No agreement exists with other jurisdictions to recoup the costs of non-natives being cared for in nursing homes and hospitals at the taxpayer’s expense, is the Minister to seek reciprocal agreements with other countries

3.12  The Deputy of St. John of the Minister for Health and Social Services regarding the recovery of the costs of non-natives being cared for in nursing homes/hospitals at the taxpayer's expense:

I am given to understand that this is to be answered by the Minister for Health and Social Services. Given that presently no agreement exists with other jurisdictions to recoup the costs of non-natives with as little as 5 years' residency being cared for in nursing homes and hospitals at the taxpayer's expense, if the person has no means of payment, what action, if any,  is the Minister taking to put  in place a reciprocal agreement with other countries?

Deputy A.E. Pryke of Trinity (The Minister for Health and Social Services): I will ask my Assistant Minister to answer.

Deputy E.J. Noel (Assistant Minister for Health and Social Services -

rapporteur):

I thank the Deputy of St. John for this question as it gives us an opportunity to clarify matters, therefore, if I may take this question in 2 parts. With regard to the nursing home care it is important to remember that the reciprocal health agreement with the U.K. covered hospital and G.P. medical services only. It did not cover personal care services provided in residential care homes. As such, the ending of the agreement has had no direct impact on individuals in care homes. Jersey does not meet the care costs of Jersey-born individuals now living elsewhere in the same way other countries do not provide support for individuals born in countries who have chosen to settle in Jersey. This, in the broadest sense, could be seen as a global unofficial reciprocal agreement.

1. The Deputy of St. John :

Given the Assistant Minister's reply, and as Jersey residents in general who live abroad would be paying for their own medical needs because they would be generally well educated and carrying out their work where they would have been able to put money aside, can it be right that Jersey taxpayers are having to pick up bills, as explained earlier, for quite a number of people who have just recently moved to the Island, and "recently" being 5 or 7 years? Can the Assistant Minister give a reason and will he explain why no negotiations are put in place ...

The Bailiff :

Would you be kind enough to show respect to the Assembly by addressing the Assembly without your hands in your pockets?

The Deputy of St. John :

Sorry, Sir, I was trying to get my handkerchief out. You have now thrown me [Laughter] yet again, for the second time this morning.

The Bailiff :

I am sorry to have interrupted you, Deputy , I should perhaps have waited until you had finished your question. I must say on that subject, perhaps I could take the opportunity of saying that I think this is really a matter for the Chamber rather than for the Chair. I think my successor would welcome some advice from the Chairman of the P.P.C. as to Members' comportment when they are addressing the Assembly. But, in the meantime, the default rule is no hands in pockets, please, Deputy .

[Laughter]

The Deputy of St. John :

You are cutting me off at the knees, again. I think I will call it a day, this morning, and sit down.

The Bailiff :

Have you put your question, or are you abandoning it in mid-flow? The Deputy of St. John :

No, I have put enough of the question to have an answer, Sir.

The Bailiff :

Good.  Assistant Minister?

Deputy E.J. Noel:

I dispute what the Deputy of St. John said because on a personal level I have 2 members of my family that have retired overseas, unfortunately, and they are not in the situation that the Deputy has described; they are in a similar situation that he believes that those people in Jersey are settled. So I do not think it is true to say that when Jersey residents do move abroad that they are necessarily contributing significantly to the economy of the country that they go to. With regards to the 5-year rules, that is really something that the Social Security Department deals with, not a Health and Social Services issue, but I could say that the work that we are doing currently in health tourism is much broader than the commonly-known definition of health tourism which is people specifically coming to Jersey to gain access to our hospital services. We are taking a quite broad definition of that and are bringing policies and procedures in place to deal with that and these should be in situ by September.

2. Deputy R.G. Le Hérissier:

Would the Assistant Minister confirm that one of the reasons why residential care is becoming such a big issue is the enormous costs attached to it? Of course, we have had in the background this intended solution of an insurance scheme for years and years as a talking point but not as a realisation point. Could the Assistant Minister tell us when, in co-operation with his Social Security counterparts, will this be put in place?

Deputy E.J. Noel:

I agree with the Deputy of St. Saviour. The introduction of some type of payment

mechanism to cover for our elderly care is really a question for the Social Security

Department. Naturally, the Health Department will be working closely with them to ensure that it is the best possible solution. Thank you.