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WRITTEN QUESTION TO THE MINISTER FOR TREASURY AND RESOURCES BY DEPUTY G.P. SOUTHERN OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 12th JUNE 2012
Question
Would the Minister, in relation to the recent Health and Social Services White Paper, advise –
- what Health capital projects, if any, from the White Paper (totalling £20.4 million in the 3 years to 2015), he recommends should be included in the bids for capital expenditure?
- what explanation there is for the ability of the Council of Ministers to fit between £27 million and £34 million in the States spending envelope with no increases in charges or taxes in phase 1?
- will there be cuts in other department budgets to accommodate this?
- what growth projections in States revenues are built in to this plan?
Answer
- The Minister can confirm that the Council of Ministers is proposing to include all the Health capital schemes within the White Paper in the draft Medium Term Financial Plan as follows:
| £'000 £'000 £'000 |
Health & Social Services | 2013 2014 2015 |
Upgrade of Main Theatres | 2,100 1 ,837 - |
The Limes Refurbishment | 1,700 - - |
Replacement General Hospital - feasibility | 350 - - |
Replacement General Hospital - planning | - 2 ,000 - |
Mental Health Facility at Overdale - feasibility | 350 - - |
Intermediate Care | - 5 00 - |
Relocation of Ambulance and Fire Station - feasibility | 100 - - |
Adult Care Homes | 4,000 - - |
Children's Homes | 2,000 - - |
Refurbishment of Sandybrook | - 1 ,700 - |
Replacement MRI Scanner | - - 2 ,277 |
Replacement RIS / PACS IT assets | - - 1 ,567 |
Health & Social Services total | 10,600 6,037 3 ,844 |
The £500,000 funding for Intermediate Care has been brought forward to 2014 in the MTFP from the total included for 2015 in the White Paper.
- Commitments were made to growth for the Health and Social Services Department budget in the 2012 Business Plan. For ease of reference these areas for growth are set out in the table below.
| 2013 £'000 | 2014 £'000 | 2015 £'000 |
Health Growth @ 2% | 3,470 | 6,920 | 10,550 |
Medical Staff Sub Specialisation | 300 | 610 | 920 |
Nursing Establishment | 1,000 | 2,030 | 2,080 |
Nursing Terms and Conditions | 600 | 620 | 630 |
Totals | 5,370 | 10,180 | 14,180 |
The current draft of the Medium Term Financial Plan includes these committed growth items from the 2012 Business Plan in the base budget assumptions for 2013 to 2015.
In addition the Health and Social Services Department has made a number of growth bids to be considered alongside bids made by other Departments. These growth bids are listed in the White Paper and for ease of reference are shown below.
Priority Area | Workstream | 2013 £'000 | 2014 £'000 | 2015 £'000 |
Services for Children | Services for Children starting with Early Intervention | 623 | 736 | 858 |
Services to encourage Healthy Lifestyles | Healthy Lifestyles starting with Alcohol | 300 | 435 | 530 |
Services for adults with Mental Health issues | Adult Mental Health... starting with Improving Access to Psychological Therapies | 344 | 736 | 1,132 |
Services for Older Adults | Older People... starting with Dementia | 742 | 1,813 | 2,436 |
| Intermediate Care | 1,325 | 2,338 | 2,888 |
| Long Term Conditions... starting with Chronic Obstructive Pulmonary Disease | 701 | 1,344 | 1,652 |
| End of Life care | 399 | 806 | 826 |
Cross Cutting workstreams | Workforce, Estates, Information Technology, Commissioning & Strategic Partnerships, Informatics, Funding & Policy | 590 | 671 | 714 |
Recurring Total Costs |
| 5,024 | 8,879 | 11,036 |
Additionally there are other growth bids that may directly benefit HSSD and these are as follows:-
| 2013 £'000 | 2014 £'000 | 2015 £'000 |
Vehicle Replacement | 100 | 200 | 300 |
Health Maintenance (JPH) | 700 | 700 | 700 |
HR HSS - 2 additional posts arising from Verita report | 200 | 200 | 200 |
Totals | 1,000 | 1,100 | 1,200 |
The table on page 31 sets out the costs of delivering the service changes proposed in the White Paper. These are new/additional costs required to provide the services outlined. However, if the service changes are not approved, the pressure of the ageing demographic is likely to cause additional unsustainable pressure on, in particular, Hospital services over the period.
Drafting of the MTFP is consistent with the delivery of the business cases produced to plan and deliver the service changes described in the White Paper. This reflects the close working links between the Health and Social Services Ministerial Oversight Group and the drafting process for the MTFP. Subject to the States' approval of both the White Paper and the MTFP there is potential, by 2015, for an extra £28 million a year will be invested in the Island's Health and Social Services, with £25 million of this being additional funds provided within the MTFP. This is a substantial investment in these services and illustrates the Council of Ministers' commitment to delivering the Strategic Priority to "Reform Health and Social Services".
The numbers referred to on page 31 are taken from the proposed capital schemes as set out in the draft MTFP. While these capital projects will support the implementation of the White Paper, with the exception of £500k in 2014 these capital projects are not directly associated with service changes but rather reflect the need to refurbish existing estate in order to meet needs.
Preparation of the MTFP has involved careful balancing of expenditure against projected revenues. The Minister and the Council of Ministers are pleased to be able to present a draft MTFP that does not include any new taxes or increases in the rates of Income Tax or GST.
- No department is suffering "cuts" in order to fund growth in Health and Social Services. The amounts available for growth in departmental cash limits have been subject to a prioritisation process which may have meant some departments were unsuccessful in obtaining growth they were seeking. Aside from the planned CSR savings no department has had its cash limit reduced. In fact all departments will now have guaranteed minimum budgets for a three year period once the MTFP is approved.
- In the draft MTFP States revenues are forecast to rise from £639 million in 2013 to £700 million in 2015.