap, so it differs considerably from income tax, where there is no cap on the upper limit. Removing the cap is extremely dangerous and could have a significant impact on the Island and its finances.

Deputy K.F. Morel :

If I may ask the Connétable to give way.

The Bailiff :

It depends whether the Connétable is prepared to give way. The Connétable of St. Peter :

Yes.

Deputy K.F. Morel :

It is just for a point of clarification and I do, possibly, look to the Minister for Education to help with this, but I believe that it was in this Assembly the Attorney General confirmed that L.T.C. was a tax. I am happy to be corrected on it, but I believe that that is what happened in this Assembly.

The Connétable of St. Peter :

I think I have not argued that it was not a tax, I have said it is different from income tax. The Bailiff :

There may be no difference in the distinction, Connétable , but if you would like to carry on. The Connétable of St. Peter :

The significant difference here is that it has a cap on the upper limit. Removal of the cap converts the charge into another element of our income tax. The effect of this proposal is that, when businesses look at our Island, they will see a tax rate now, our basic rate has moved from 20 per cent to either 2one per cent, or 22 per cent. The significance of this is that as they look at the cost of doing business here and the cost of the employees and the subsequent cost to them, the cost of doing business in Jersey will be 1 or 2 per cent more than in several jurisdictions very close to us, that compete for the same business. Low earners are already protected and do not pay the L.T.C. charge, but this Amendment seeks to increase our basic rate of income tax via the back door. I would urge Members to consider that, without this business coming into the Island, we would not have the level of income that we currently have in our Government Plan and would be unable to undertake much of our expenditure. I urge you to think about this and not to support this Amendment. It is both dangerous and damaging, both to our Island and our Islanders.

8. Deputy J.A. Martin:

I will try not to speak twice on this Amendment, but if I have to come back again, I certainly will. It is an Amendment to a very flawed Amendment from the Corporate Services Panel, because I have no problem with Scrutiny scrutinising my budget or the funds, absolutely not. I have an excellent Panel that does it. Why I say it is fundamentally flawed is because the Corporate Services Panel never once asked me why it was going up one per cent. They then, in their own logic, lodged an Amendment, saying that they would prefer what the actuary has offered at 0.5 per cent. There is nowhere in the actuary's report that says it should be 0.5 per cent. So, let us get that right and I put that challenge out there before lunch and if one of Scrutiny can find that for me, but out of courtesy. I do not care who scrutinises my budgets, I do not care, but come and speak to the Minister, speak to the officers and say: "Why is this?" if they thought .. Scrutiny, sorry: "The actuary said 0.5 per cent. Why did you think one per cent?" I had that question from my Panel. First, I want to deal with this Amendment. Senator Mézec said there is nobody who goes out on the doorsteps saying: "We are going to put your taxes up." Myself, Deputy Breckon, Deputy Le Hérissier and Power were so fed up in 2007 to 2008, waiting for this L.T.C. charge, our Scrutiny Panel went out, got an expert and basically came up with the scheme we have today, so before the elections, I was going around saying it, because I had heard the terrible things, what happens when you have saved up, you have bought a modest house, you might have some modest money. People were losing everything, so do not tell me I do not have the courage of my convictions and I have not said that I support this. I support the one per cent, Senator Mézec . It is a Reform thing, they do not want anybody to pay. That is what they do. I am proud that we have this. The U.K. are still going out now, they would love this. When Theresa May tried to bring it in, Labour called it the dementia tax and they lost the majority. Boris is trying to do it. He said it is £5 billion, so that people will not lose their homes. Let us work cross- party - imagine trying to work cross-party - and work together and bring something like we did 70 years ago until the social security scheme, because they know L.T.C. is breaking the National Health Service in the U.K. We have cracked it, but we have not cracked for who is taking out and who is paying in.

[12:30]

