Bariatric or gastric band surgery

1240/5(3017)

WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY G.P. SOUTHERN OF ST. HELIER

ANSWER TO BE TABLED ON TUESDAY, 10th OCTOBER 2006

Question

Further to his answers to questions on bariatric (gastric band) surgery given on 26th September 2006, would the Minister inform members –

1. what timescale is envisaged for the establishment of a partnership arrangement with one such centre' referred to in part a) of his answer?
2. when the Waiting List Project Board, referred to in part b), is expectedtohavecompletedand considered its findings?
3. what proportion of the possible£400,000 funding that is requiredtocomplete the procedurefor all thoseon the waitinglisthe is seeking to find and agreeinthe2007budgetfor the most extreme cases'?
4. how manyofthe40 patients can expecttohave surgery inthecomingyear?
5. whether funding for the appropriate intermediate treatment clinics for those whoremainonthe waiting list will bemaintained?

Answer

1. In my answer to the Deputy 's question on Tuesday 26th September 2006, I made reference to the fact that the Health and Social Services Department is currently considering the best means by which it can enter into a partnership agreement with a tertiary centre in the UK to provide for this form of surgery. It is anticipated that for this agreement to be fully negotiated, implemented and evaluated it will take some three to six months from now.
2. Members of the Waiting List Project Board will consider the business case for bariatric surgery within the next two weeks. It is anticipated that the Waiting List Project Board will advise my Senior Management Team of its views at the beginning of November of this year. The prioritisation for next year's funding is not yet complete. The Deputy must not be under the illusion that bariatric surgery is the number one priority for my Department. The fundamental challenge for my Department is to prioritise a wide range of competing health and social care developments – all of which have somehow to be reconciled within strict budgetary limitations laid down by the States of Jersey and underpinned by the current Finance Law. My department is currently considering what priority it intends to give to such matters as bariatric surgery, new drugs for cancer treatments, funds for nursing home places to reflect the needs of an ageing population – and a wide range of other such compelling matters.
3. Since my answer to the Deputy 's question on Tuesday 26th September, my officers have advised me that it may be possible to reduce the cost from approximately £400,000 down to £300,000 if the entire surgical list is provided to the eventual partnering tertiary centre referred to in (a) above. Beyond that, it is not possible for me to determine which cases will be operated on next year. This decision making is complex and is a balance between the appropriacy of the surgery (an issue fully explored in my answer of 26th September), the logistics of transferring the patients by an appropriate means (given the chronic morbidity of the patients), and the clinical priority (vis-à-vis other pressing clinical priorities for the Department). These matters are the responsibility of my officers and the relevant clinicians.
4. My response to this question is addressed in (c) above.

5. The Deputy is correct in identifying through this question the importance of intermediate forms of intervention which, if successful,mean that patients do not require such radical surgery.Thereare a rangeof services provided by theDepartmentwhichfall into this intermediate' category. These include a Weight ManagementClinicwhich is held everyThursdayatOverdale Hospital. Also a bariatric clinic is provided approximately every six weeks from the Diabetes Centre in Kensington Place. Beyond that, there is, of course, a rangeof health promotion activities which focus upon keeping fit andactive – the much publicised health promotion vigorous walksaroundthe countryside and coastal areas, and supervised weighttraining and exercise classesaretwo cases in point.