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2019.10.08
1 Connétable K. Shenton-Stone of St. Martin of the Minister for Health and Social
Services regarding the creation of health hubs' around the Island to help reduce the number of hospital admissions: (OQ.227/2019)
Further to reports that the new Jersey Care Plan will include the creation of "health hubs" around the Island, to help reduce the number of hospital admissions, will the Minister advise whether these hubs will offer minor outpatient surgeries; what consultation, if any, he intends to undertake with the Parishes; and how these hubs will be funded and fit with the objectives of the Government Plan and its efficiencies programme?
Deputy R.J. Renouf of St. Ouen (The Minister for Health and Social Services):
Minor operations are already provided in some G.P. (general practitioner) surgeries on the Island. The Jersey Care model will seek to provide outpatient care closer to Islanders' homes, where that is deemed clinically appropriate by all the clinicians involved in a patient's care. As to the proposed Jersey Care model, there is a planned schedule of public engagement with all Islanders, if this is approved by the Council of Ministers and I am sure Constables will be involved in that engagement.
[10:00]
Changes in the care pathways, as a result of the Jersey Care model, will be funded within the existing health envelope. In other words, funding should follow activity.
- The Connétable of St. Martin :
Where will these health hubs be situated? Are they going to be situated in G.P. surgeries? I would just like to say that we keep hearing about health hubs and in St. Martin we have space to set up a health hub and we have the will for the healthcare in the Parish. I have spoken with the Minister for Health and Social Services and I have spoken to the Chief Minister, I have spoken to the Chief Executive and I think I have invited all of them to St. Martin to have a look at our prime unit ready for fitout. All we need is a decision to be made. We have waited so long for the hospital to take place, I just would like to ask the Minister whether he would like to come and visit our unit and whether he would like to think of having the golden opportunity of setting up a health hub in
St. Martin .
The Deputy of St. Ouen :
I do thank the Connétable for her invitation and I would be very pleased to take up that invitation. I am very impressed with all that St. Martin has done to service the Parish community. I can visit and I can bring appropriate officers to see if it might be possible to establish a hub there. A hub could be established anywhere, so anywhere that is appropriate for its purpose. So, it might be a G.P.'s surgery, it might be a building owned by a Parish. It could be a church hall somewhere. As long as it is appropriate and accessible and has the agreement of the community, it seems to me.
- Deputy G.J. Truscott of St. Brelade :
I buy into this particular initiative and to a degree it makes sense but, obviously, it is happening out there at the moment. We have doctors surgeries doing a lot of the procedures, testing for blood pressure, et cetera. I cannot square the circle vis-à-vis the Government, in one sense, is wanting to bring all of the departments into one building to save on efficiencies and duplication and then we have the Health philosophy of going out there and spreading the infrastructure. Can the Minister help me square that circle?
The Deputy of St. Ouen :
I hope I can. I feel that a health service should be delivered in an entirely different way to a public service. So, there might be synergies of bringing public servants together, but I think the model of asking everybody to come into a single building in St. Helier - we have almost 200,000 outpatients appointments per year in Jersey and that seems a ridiculous number - all of them coming into town, often repeatedly and, of course, there are 30,000 people in town. They will need their own centre, or centres, for their care. Equally, those hubs might be placed at strategic points in the Parish and in the questioner's Parish we have established a service at Communicare that now provides certain health services and advisory services and has been a great success and we will build on that.
- Deputy G.P. Southern of St. Helier :
Would the Minister mind informing Members how many hubs he has established so far, or is in train of establishing and how many is his target for hubs around the Island?
The Deputy of St. Ouen :
We are at a very early stage of this planning and the Jersey Care model will be presented to the Council of Ministers as a strategic vision, but the detailed planning will be undertaken after approval, if given, by the Council of Ministers and public engagement. So, there are no numbers as yet. We have begun, of sorts, with the enterprise at Communicare, which brings closer to home some of the services that we would like to offer.
- Deputy K.F. t. Lawrence:
Could the Minister just clarify, because in a recent Future Hospital Review Panel meeting I remember being told by officers that the Health Department is no longer considering a hub and spoke model to deliver health services. Would the Minister please clarify whether it is, or is not, considering a hub and spoke model as we are discussing today?
The Deputy of St. Ouen :
We are here discussing very precise terminology. I wonder what the Deputy might mean by "hub and spoke". Hub and spoke to me seems to infer a large central operation, which is directed outwards. We want to ensure that people can access healthcare needs in appropriate places and for the lower level of need that could well be provided within a hub, which is closer to their home.