Budget allocated to stock personal protective equipment (P.P.E.)

2020.04.21

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

budget allocated to stock personal protective equipment (P.P.E.): (OQ.101/2020)

Will the Minister inform Members what budget was allocated year on year over the period 2014 to November 2019 to fund the provision of emergency personal protective equipment for medical and other staff to protect against the prospect of a flu-like pandemic, such as we have since witnessed?

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

I am grateful to the Deputy for his question but if I may just pick up on the very last few words he has used, "a flu-like pandemic, such we have since witnessed"? Coronavirus is not flu. We are still learning a great deal about it and how it behaves. But we do know that it transmits far more rapidly than flu. So I would have to say to the Deputy we have not witnessed a "flu-like pandemic". This is something that the world is grappling with because it has not experienced the likes of this before, at least in living memory. But to answer the specific question, if I can provide some context going back to 2009 when Jersey was undertaking H1N1 pandemic preparations, that was known as the Swine Flu, and during that time H.C.S. (Health and Community Services), or whatever the Department was at the time, saw the establishment of a pandemic inventory. Now Swine Flu had a less serious impact on the Island than expected, so much of that inventory was not used. But in the years from 2009 it has been recognised that a flu pandemic was a serious risk to the Island and so the approach was then adopted that rather than having 2 separate stores - one pandemic, one business as usual - the pandemic store was integrated into the business as usual store and the business as usual inventory was increased by 10 per cent. So what this means that given the pandemic stock was incorporated into the wider stock holding we cannot identify any further spend specifically on stock for pandemics in the years that the Deputy has asked about. I can tell him in normal circumstances just under £200,000 a year is spent on P.P.E. Of course during this recent period we have procured P.P.E. and we have got stocks which have cost several millions of pounds, and there is about £5 million worth of P.P.E. either in stock or in the pipeline for delivery. That answers as best I can, I hope, the question put by the Deputy .

1. Deputy G.P. Southern :

That is hardly an answer but is the Minister aware that in the U.K. under austerity measures, for example, in this period the budget for flu-like pandemic outbreak P.P.E. went from £850 million to £500 million, a cut of 40 per cent over this time period? Can the Minister assure Members that such an austerity driven cut was not engaged with in his Department during this period?

The Deputy of St. Ouen :

I am not aware of any cuts to the P.P.E. provision in recent years.

2. Deputy M.R. Higgins:

Can the Minister tell us, following the pandemic emergency exercise in November and December of last year, were any changes made to P.P.E. equipment or levels and did they consult the World Health Organization beforehand, regarding the current level of risk of a pandemic?

The Deputy of St. Ouen :

Our Medical Officer of Health is logged into all those channels such as the World Health Organization, Public Health England and the network that is spread internationally. The Medical Officer of Health would have been aware of pandemic preparations and any worldwide changes to that preparedness and would have been reporting to the Department and to Ministers. The results of last year's exercise on preparation, I do not know whether that immediately led to any increase in P.P.E. stocks. We would have held a normal P.P.E. stock check at that time, including the reserve for pandemics.

3. Deputy M.R. Higgins:

Could the Minister reveal that information in a written answer to Members? He was not fully aware of the facts on either and if he could put a written answer to Members that would be very much appreciated. Will the Minister please do so?

The Deputy of St. Ouen :

Can I just clarify, the question is: were any changes made to P.P.E. stocks in my Department following the exercise last year? Is that the question?

Deputy M.R. Higgins:

That is correct and also what steps were taken to speak with W.H.O. (World Health Organization) and analyse the possibility of a pandemic arising, which happened within, I think, a month.

The Deputy of St. Ouen :

I think I have answered that last part in that our Medical Officer of Health

The Bailiff :

The actual question to you, Minister, is whether you would do it in writing subsequently?

