Funding for Primary Care

22.12.12

9 Deputy G.P. Southern of the Minister for Social Security regarding funding for

Primary Care (OQ.133/2022)

Will the Minister inform Members what progress, if any, she has made in negotiations with primary care providers to establish sustainable funding for primary care and, if no progress has been made, when does she expect to have done so?

Deputy E. Millar of St. John , St. Lawrence and Trinity (The Minister for Social Security):

I thank the Deputy for his question. Regrettably, it is not one I can really answer. The review of sustainable primary care funding is being conducted by the Minister for Health and Social Services over the course of the next year. While I am committed to working with the Minister in terms of developing the primary care strategy and a sustainable funding model, it would be inappropriate for me to comment on that review just at present.

1. Deputy G.P. Southern :

I am rather disappointed to hear the answer as given. Surely there must be the most together approach to this particular issue, one that relies on both departments to establish sustainable funding for primary care.

Deputy E. Millar :

I disagree. I think the review funding sits clearly with the Minister for Health and Social Services; she will be conducting that review. The Minister and I met with the primary care body last week. We hope to continue working with them closely, collaboratively and in partnership to develop our primary care services. There is a huge amount to talk about and that work is underway but I cannot comment on the review because I am not directly involved in it at this stage, but as soon as the review is ready and the Minister has some aspects to talk about, I will be very happy to discuss them with her.

2. Deputy S.Y. Mézec :

If it is not appropriate to provide a clear answer to Deputy Southern at this point because of the ongoing review, why is it appropriate to continue to take a substantial amount of money out of the Health Insurance Fund for another purpose when that review has not concluded?

Deputy E. Millar :

I think that is something that is going to be debated over the course of the coming week. Deputy S.Y. Mézec :

Without having to waste a supplementary, would the Minister aim to answer my question which was for her position?

The Bailiff :

Yes, the fact that it may be debated subsequently is not an answer to the question. Minister, if you could hazard your answer.

Deputy E. Millar :

I believe that, as amended by the Council of Ministers, all the monies that we propose to remove from the H.I.F. (Health Insurance Fund) for 2023 are going directly towards primary care services and services that are directly for the benefit of patients. Withdrawing that funding will mean that some of those services will also have to be withdrawn. We have this year, just to add on to what is happening from the Social Security Department, my predecessor and the primary care body announced this year investment of £9 million into primary care. This investment provides direct financial support for the employment of nurses, paramedics, pharmacists and healthcare assistants. This is aimed to allow practices to develop their provision of services and ensure that patients receive the right care at the right time in the right place and from the right person. For example, Islanders can go and see a nurse for routine monitoring rather than a G.P., which both preserves G.P.s’ time and also be a cost-efficient service for the patient. The £9 million includes a wage support scheme, which will help practices with the cost of employing healthcare professionals such as nurses, paramedics and healthcare assistants. A budget of £1 million is available in 2022 and a further £2 million will be available in 2023. This funding will be phased out in 2024 and 2025 as new ways of delivering care in funding are rolled out in conjunction between the Health Department and the primary care body.

The Bailiff :

Are you able to bring your answer to a close? Normally one minute 30 seconds is what is roughly ... if you have one last sentence, that is fine.

Deputy E. Millar :

I had a little more but that is the flavour of the £9 million investment.

3. Deputy S.Y. Mézec :

Interesting but not an answer to my question. I also do not agree that it is true that services would not be able to be provided if money did not come from the H.I.F. for it. That can be provided by another means if we choose to; we can choose to budget these things how we like. Would the Minister indicate whether she believes the negotiations, which Deputy Southern refers to in his question, will be easier or more difficult to conduct if money has been taken out of the H.I.F. for another purpose?

[14:45]

Deputy E. Millar :

I believe that what matters to G.P.s is that they are paid for the provision of their services. I do not think the G.P.s themselves will be particularly concerned whether the money comes from the H.I.F. or the general reserve, but we must accept that there are a number of other pressures that we need funding from the general reserve to meet. Having discussed with the Minister for Health and Social Services, I do believe that if the money does not come from the H.I.F. then services will have to be withdrawn.

4. Deputy G.P. Southern :

I find it rather shocking to find that a Minister for Social Security denies having total responsibility for the funding of primary care because she does surely. Does she not agree?

Deputy E. Millar :

I am surprised by the Deputy ’s shock because I do not believe I denied any responsibility for funding. The responsibility clearly sits with me at the moment. What I do find odd is that the Minister for Social Security has any responsibility for provision of primary care, which very clearly in my opinion sits with the Minister for Health and Social Services. That is an entirely sensible way forward, that is what I will be working with the Minister for Health and Social Services over next year and the year after to ensure we have both an adequate primary care strategy which meets the needs of patients, the practices and there is funding available. We will be working very closely with the Minister for Health and Social Services to achieve that.