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QUESTION TO BE ASKED OF THE PRESIDENT OF THE HEALTH AND SOCIAL SERVICES COMMITTEE ON TUESDAY 25th MAY 2004, BY
DEPUTY R.G. LE HERISSIER OF ST. SAVIOUR
Question
Would the President advise members –
( a ) of the average cost of employing a consultant in terms of a consultant's salary and benefits and the
numbers and costs of support staff needed to support a consultant's rôle? and,
( b ) what alternatives to employing local consultants, if any, have been investigated by the Committee and
what the outcome was of this examination?
Answer
( a ) The current salary range for a Hospital Consultant is £54,340 - £99,898. Additional costs in relation to
superannuation, are 15 per cent whilst the employers social security contributions are 6.5 per cent of salary up to a maximum (capped amount) of £2,249 p.a.
T h e a v erage cost, therefore of each consultant is approximately £94,000.
E a c h Hospital Consultant post requires varying infrastructure depending upon specialty. These may
include middle grade and junior doctors, (some specialties have neither), specialist and general nurses, and the input of a range of professionals allied to medicine (scientific officers, radiographers, pharmacists, physiotherapists, speech therapists etc).
I n ad d ition, each consultant is supported by a medical secretary, clinical infrastructure, the medical
records function and a variable quantity of clinical supplies, drugs and prostheses. The cost of such support varies according to specialty.
I t is n ot possible to delineate, in precise terms, the specific support required to service the role of a
consultant. Both the clinical infrastructure and the non-clinical infrastructure of the General Hospital is deployed entirely to meet the needs of hospital consultants. By virtue of their clinical authority, hospital consultants can request everything from a high tech magnetic resonance image (MRI) at one end of the spectrum to the ambulance service arranging for the patient to actually attend the hospital at the other end. The infrastructure of the General Hospital must, if it is to be efficient and of high quality, be flexible (to provide services to all the specialisms) and robust.
( b ) The deployment of hospital consultant staff is constantly under review by the Health and Social Services
Committee. The result of this work finds expression in the Committee's Medical Manpower Strategic Plan which was produced following widespread consultation. This strategic plan describes the basic requirements of what is the minimum hospital consultant staff configuration required to meet the health care needs of the population of Jersey.
E v e r y general hospital requires a core set of services. At the very heart of the core are the following
emergency services:
Accident and Emergency
Trauma and Orthopaedics
Coronary Care Unit
Maternity and Special Care Baby Unit Intensive Care Unit
General Emergency Surgery
General Emergency Medicine
Supportive diagnostic services (including Radiology and Pathology)
W ithout these services, the general public is fundamentally at risk of untreated injury and harmful disease.
The size, geography and the catchment population determine what other services are built upon this core infrastructure. The smaller the general hospital the more additional specialist and tertiary services are provided from other (larger) general hospitals or tertiary centres.
In J e rs ey there are forty seven consultants and they are supported by visiting consultants from the UK
who provide a range of services, including:
Bariatric Service Clinical Oncology Paediatric Cardiology Plastic Surgery Nephrology Radiotherapy Rheumatology Specialist Neurology Specialist Urology Thoracic Surgery Vascular Surgery
In a d d ition to this, the States of Jersey are well served by highly specialised consultants working from
major tertiary centres in the UK.
L o c a l consultants are fortunate in that they are assisted in their acute work by a number of general
practitioners, who act as clinical assistants'. The Health and Social Services Committee will be examining ways in which other health care professionals, such as nurses, technicians and support workers, can take on tasks which were previously the sole preserve of hospital consultants.