9754 Impact of a lack of income on the health of individuals and communities

2016.12.12

10 The Deputy of St. Ouen of the Minister for Social Security regarding the impact of

a lack of income on the health of individuals and communities: [9754]

Following the work of the Health Intelligence Units in compiling the Jersey Health Profile 2017 and its finding that a lack of income is a factor affecting the health of individuals and communities, what assessment, if any, has the Minister made of that finding and what action, if any, will she take as a result?

Deputy S.J. Pinel (The Minister for Social Security):

This document, the Jersey Health Profile, was published a few weeks ago and I would like to congratulate the Health Intelligence Team for presenting the statistics in such an accessible way. It is a very valuable piece of work which clearly has implications for all departments. Although the report provided many local statistics it did not present any specific information regarding the health of low income residents. Instead it drew attention to some of the issues that are generally accepted to be associated with health inequalities. These issues include income and also housing, education and working conditions. The report also references some of the activities and policies which can reduce health inequality. For example, the report has commented on the low levels of unemployment in Jersey and reductions in the numbers of people actively seeking work. The department has already committed to several projects specifically aimed at improving health outcomes for lower income groups. The Back to Work teams have extended the support available to jobseekers with long-term health conditions. The new Pension-Plus scheme will be launched in January providing increased support to low income pensioners with dental, optical and chiropody costs. We are working with external advisers to review the current system for support with G.P. costs.

1. The Deputy of St. Ouen :

With reference to the key finding made in the Scrutiny Report, Living on Low Income, that the current provision in income support has failed to deliver on an assurance made to this Assembly in 2008 when income support was introduced, that no one should fear the cost of going to their doctor because income support would cover that cost... Specifically, what steps is the Minister taking within the G.P. advisory groupings that she is working in to ensure that low income households will have access to G.P. services without charge?

Deputy S.J. Pinel:

In answer to the Deputy 's question, we have secured the assistance of expert health economists who are currently reviewing the payment system within primary care. We have asked them specifically to comment on mechanisms to support low income groups' access to G.P. services and look forward to receiving their recommendations in the first quarter of 2017.

2. Deputy G.P. Southern :

Could she name the consultants that are advising her and could she give an indication of when we can expect to see their report?

Deputy S.J. Pinel:

No, I cannot name the consultant but I have already said that we will be receiving their recommendation in the first quarter of 2017.

3. Deputy G.P. Southern :

I find that astonishing if the Minister cannot name the advisers that she is relying on on such an important issue. What do you mean: "I cannot tell you"?

Deputy S.J. Pinel:

I do not think I said: "I cannot tell you." I said: "I chose not to."

4. Deputy G.P. Southern :

Can the Minister explain the grounds on which she is refusing to answer a question and inform this Assembly? Is there is some sort of commercial confidentiality or some other secrecy going on?

The Deputy Bailiff :

I will allow it as a supplementary, Minister. You can answer that. Deputy S.J. Pinel:

Thank you very much. [Laughter] No, there is no commercial secrecy at all. I just do not know the names of them but I will find out for the Deputy .

5. Deputy M. Tadier :

Will the Minister state what she thinks is the correct level of financial disincentive to stop poor people from visiting the doctor?

Deputy S.J. Pinel:

Sorry, I did not quite understand the question the Deputy asked. Deputy M. Tadier :

I will repeat it. What does the Minister think is the correct level of financial disincentive to stop poor people from visiting the doctor?

Deputy S.J. Pinel:

The people on income support, depending on their medical requirements, as the Deputy will know, have free access to the doctors depending on how many times they visit. Sometimes it is 4 times a year, sometimes it is 12 times a year. It totally depends on what their requirements are but those visits to the G.P. are paid for and, as the Deputy will well know, the G.P. visits are subsidised for everybody in the Island through the income support scheme.

6. Deputy M. Tadier :

Supplementary. The reality is that we know that whether people are on income support or not many do not visit the doctor because they say it is too expensive, they cannot afford it, but also people who are on income support in some cases have had their rental components reduced to pay for their Household Medical Accounts only to find out later on that they cannot afford to pay their rent. So does the Minister agree that this is an urgent problem and if not for the majority of people who find it difficult to pay certainly for the most vulnerable on her watch and what action will she take to address this?

Deputy S.J. Pinel:

I think I answered that question in my opening remarks but I have already said that the economists are looking at the groups accessing G.P. services in the lower incomes and we are also doing the Primary Care Strategy so there is a lot of work already underway.

7. Deputy M.R. Higgins:

The Minister eventually partly answered my question. The external consultants, can the Minister tell us when they were appointed?

Deputy S.J. Pinel:

Not the exact date but I can get that for the Deputy .

8. The Deputy of St. Ouen :

Just to ask: will the Minister share the reports of her expert health economists with my Scrutiny Panel when it is available?

Deputy S.J. Pinel:

Yes, we always share the reports with the chair and the Scrutiny Panel in advance of any Scrutiny hearing and we will make sure they have a copy of the report in advance of it being public.