New Community Alarm Service

22.11.01

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

Community Alarm Service (OQ.105/2022):

Will the Minister outline what steps are being undertaken to ensure that take-up for the new digital telecare system is greater than that of the community alarm system? Will the Minister further indicate if she considers that doubling the cost to patients to over £250 a year is likely to be counterproductive in increasing its use?

Deputy K. Wilson (The Minister for Health and Social Services):

Thank you to the Member for his question. To ensure the greater take-up of the new telecare system we are working to ensure that individuals are aware of the system and how to access it through government communication channels and also Airtel-Vodafone’s own communication channels. Currently, we have onboarded an additional 73 new customers to telecare. I responded in my response to a Written Question on 217/2022 on this issue also. I do not intend to change the direction of travel with regard to the transitional subsidy for those who choose to use the telecare service. For those patients who require the service as part of their care package, they will continue to receive the service free of charge, as will those who are in receipt of income support or Pension Plus. Without the data or patient feedback, I am unable to opine if the cost of telecare will be counterproductive to its use. However, if the data and patient feedback begin to indicate a reduced uptake due to the cost of the service, then we will look into this and make some amendments to ensure that people are able to access the services that they require.

1. Deputy G.P. Southern :

Is it the Minister’s target to expand the use of telecare and, if so, will she consider and has she considered whether she should be increasing the subsidy to make the use of these devices free?

Deputy K. Wilson :

As I have said, I do not want to particularly repeat myself but I am not going to change the direction of travel. But I have indicated that if there is an issue around the use and the uptake then we will look at this to address it.

[11:30]

2. Deputy M. Tadier :

My alarm bells go off when I hear the Minister saying we might make this free in the future so that more people can access it but we are going to have a period first whereby we do not have as many people and then if something bad happens then we might make it free. Is the personal cost and the individual cost of somebody perhaps having a fatality and not being seen quick enough because they do not have these alarms a price that is too high to pay and we should not be waiting for something to go wrong and that it is within the Minister’s gift to simply say let us forego all the bureaucracy and all the worry that many of certainly my constituents have and make this free now?

Deputy K. Wilson :

I have not said anything about free for all. Basically, what I have said is that for those patients who do require the service as part of their care package there will be no change to that. There are 2 groups of people who use this system. There are those who need this as part of their care requirements and there are people who choose to use this for a whole host of different reasons. The benefit of the telecare system is that it has additional options around other aspects of surveillance that families might like to adopt as part of the overall approach to delivering a telecare solution to care and support in the community. What I can say is that it is really important that we maintain the focus between the 2 different groups of people so that those who do require it as part of their care package continue to receive it.

3. Deputy M. Tadier :

Does the Minister not accept that it sounds to Minister for the Environment like we are creating and perpetuating a 2-tier system in this and, if I have understood right, that new applicants to the scheme will not be getting it free while pre-existing ones will be having it free if it is already free? Does she not think that that will create unnecessary confusion and ill-feeling with the public, whereas the sensible thing to do is to offer the same product to everybody and sensibly, in a rich Island like ours where we are trying to provide better healthcare to all of our constituents, is to make that free at the point of access?

Deputy K. Wilson :

As I have said, for those people who require the system as part of their care package, it is fully funded and I accept that there will be people who do not require it as part of their care package but may choose to use telecare by choice. For those who do choose to use the system, there is a cost which is set to increase, which he highlights, and for those already using the system there is a subsidy in place to mitigate the impact of the increase. The first year remains at its present rate of £10.50 and in a year’s time we will be raising this to £14 and by July 2025 the cost will be £21. So, as I have said before, my intention is not to change the direction of travel in terms of what funding mechanisms have already been set up, but by 2025 it is clear that the subsidy will cease and that this will mean that there are going to be 2 tiers of users of the telecare system, which has been the case previously, those being who choose to pay and those who will rightly receive the service free as part of their care package.

4. Deputy S.Y. Mézec :

The Minister said that she is not initially going to change the direction of travel on this and that is a direction of travel which means greater cost to those who use the service. Does the Minister expect us to believe that we need more data to tell us whether or not that makes the scheme more or less accessible? Would she confirm whether this direction of travel, of charging more for patients to use health services like this, is one that she will be applying to other parts of her remit?

