Urgent oral question concerning additional support announced for GP visits

2.  Urgent Oral Questions without Notice - The Minister for Social Security 13th March 2008

2.1   Deputy G.P. Southern of St. Helier :

Will the Minister explain exactly what the additional support to be provided for G.P. (General Practitioner) visits announced in the media yesterday entails?

Senator P.F. Routier (The Minister for Social Security):

I have just had about 10 minutes notice of this so I will do my best to answer the question. It is recognised that when people were applying for income support there would be some people who previously had H.I.E. (Health Insurance Exemption) who would not qualify for H.I.E. under the new system. We always anticipated that those people would make application for special payments because we recognise that - the same with all the other transition arrangements that we have put in place where people to move from one system to the new system - it would be appropriate for them to have a transition over a number of years. It is only now, since we have had all the applications in for income support, we are now aware of those people who used to have H.I.E. who are no longer going to have the benefits of being able to go to the doctors for free. We recognise that and we want to put in a special arrangement. Some people have requested that they have a household medical account. We have decided to do that. Of course as people who also were H.I.E. we have already made arrangements for free prescriptions so they are covered for those. Every person who used to have H.I.E. and did not qualify for income support will receive an H.M.A. (Household Medical Account) of money put into their account of £1.96 per week. That will allow them to go to the doctor for up to 4 visits a year. That is precisely what the medical profession are telling us is the number of visits which people would require to go if they are healthy. If they are not healthy and if they have any chronic conditions they then can apply for further visits which will be agreed between the department and the G.P. If anybody has any concerns about going to the doctor who were previously on H.I.E. they can go to the doctor without any fear of not being funded for their health requirements if they have an urgent medical need.

1. Deputy G.P. Southern :

Can the Minister firstly state to Members why he did not make a statement in this House when the House was sitting and decided to make this decision, which affects some one in 8 of H.I.E. recipients and income support recipients why he chose to make the statement in the press and not to this House?

Senator P.F. Routier:

I think Members will recall that during the income support debate it was recognised that there would be some occasions where there would be amendments and additional changes to income support as we go along as we learned more about the system. It was no disrespect to the House at all. It was more about getting the information out to the people themselves and to the G.P.s. I wanted to ensure that they be put in place as soon as possibly we could. Perhaps if I was at error not to have made a statement, I apologise for that but I thought it was more important that the people who really wanted to know about the medical benefit should be told.

2. Deputy G.P. Southern :

Thank you. In terms of accurately informing recipients of this benefit, is the Minister aware that this morning on the radio he said: "The patient does not actually pay any money to the doctor" which is an incorrect statement because all ex H.I.E. recipients will now pay £5 on a visit to the doctor?

Senator P.F. Routier:

I am afraid the Deputy 's information with regard to everybody paying £5 is incorrect because if he was to speak to many of the doctors or the majority of doctors they do not charge £5. They have made a commercial decision not to charge £5.

3. Deputy G.P. Southern :

In the measures which came to this House, did the Minister not explain to Members that a nominal payment of £5 was an important part of the income support and the G.P.'s benefit that he was introducing?

Senator P.F. Routier:

In the negotiations for introducing income support the G.P.s themselves made it clear to us that their negotiating team wanted to have a £5 charge. The G.P.s are commercial enterprises who make decisions for themselves. I have no clear indication from all G.P.s but certainly I am aware that the majority of G.P.s have made a commercial decision not to charge their patients £5.

4. Deputy J.A. Martin of St. Helier :

Just to expand slightly on that theme. It concerns me that obviously this then will entail that exactly the same people in the same position, depending on which G.P. they go to, may be charged £5 and then pay the rest of their account out of their own money which is saved at Social Security. Is the Minister going to do anything so everybody is treated in the same way?

Senator P.F. Routier:

G.P.s are commercial enterprises who charge varying rates for their services. You will find that even if some medical surgeries decided to charge £5 they may be one of the ones that charge less than the ones that charge a higher amount. I am not sure that there can be any mechanism which can ensure that the patient is dealt with in the patient decides which G.P. they want to go to and the G.P.s advertise their charges and the patient decides whether they want to pay that. In the circumstances of H.I.E., obviously for the people who were on H.I.E. the income support system covers the costs.

5. Deputy G.P. Southern :

Would the Minister explain to the House exactly which groups of people have been omitted from this aspect of income support? Will he inform Members where the additional £100,000 - or approximately that figure - is to come from to cover this new arrangement?

Senator P.F. Routier:

It is a cross-section of the community who used to have H.I.E. You must remember that H.I.E. was a very badly targeted benefit because it went to a lot of people who had fairly high incomes. Although it had a lowish level income bar to it, it disregarded a lot of benefits. It disregarded many of the benefits which are provided. That is the purpose of income support, to include all those payments. There are a cross-section of the community who had high incomes who have now been taken out of the system which is what income support was intended to do. With regard to the additional funds, it is not additional funds. It will be money which we already have allowed for within our income support budget because we did anticipate that people would be making applications for special payments.

6. Deputy G.P. Southern :

Just finally could I press the Minister to put in writing a description of which groups have been affected and who is going to be affected?

Senator P.F. Routier:

I gave that answer to the Deputy yesterday casually when he asked me the same question. While I am on my feet may I please remind Members to please ensure that if anybody asks them about whether they can go to the doctor if they are on income support, they can go to the doctor and they must go to the doctor. If they have any medical concerns they should go to the doctor and not be concerned about whether it is going to be paid because income support will pay their fee. [Approbation]