The Deputy of St. Ouen : I will write that out.[1]

4. Deputy R. Labey :

What was the motivation locally for downgrading the level of P.P.E. offered to ambulance staff? The Deputy of St. Ouen :

I am not aware that P.P.E. has been downgraded to ambulance staff. There is a guideline for emergency services and their P.P.E. requirement is set out in that. I am not aware that that has been challenged. I refer to the Minister for Home Affairs, who answered a question earlier, who confirmed that the emergency services have the stocks they require. There did not seem to be issues from him. The stock they have mirrors guidance for ambulance staff. It is under regular review. If the ambulance service has any concerns they are able to raise them, but we have not been informed of any concerns.

5. Deputy R. Labey :

I find that interesting. Categorically, the Minister is saying that if there was any reduction in the level of P.P.E. for paramedics and ambulance staff that was not driven by a lack of maximum P.P.E. to go round?

The Deputy of St. Ouen :

I wonder if the Deputy is referring to an email sent to all States Members recently by a member of the public that included pictures of ambulance staff. We have established that those ambulance staff are not from Jersey. Those are N.H.S. (National Health Service). We know that by looking at the uniforms worn. The concern raised by that member of the public, who is emailing us, is general because that member of the public has picked up on the concerns nationally, but what has happened in England has not happened in Jersey because we have adopted our own guidelines and there has been no reduction, so far as I am aware, of P.P.E. for ambulance crews. They do not always need to use the highest level of P.P.E. but they have it available for the circumstances in which that is needed.

Deputy R. Labey :

For the record, the motivation for my question did not come from that email but from within the Minister's Department, but thank you.

6. Deputy R.J. Ward :

We are all learning from this current situation. Would the Minister agree that the decision to combine stocks of P.P.E. was simply a mistake and will he commit to future separate stocks being maintained so that we are better equipped should anything like this happen in the future?

The Deputy of St. Ouen :

I am sorry, can I ask for clarification? Who was combining with who and in what circumstances was the

Deputy R.J. Ward :

You mentioned in a previous answer that a decision was taken some time ago to take the P.P.E. stocks and combine them with general stock but just to increase the amount by 10 per cent, thus not have a division between them. Do you agree that that was a mistake and we should go back to the system that we had?

The Deputy of St. Ouen :

I do not think I can agree that on the hoof. That needs careful discussion on how these things are managed logistically as supply and demand. For example, P.P.E. has a limited shelf life in some instances, so if we had a separate warehouse labelled "the pandemic warehouse stock" and it just sat there awaiting a time when a pandemic might arise, that stock would quickly become out of date. There needs to be a throughput of stock but there needs to be adequate margin, it seems to me, to ensure exactly how we use it and to ensure we have preparedness for a pandemic. I would be very willing to speak with the Deputy but I think we would need officer advice on exactly how to best prepare.

7. Deputy R.J. Ward :

A simple stock rotation, I am sure, can be used but is it not that we have to be cautious in the coming years and think about this preparation and learn from where we are now? I understand hindsight is a wonderful thing, and it is not a criticism of the Minister for that, but commitment to learning from it I think is very important for the people of Jersey.

The Deputy of St. Ouen :

I would wholeheartedly agree with that. We must learn and we would want to learn because it is all about protecting Islanders' lives and making sure that we are in a position to respond adequately. I am sure there will be lessons to learn and we will learn them.

The Bailiff :

Before I call on Deputy Southern , a number of Members again have indicated that they wished to ask questions when I had already announced who the questioners will be with the final supplementary. We are really losing time so I am afraid I cannot allow more supplementaries on this particular question.

8. Deputy G.P. Southern :

Given the chaos that we saw in the early days especially of the outbreak of the pandemic, does the Minister not consider that he ought to revisit the recommendations that came out of the pandemic simulations recently and that whatever level that we have got in preparedness for P.P.E. is inadequate and we should do better next time?

The Deputy of St. Ouen :

I will certainly revisit those recommendations. The whole of the Government, the whole of the Assembly must, with Scrutiny's involvement also, when the time comes, look back and carefully examine. I will commit now to saying that we had insufficient stock and that needs to be looked at, I do agree with the Deputy .