Affordable primary care

20.11.30

3 Deputy G.P. Southern of the Minister for Health and Social Services regarding

affordable primary care (OQ.355/2020):

Will the Minister inform Members which, if any, groups of vulnerable patients have been selected to receive affordable primary care through subsidised G.P. (general practitioner) consultations, as required by P.125/2019; and furthermore, provide an estimated date for announcing what these groups are and delivering this particular service?

The Deputy of St. Ouen (The Minister for Health and Social Services):

I have answered this question before and I do not believe I am going to satisfy the Deputy just at this moment. But, as I set out in an answer to the Deputy 's Written Question 466, and various similar questions in preceding weeks, officers are continuing discussions with G.P.s to deliver a scheme, which will meet the terms of P.125/2019. The exact nature of the groups to be included in the scheme is part of those ongoing negotiations and thus I cannot say which finalised groups have been agreed upon yet. It remains the intention for the scheme to be introduced by January and it would be inappropriate, because of the discussions and negotiations, to provide further information. As soon as we can, we will publish the details.

1. Deputy G.P. Southern :

If I may, such an answer is risible. Is the Minister aware that he is about to pass the date for amending anything that might occur in 125 and that without knowing which groups are being addressed, no one can analyse whether that is appropriate, how much it is going to cost, how many people will be affected, et cetera?

[15:00]

The Deputy of St. Ouen :

Until the negotiations are concluded, no one can say which groups will be included within the agreed scheme.

Deputy G.P. Southern :

Is the Minister negotiating in the blind, in the dark? The Deputy Bailiff :

Deputy Southern , you have had your supplementary. You will get a final supplementary in due course.

2. Deputy R.J. Ward :

Does the Minister collect or have data that identifies how many individuals have conditions that have worsened due to not consulting with a G.P. as a routine matter or early on? Particularly in those vulnerable groups that may be identified in the proposition that has been referred to.

The Deputy of St. Ouen :

It is difficult to collect data as to the reasons why a condition may have worsened. But we have certainly, as States Members, identified that accessibility to primary care is a key measure for improving healthcare in the Island. That is exactly what the Government Plan set out to do and what is being done by the negotiations being conducted. Not by me, in fact, but by the Minister for Social Security as the Minister responsible for the Health Insurance Fund.

3. Deputy R.J. Ward :

A simple question: does the Minister believe that some patients have had conditions that have worsened because they have not accessed a G.P. due to accessibility of G.P.s?

The Deputy of St. Ouen :

Yes, absolutely I believe that, and I believe that is shared by most, if not all, Members. It is recognised as a problem that we need to resolve. Government agreed to do that in the Government Plan and it is doing so.

4. Senator S.Y. Mézec :

The instruction of the Assembly to the Government to deliver a new system by the start of next year was unambiguous and clear. Does the Minister think it is acceptable that this late in the day we are completely in the dark over what the details of this may include? How can we have confidence that it will be delivered as the Assembly has instructed him to do?

The Deputy of St. Ouen :

The Senator was serving in Government until recently so he will know how so much of Government was redeployed to deal with the COVID crisis. But that in the summer many officers and workstreams came back to what was more normal working. But it did mean that we had lost several months in trying to develop the solution to this. As a result, it was decided within Government that this work would pass to the Minister for Social Security as she, rather than myself as Minister for Health and Social Services, already had a funding stream with which this could be delivered. That was the important key. We wanted to deliver within the timeframe promised by the Government Plan. Very unlikely I would have been able to do that trying to invent a new funding mechanism from the autumn onwards. So taking the existing resources within the Health Insurance Fund, the Minister for Social Security took on these negotiations and she is progressing them.

5. Senator S.Y. Mézec :

Unfortunately, it is just a repetition of the question, which he did not attempt to answer. How can we have confidence that this will be delivered by January next year when so late in the day we have no details available to us at all and seemingly no ability as Members to influence or amend those proposals when they do come to the Assembly? So can he give the Assembly a cast-iron guarantee that come January next year the instruction that we gave the Government to implement the new system will be delivered and that there will not be excuses for delay after that?

The Deputy of St. Ouen :

I am not party to the negotiations but I know that people are working very hard, both on the part of G.P.s and on the part of Government, to conclude these negotiations, which would allow a notification to be made of the scheme to States Members.

6. Deputy G.P. Southern :

I find this attitude to the Assembly rather deplorable on the part of the Minister who is refusing to even say how many patients they are negotiating around. Surely they must have that information to agree that we are talking about delivering this reduction in fee to a certain number of people. You cannot have a negotiation unless you have some numbers there. So will the Minister inform this Assembly as to what number of people, because it could be 10,000 people, it could be 30,000 people. Will he give the numbers that he is negotiating over to this Assembly now?

The Deputy of St. Ouen :

The Deputy labours under a misapprehension. I am not negotiating, as I have said. This is passed to the Minister for Social Security and therefore I am not able to divulge, because I do not know. But, in any event, it would be inappropriate to conduct negotiations on the floor of the Assembly. That must be the case.

Deputy G.P. Southern : This is a shameful negation ...

The Deputy Bailiff :

Deputy Southern , it is not appropriate to comment on an answer in those terms.