As I say, this is officers, this is actuaries, this is thinking we have to go for one per cent now. I have said to Scrutiny I will not come back for 20 years. We have got a scheme, but it is a young fund. Let us put it on a good footing. Let the people who are taking out the most start paying a reasonable amount. I mean, it is peanuts: 30 per cent pay nothing; middle earners, this will be about another £100. Yes, my scheme hits the higher earners to approximately £680. The very high earners, as Senator Moore said in her opening to the Amendment, it does hit, so I think I am helping everybody, because I am protecting the people who do not pay tax, the middle earners, but this scheme needs to be put on a good footing. It is something we should be absolutely proud of. What I would really like to say, it was not as easy as everybody thinks. I had a couple of very interesting debates with the whole of C.O.M. (Council of Ministers) and it could have gone one way, or the other. In the end they said: "I think the Minister for Social Security has probably got this right" and we lodged this in July. Now, according to Senator Mézec , our population is too stupid to know that it was going up one per cent, because they would not know. That is what he said in his opening speech: "People do not really know what is going on." Now, nobody got the hump about the one per cent until the last few weeks, when Reform came along and said: "Let us abolish the cap" and it has gone mental on the Facebook and they are going: "No, no, no" and, according to Senator Mézec and those behind me, it is only the rich. My scheme, the rich will pay more, the elderly will pay. I am sorry, it is what it is, the rich elderly will pay. The people who pay nothing, one per cent of zero is still zero and I cannot make it any more. This really is a flawed Amendment on an absolutely flawed Amendment and I look forward to the evidence, because I have read Scrutiny. It is all about evidence. The Senator said, in her opening speech, she feels too much money might come out of the economy. Nobody was barking, everybody was willing to pay, so what do you do? You bring an Amendment. We are putting up our tax exemptions and it would have evened it out, but no, let us put more, let us not scrutinise it properly and let us just .. probably it does look popular, but not when people were willing to pay it. Not one word we had. On the parking we had a 4,500 petition, but not on the L.T.C. Everybody was willing to pay, because they know it is targeted and it is to the right people. The only thing I say, throw out this Amendment. When we get back to the main Amendment, throw that out too.

9. Deputy L.B.E. Ash of St. Clement :

I am pleased that Senator Mézec is going to vote in the election. I am fairly sure that you have been lured in by the freebies on offer. If you are close to Mr. Corbyn, perhaps you could say he has left beer off the freebie list.

The Bailiff :

If you could direct remarks through the Chair, please, Deputy , because .. Deputy L.B.E. Ash:

Sorry, Sir. If he is close to Mr. Corbyn, he can put that. I think Senator Gorst has already touched on this, but the wealthy do pay more. Now, he said about the 32 per cent of tax is paid by the top 5. In fact, 62 per cent of tax is paid by the top 20 per cent. The bottom 20 per cent of earners pay just 2 per cent, so there is a massive amount paid by the wealthy people on the Island for tax. It is also the same in this L.T.C. If you are on £50,000, which is a fair wage, you will pay £800, or give or take you will pay £800. If you are at the top cap level, that we are resetting of £250,000, you will pay £5,000, so you will be paying £4,200 more than someone earning £50,000 a year, so you are already paying considerably more. Now, one last point I would like to make on this, we do not, in fact, have one cap, we have 2 caps, because we have a cap at the bottom as well that says if you are earning less than that amount, you do not pay this. So, if you have a cap at the bottom, surely it is only fair that you have a cap at the top, as well.

10. Connétable R.A. Buchanan of St. Ouen :

I do apologise for my voice, which is rapidly disappearing on me. The Amendment has its merits, let us be honest. It is very easy to say that the wealthy should pay more and there are not many voters out there that are going to have a lot of sympathy with that. However, as somebody with a financial services background, I would urge a word of caution. Jersey has a very successful economy, because we can attract and keep highly skilled, highly paid and very wealthy people. It is worth bearing in mind that these people are very mobile, they can move from country to country and are easily chased away by high taxes. The taxes and contribution they pay on their income all over the world, it is an important factor in deciding where they live, so let us be under no illusion: Jersey is in a competitive position for these highly skilled people and our finance industry and other industries in the Island depend a great deal on their skills. They are paid highly for a reason, because they are highly skilled and highly qualified. The fact that we have an upper cap, there is a very good reason for that and that is because other countries around the world, that compete for these people, also have a cap. Believe you me, these people are ruthless. They will look at a situation, they will assess what they have got to pay, what they can sell their skills for and if we become uncompetitive, they simply will not come. If they leave, or will not come to us, our economy will struggle, because whether we like it or not - and I know that Reform are not that happy that we have an economy that is based on wealthy people, but sadly we do - the benefits that we pay to people depend on the skills of the people that run that industry. They make a very important contribution to our society and indeed, as Deputy Ash has alluded, they contribute substantially in terms of the revenue. We have raised the cap and we have raised their costs. By my calculation, somebody on £250,000, we are asking them to cough up another £3,240 a year. That is a lot of money in cash terms and, believe you me, those people, although they earn a lot of money, are not daft and they will see that as a big increase. So, my message is: let us think carefully about this, let us think carefully about our finance industry and the damage it might do and think carefully before we vote on this Proposition.