What attempts have been made with the UKs Health Minister in relation to the cessation of the reciprocal Health Agreement? What attempts have been made with the French Health Minister to accessing healthcare system

4.6   Deputy P.V.F. Le Claire of the Minister for Health and Social Services regarding the cessation of the reciprocal Health Agreement with the United Kingdom:

I think I could use an Aspirin first after that round. Can I ask the Minister, please, what attempts, if any, have been made by the Minister to engage face to face with the

United Kingdom's Health Minister in relation to the cessation of the reciprocal Health Agreement? What attempts, if any, have been made to engage face to face with the French Health Minister to consider accessing their highly regarded healthcare system as an alternative option?

Senator J.L. Perchard (The Minister for Health and Social Services): I am sorry, I have misplaced my paper and I am not sure where I put it. Deputy P.V.F. Le Claire:

Surely the Minister would remember if he spoke face to face with the Minister from the U.K. or the Minister from France? He would not have to refer to his notes, surely?

Senator J.L. Perchard:

I have not even got a copy of the question. I beg your pardon, Sir, I did have a prepared answer. I have written, since my appointment as Minister for Health and

Social Services, to the Department of Health requesting a face to face meeting. I

know my predecessor also wrote to the Department of Health requesting a face to face meeting. The Department of Health have refused to date. Having said that, the most recent letter that I wrote has not yet been replied to and when chased last week, they said there would be a reply and I do not know what the reply will be saying. It does

appear that the decision by the Department of Health has been made to withdraw from certain aspects of the reciprocal Health Agreement and to that end the Minister from the U.K. does not feel it necessary to meet. I would like to put to them the fact that the meeting is necessary because certain aspects of the Agreement from which they request to withdraw have implications on our population that I would like to explore with them.

The Deputy Bailiff :

The second part of the question was whether you have engaged face to face with the French Health Minister.

Senator J.L. Perchard:

No, because ... I beg your pardon, Sir, and to the questioner, I am sorry, I was otherwise occupied. No, there has been no effort to engage with the French. We have

an agreement with France and most of mainland Europe, but the reciprocal Health

Agreement is particularly with the U.K. with regard to healthcare provision for Islanders and we have a longstanding and traditional link with the U.K.

1. Deputy P.V.F. Le Claire:

I am sure the Minister will join me and other Members in saying that this is entirely unsatisfactory from a responsible jurisdiction's perspective to cease such an agreement without having the courtesy or the wisdom on behalf of the U.K. Minister to come and speak with us face to face. I think, personally, that more should to be done from the Council of Ministers. Would the Health Minister seek from the Chief Minister and negotiate, if necessary, through the Lieutenant Governor in ensuring such cessations of services in the future from the United Kingdom are done at face to face level and not through departments and civil servants?

Senator J.L. Perchard:

I have expressed my dissatisfaction to the Department of Health. I do not want to

speak necessarily for the Chief Minister, but I know the Chief Minister has also

written to Lord Bach explaining our concerns as to the plan to withdraw from parts of the reciprocal health agreement and that the relationship with the U.K. and Jersey as a result is not strengthened by this type of internet exchange where formality and the longstanding procedures and relationships we have have really been ignored. We have expressed this but, as the Deputy and questioner will know, the U.K. Government is under some pressure with regard to resources and it is looking to withdraw from its reciprocal Health Agreement with not only Jersey but other islands and countries, as is its right.

2. Senator A. Breckon:

Contrary to what the Minister has just said, is he aware of a European Union directive that strengthens arrangements between countries where people get free treatment or their money back for health treatment in another country?

Senator J.L. Perchard:

I am not aware of the specific directive but there is little doubt that what I have just said with regard to the reciprocal Health Agreement, the U.K. are extending this policy of withdrawing from a reciprocal Health Agreement not only with Jersey.

3. Deputy R.G. Le Hérissier:

Would the Minister acknowledge that, having read the file, it seems very odd that we are going out totally on a limb when Guernsey and the Isle of Man have, so to speak, accepted the agreement? Why was there not a more active stance taken at a time when it might have been possible to influence the turn of events?

Senator J.L. Perchard:

The details of the agreement with the U.K. vary from Guernsey, Jersey and the Isle of Man. Jersey had a very beneficial health agreement with the U.K. and Guernsey's was not quite the same. Guernsey have effectively agreed to accept the proposal put forward by the U.K. and are now advising its residents to ensure that they have insurance. I have taken a more robust stance in attempting to at least delay the decision. We will be making a decision later this week - after the receipt of this imminent letter - as to which way we will go, but it may well be that we will have to concede, as Guernsey has done, I think, prematurely.

4. Deputy A.E. Jeune of St. Brelade :

Would the Minister be kind enough to give an assurance that he will let the people of Jersey know, before the cessation date, what cover they need to take in order to ensure they are not in difficulty when travelling to the United Kingdom?

Senator J.L. Perchard:

Not only will I give that assurance, but we have done, in anticipation of the possible fact that the U.K. will not allow us an extension, a lot of work in this respect and we are ready, effectively, to push the button in order to raise public awareness, and not only public awareness but to direct the public as to where they can go for health

insurance. My department and I have been involved in discussions with insurance

companies so that they are aware as to the type of cover that is required. But there is

absolutely - and it is absolutely right - a need to raise public awareness as to what is covered and what is not.

The Deputy Bailiff :

All right, you have answered the question. Deputy Le Claire, the final question.

5. Deputy P.V.F. Le Claire:

The latter part of my question was to emphasise the ability for us to reach over to a much closer mainland and access their far greater and far more effective healthcare system, recognised in the World Health Organisation as having one of the best cancer treatment facilities in the world. If the Minister has not had an opportunity as yet to meet face to face to talk with the French Health Minister to look at options for other issues in relation to what we might be faced with once this reciprocal health

agreement goes, if he is prepared to go to do that, is he prepared and is he also minded to set a taskforce upon this issue, which has been languishing in the background for nearly a decade now at Health and Social Services, and report back to the States with the findings?

Senator J.L. Perchard:

With respect to the questioner, we are talking about a reciprocal Health Agreement with the U.K. so it is pointless having an agreement with France when somebody is travelling and becomes ill in the U.K. or if we are sending a patient away or a student is studying in the U.K. The agreement with the U.K. is relevant to the U.K. of course. We have an agreement with France but if the questioner is suggesting that we use the French healthcare system to treat patients that we send away, it is something that we could well look at, yes.