Deputy K. Wilson :

Well, again, as I said, for those who require it as part of their care package it is free of charge and there is a choice ... for those people who choose to use telecare there will be a charge in order for that facility to be available to them.

Deputy S.Y. Mézec :

With respect, that was not very close at all to an answer to either part of my question I posed to her. The Bailiff :

Well, I think the question was: do you agree that that is bound to have - and I paraphrase - a chilling effect on the take-up of the telecare system if it comes at a significant cost?

Deputy K. Wilson :

I will repeat that I do accept that we should be driven by evidence-based decisions and I think data is important when we are attributing money to the cost of services, which I know the Member has also alluded to in previous discussions, which is important. But the issue here is that we will make sure that the data drives the decisions as to whether or not the take-up of the telecare system indicates that there is a problem associated with the cost, and when we have that data we will make some further decisions as to what next steps to take.

5. Deputy S.Y. Mézec :

Is the Minister suggesting that her proposed approach to this, which is to await data to tell us what we already know it will tell us, which is that this will make this less accessible, so that she can then make a reactive decision on how to make it more accessible is a sensible way of managing the health of the people who we represent? Would it not be better to take a common-sense approach, which is to start by making this as accessible as possible, which is not the option she appears to be taking?

Deputy K. Wilson :

Well, I think that is a view, but what I want to say is that we have committed to expanding telecare services. We do not know what the uptake will be. We do not know whether the cost will be prohibitive and that is why we are promoting and engaging people in its use and at the point at which it becomes an issue as to whether or not this is affordable we will look at it again.

The Bailiff :

In an exchange that took place a little bit earlier I was not sure if I missed someone over there who wanted a question.

6. Deputy A. Howell of St. John , St. Lawrence and Trinity :

I am just seeking clarification as to whether the Jersey Telecom package of the community alarms is being phased out or has it been phased out already? I just would like the Minister to admit to the House that any of the additional apps that are to be included in the new scheme will be at an additional cost for everyone.

The Bailiff :

Are you able to assist with that, Minister? Deputy K. Wilson :

What I can say is that I can confirm that the community alarm system is being upgraded to the digital system. So, yes, we are phasing out the old system. We have about 1,040 Islanders already subscribed to the analogue system, which basically calls for help when a service user presses a button. The existing system has not been updated for a number of years and the technology is being replaced. When we retendered, we wanted to secure a system that offered multiple connectivity methods, including the mobile network, wi-fi and battery back-up. The system that we have now is producing greater resilience than the analogue system. It does offer additional capability and capacity and additional applications can be added, for example, like motion sensors, pill dispensers and fall sensors. These are going to support some of the care in the community initiatives that are already under way. I cannot really give the detail that the Deputy has asked for in relation to the cost of each application but I would be happy to let the Deputy know the detail of that as we go forward.

7. Deputy A. Howell :

Is it possible for Islanders to continue with their current community alarms, which many of them really appreciate?

Deputy K. Wilson :

I think we are going through a phased implementation of this. Clearly, this is a dialogue with individuals. What we want to do is sell the benefits but this is a discussion with Islanders in terms of what they need. What I can say is that the analogue system itself will become increasingly difficult to maintain over time, so what we want to do is we want to support people to make that transition because we think it offers better benefits.

8. Deputy G.P. Southern :

I think the Minister said it at the very end there, because we want the uptake to be as large as possible because we think it offers a better system. How wonderful, but does she not accept that, given the target of increased penetration, increased uptake, then does she not accept that charging for that uptake is the guaranteed way to make sure it stays as little as possible? If you make it free from the start, then you get the uptake and you will see how many people can take this. I remind the Minister, if I may, that one of the conditions that we are guarding against is the accidental fall that means that many elderly people end up very ill indeed and are occupying a hospital bed at who knows what cost ...

The Bailiff :

I think this does have to be a question really. Deputy G.P. Southern :

Does she not accept that that could happen to her or to Minister for the Environment tomorrow and that that sort of cover is what we need?

Deputy K. Wilson :

As I have said, I think people who need support as part of their care package receive and will continue to receive their telecare free of charge.